How to respond to self-harm: A parent’s guide
It’s a parent’s nightmare. Your teen is self-harming. You are saddened, angry, unnerved, and at a loss for words. How did it come to this? What did you miss? Why on EARTH would someone do that to themselves?
Why does my teen self-harm?
Self-harm (sometimes referred to as non-suicidal self-harm) is the deliberate damage to one’s own skin tissue without suicidal intent. In it’s simplest form, it’s a coping mechanism for dealing with upsetting emotions. The person conditions themselves to be relieved by physical pain, as it momentarily takes away from their emotional pain. In the short-term, it helps the person feel better; in the long-term, makes things much worse.
Therapists hear about many different forms of self-harm from their clients. Cutting (by way of a razor or other sharp tool) is the most common, however, the stories around different methods is endless. Regardless of the method, a teen who is self-harming requires intervention. Some people may tell you that your teen will “grow out of it” or that it’s “just a phase" (or fad). On the contrary, people who self-harm regularly as a teenager often end up struggling with their mental health well into adulthood, if they do not receive treatment.
Are they doing it for attention?
Most people who self-harm say that they do it for some type of relief. That being said, there is sometimes a secondary gain for the person when friends/family/teachers start responding to the person differently after learning about the self-harm. Any behaviour can be reinforced by people’s reactions to it, such as allowing the teen to hand in an assignment late, or gaining the concern of a friend at school. It is important to remember that even if there is something about the behaviour that is reinforced by other’s attention, it is not something that they can simply “turn off”.
As a parent, how can I help?
Firstly, don’t panic (easier said than done, we know!). When we are panicked as parents, we tend to lean on ineffective parenting strategies, such as blaming, shaming, or punishing. On the other end of the spectrum, we also don’t want to respond with an extraordinary amount of warmth and affection, as this could inadvertently reinforce the behaviour. (Think about it: “Finally, someone is noticing my emotional anguish, this feels good!”). Instead, focus on addressing the issue with your teen calmly and matter of factly. Invite a conversation with your teen, but be sure not to demand one. Listen with curiosity, empathy and let your teen know that you are concerned and will help them through this.
Because of