Can Self-Harm in Teens be Prevented?
Self-harm can include cutting, burning, scratching, or otherwise hurting your body due to emotional turmoil. Some people might punch a wall. This behavior is done without suicidal intent.
The average age people start is 13. And for most, 45%, the preferred method is cutting.
If you're worried about a teenager you know, it can be hard to know when to worry about self-injury, what to look for, and how to approach the topic in a way that doesn't prompt a blank stare or defensiveness. Some families are worried that if they talk about it, they could plant the idea in their child's head.
Haley Stephens, PhD, a pediatric psychologist, offers advice for how families can see early warning signs, how to help prevent the behaviors, and if they’ve started, what treatment might look like.
Recognizing the Signs of Self-Harm
It’s easy to believe that self-harm is something that happens in other families.To parents who have worked hard to nurture a loving relationship, finding out that their child struggles with these feelings can feel like a gut punch.
It’s important to recognize that it affects a wide variety of people.
How Prevalent Is It?
17% of teens will self-harm routinely. But nearly 30-50% will try it, Stephens shares. And as staggering as those numbers are, Stephens also notes, “it feels to me that self-harm is on the rise. And research is showing this as well.”
Some of the things that make a teen especially at risk are:
- Having friends or family who self-injure
- Acute stress
- Mental health conditions
- Drug or alcohol use
Why Do They Do It?
It can seem counterintuitive to add pain when you’re going through a hard time. But try to understand why your child does it. This can help with avoiding shaming language.
“It can serve many functions,” Stephens shares. Some of the reasons teenagers have said that they first started self-harming include:
- Emotional regulation
- Manage upsetting thoughts
- Feel in control
- Feel something or feel real
- Self-punishment
- Social support
- Decrease demands
Why Don’t They Do It?
“Most of the time, they think about it for less than an hour before doing it,” Stephens says. It’s an impulsive choice. Not a manipulative one or an attention-seeking one.
“We shouldn’t view it as such; we need to take it seriously.”
Why Is It a Problem?
Considering all of the emotional good teens say they feel from self-injury, some people wonder why they need to stop it at all. But ultimately, self-injury isn’t the best coping strategy out there. “We want teens to acquire sustainable coping strategies,” Stephens shares.
Self-injury also makes it more likely that a person will die from suicide. While self-harm itself doesn’t stem from suicidal thoughts, it can help teens acquire the capability to self-harm. “It’s very hard to override that primal desire to protect your physical health. But humans can overcome that self-protective instinct through repeated self-harm,” Stephens says.
Looking for Positive Strategies?
Finding a new coping strategy to replace self-injury can help your child meet their emotional needs safely. Here are some of the strategies recommended by the Cornell Research Program on Self-Injury and Recovery.
Preventing Self-Harm
It sounds silly to say. Most parents have worked on helping their child flourish emotionally in every way they know how to.
But adolescence changes the playing field. And even if your child hasn’t self-harmed, they may have friends who are and might be becoming curious.
The best way to prevent it is to talk about it.
Stephens understands this prevention tip might cause some anxiety in parents. “Some parents worry they could plant the idea to self-harm. But the research shows that talking about self-harm prevents self-harm.”
How to Talk to Your Child About Self-Harm
If you already know or suspect that your child has self-harmed, you might be in a heightened emotional state. You love every inch of your child. Accepting that they’ve harmed themselves can make you feel angry, frustrated, or anxious.
But being the adult means being a safe person and creating space for their feelings.
Where: Choose a private setting. Some place where siblings, friends, or even distracting noises won’t be a problem.
When: Pick a time when everyone is fed, rested, and calm.
What to Do: Start with open-ended questions, like how they’ve been feeling recently.
Eventually, you need to ask the question.
Have you ever thought about self-harm?
No matter what they say, stay calm, avoid judgment, and validate their perspective.
They may say they feel overburdened by chores. Now isn’t a good time to bring up the chore distribution chart.
If there are emotional concerns, ask how you can work together to keep them safe.
Make it a Normal Conversation
Emotional check-ins shouldn’t only happen when your child is having a hard time.
“Routine decreases defensiveness. It also gives families the chance to celebrate the good times.” If your scheduled check-in happens to be on a day where everything is going well, take the time to celebrate.
How often you should have these check-ins depends on you and your child. By planning them collaboratively, you’re able to work together from the start.
What If They Are Self-Harming?
Before you ask the question, you need to be prepared for what you’ll do if the answer is ‘yes.’
Speaking to a behavioral health professional can create support for everyone to feel safe while healthier coping strategies are developed. But many are worried about what speaking to a professional looks like, or means. There's fear that your child will be labeled. Many have outdated concepts of what behavioral health looks like.
But in modern healthcare, these are the steps that behavioral health professionals can provide.
Assess
What treatment is needed depends on how frequently or severely their self-injury is, as well as what other risk factors are at play.
Inform
If the provider is the first line of help a teenager seeks, the next step will be informing the parent or caregiver. Collaboratively, they can talk about safety and understanding.
Develop a Safety Plan
The hardest step is working together to identify a set of guidelines that improves health for everyone. That can mean restricting access to methods of self-harm.
It can also mean spending less time alone or checking in daily with a parent. Some families develop a code word to indicate that more support is needed.
Identify the Role of Self-Harm
What self-harm is currently providing, whether that’s feeling real or acting as a way to punish themselves, is important to understand. This can help identify other strategies that could provide the same positives without the negatives.
Communicate Feelings
Putting language to what they’re feeling can make it easier to understand. They can also learn how to advocate for themselves in stressful situations with friends and family.
Problem-solving Growth
Finding new ways to navigate problems, like stress, can benefit from behavioral health treatment.
Involving Parents or Caregivers in Treatment
By improving family relationships, everyone can work as a team to prevent self-harm.
Assess the Impact of Social Media & Friendships
Having friends who also self-harm can make it tough for a teen to recover. And if their social media has seen them engage with self-harming content, it might keep sending that to them. While recovering, teens may have to step away from things that aren’t aiding in their recovery.
Get Help Now
If you believe your child is having a mental health emergency, please don’t wait to get help.
- Go to your nearest emergency room, or call 911
- National suicide prevention lifeline: Call or text 988, or chat online
- Trans Lifeline 877-565-8860
- Trevor Project Lifeline 866-488-7386
Conversations with a Child Psychologist
This free webinar series takes place once a month, for a lunch and learn opportunity for parents. If you're not available, you can also watch recorded sessions. Register to attend live to participate in Q and A at the end of the session.
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