Understanding Self-Injury
Most of us know about teens and cutting — how some use a sharp object like a razorblade, knife, or scissors to make marks, cuts, or scratches on their own body. But cutting is just one form of self-injury. Teens who self-injure also might burn, scratch, or hit themselves; bang their head; pull their hair; pinch their skin; pierce their skin with needles or sharp objects; or insert objects under their skin.
Self-harming is a serious issue that affects many teens. Like other risky behaviors, it can be dangerous and habit-forming. In most cases, it is also a sign of deeper emotional distress. In some cases, peers can influence teens to experiment with it.
The topic of self-injury can be troubling for parents. It can be hard to understand why teens (or even preteens) would hurt themselves on purpose, and worrisome to think your teen — or one of their friends — could be at risk. But parents who are aware of this important issue and understand the emotional pain it can signal are in a position to help.
About Self-Injury
When It Starts
People who self-injure usually start doing it during their teen years. Some continue into adulthood. In some cases, ther' a family history of cutting or other self-harm.
Shame and Secrecy
A sense of shame and secrecy often goes along with it. Most teens who cut hide the marks and, if they're noticed, make excuses. Some teens don't try to hide cuts and might even call attention to them.
How It Develops
Cutting often begins as an impulse. Many teens discover that once they start, they do it more and more and can have trouble stopping. It may provide a sense of relief from deep painful emotions.
Important Distinction
Most of the time, self-harm is not a suicide attempt. But it can be easy to underestimate the potential to get seriously sick or hurt through bleeding, infections, or other problems.
Cutting and other self-harm can become a tee' habitual way to respond to pressures and unbearable feelings. Many say they feel "addicted" to the behavior.
Why Do Teens Self-Injure?
Teens self-injure for many different reasons. Understanding these reasons can help you provide better support.
Powerful Overwhelming Emotions
- • Most teens who do it struggle with powerful emotions
- • Emotional pain over rejection, lost or broken relationships, or deep grief can be overwhelming
- • Pressure to be perfect or to live up to impossible standards can cause unbearable pain
- • Some have been deeply hurt by harsh treatment or situations that left them feeling unsupported, powerless, unworthy, or unloved
- • Some teens have experienced trauma, which can cause waves of emotional numbness called dissociation
- • For them, cutting can be a way to test whether they can still "feel" pain or "wake up" from emotional numbness
Physical Pain vs. Emotional Pain
- • For some, the physical pain can seem preferable to emotional pain
- • Emotional pain can feel vague and hard to pinpoint, talk about, or soothe
- • When they cut, teens say there is a sense of control and relief to see and know where the specific pain is coming from
- • Ther' a sense of soothing when it stops
- • It can symbolize inner pain that might not have been verbalized, confided, acknowledged, or healed
- • Because i' self-inflicted, it is pain they control
A Sense of Relief
- • Many teens describe the sense of relief they feel as they cut or self-harm
- • Some people believe that endorphins might add to the relief teens describe
- • Endorphins are the "feel-good" hormones released during intense physical exertion and can be released during an injury
- • Others believe the relief is simply a result of being distracted from painful emotions by intense physical pain
- • Some teens say they do' feel the pain when they cut, but feel relieved because the visible results "show" emotional pain they feel
Feeling "Addicted"
- • Cutting, especially, can be habit forming
- • Though it only provides temporary relief, the more a person cuts, the more they feel the need to do it
- • As with other compulsive behaviors, the brain starts to connect the injury to the momentary sense of relief
- • Whenever the tension builds, the brain craves that relief and drives the teen to seek relief again
- • So it can become a habit someone feels powerless to stop
- • The urge to cut can seem too hard to resist when emotional pressure is high
Other Mental Health Conditions
- • Self-harm is often linked to — or part of — another mental health condition
- • Depression or bipolar disorder can contribute to overwhelming moods
- • Mental health conditions that affect personality can cause relationships to feel intense and consuming, but unsteady
- • Intense positive attachments can suddenly become terribly disappointing
- • Personality traits that attract them to the dangerous excitement of risky behavior
- • Posttraumatic stress has had an effect on their ability to cope
- • Alcohol or substance problems
Peer Pressure
- • Some teens are influenced to start self-injuring by another person who does it
- • Group peer pressure can play a role
- • Some teens cut in groups and might pressure others to cut
- • A teen might give in to group pressure to try it as a way to seem cool or bold, to belong, or to avoid social bullying
Any of these things may help to explain why a particular teen cuts or self-harms. But each teen also has unique feelings and experiences that play a role. Some might not be able to explain why they do it.
Regardless of what may lead a teen to self-injure, i' not a healthy way to deal with even the most extreme emotions or pressures.
Warning Signs
Physical Signs
- • Unexplained cuts, burns, or bruises
- • Wearing long sleeves or pants even in hot weather
- • Finding sharp objects or first aid supplies in unusual places
- • Frequent "accidents" or injuries
Behavioral Signs
- • Withdrawing from friends and activities
- • Avoiding activities that show skin (swimming, changing clothes)
- • Spending long periods alone
- • Changes in eating or sleeping patterns
Emotional Signs
- • Emotional instability or mood swings
- • Expressions of hopelessness or worthlessness
- • Difficulty expressing emotions
- • Feeling overwhelmed or out of control
Social Signs
- • Isolation from family and friends
- • Changes in friend groups
- • Secretive behavior
- • Declining school performance
How Parents Can Help
Stay Calm and Non-Judgmental
- • Avoid reacting with anger, shock, or judgment
- • Stay calm and show that you care
- • Let your teen know yo'e there to help, not to punish
- • Express concern and love
- • Listen without trying to fix everything immediately
Get Professional Help Immediately
- • Do' try to handle this alone
- • Contact a mental health professional right away
- • Look for therapists who specialize in self-harm and teen mental health
- • Consider family therapy as well
- • If ther' immediate danger, go to the emergency room
Create a Safe Environment
- • Remove or secure items that could be used for self-harm
- • Monitor your tee' safety without being overly controlling
- • Ensure the'e not alone in crisis situations
- • Keep communication open
- • Establish clear safety plans
Provide Emotional Support
- • Listen without trying to fix everything
- • Validate their feelings
- • Help them understand that there are healthier ways to cope
- • Be patient — recovery takes time
- • Celebrate small steps forward
Learn About Self-Harm
- • Educate yourself about self-harm
- • Understand that i' a coping mechanism, not attention-seeking
- • Learn about treatment options
- • Connect with support groups for parents
- • Stay informed about your tee' treatment progress
Treatment and Recovery
Therapy
Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and other forms of therapy can help address the underlying thoughts, feelings, and behaviors driving self-harm. Therapy can help develop healthier coping strategies and emotional regulation skills.
Medical Evaluation
A medical evaluation is important to assess any physical health problems caused by self-harm. This may include treating wounds, infections, or other injuries, and monitoring for complications.
Medication
In some cases, medication may be helpful, especially if self-harm is associated with depression, anxiety, or other mental health conditions. This should be prescribed and monitored by a qualified healthcare provider.
Support Groups
Support groups for teens and families can provide connection, understanding, and shared experiences. These can be valuable additions to individual therapy.
Recovery Takes Time
Recovery from self-harm is a process that takes time. There may be setbacks, but with proper treatment and support, many teens can learn healthier ways to cope with difficult emotions and stop self-harming.
Frequently Asked Questions (FAQs)
Q: Is self-harm the same as attempting suicide?
A: No, most of the time self-harm is not a suicide attempt. However, it can be dangerous and lead to serious injury or infection. Self-harm is often a way of coping with overwhelming emotions, while suicide attempts are about ending on' life. However, teens who self-harm are at higher risk for suicide, so i' important to take it seriously and get professional help.
Q: Why would my teen do this if the'e not trying to kill themselves?
A: Self-harm is often a way to cope with overwhelming emotions. Teens may feel that physical pain is easier to manage than emotional pain. It can provide temporary relief, a sense of control, or a way to express pain they ca' put into words. I' important to understand that i' a symptom of underlying emotional distress, not a character flaw.
Q: What are the warning signs of self-harm?
A: Signs may include: unexplained cuts, burns, or bruises; wearing long sleeves or pants even in hot weather; avoiding activities that show skin (swimming, changing clothes around others); finding sharp objects or first aid supplies in unusual places; withdrawal from friends and activities; emotional instability or mood swings; expressions of hopelessness or worthlessness.
Q: How do I talk to my teen about self-harm?
A: Approach the conversation with care: choose a private, calm time to talk; stay calm and non-judgmental; express concern and love; listen more than you talk; avoid blaming or shaming; let them know you want to help, not punish; do' dismiss their feelings.
Q: Can my teen recover from self-harm?
A: Yes, with proper treatment and support, teens can recover from self-harm. Recovery often involves therapy to address underlying emotional issues, learning healthier coping strategies, and developing better emotional regulation skills. It may take time, and there may be setbacks, but with professional help and family support, recovery is possible.
Key Takeaways
Take It Seriously
Self-harm is a serious issue that requires immediate professional attention
Stay Calm
Approach with compassion, not judgment or anger
Get Help
Professional treatment is essential for recovery
🚨 Remember: Help is Available
988 Suicide & Crisis Lifeline
988
Call or text anytime
Emergency
911
For immediate danger
⚠️ Important Note
This article provides general information and is not intended to replace professional mental health advice. Self-harm is a serious issue that requires immediate professional attention. If you suspect your teen is self-harming, contact a mental health professional, your chil' doctor, or a crisis hotline immediately. If ther' immediate danger, call 911 or go to the nearest emergency room.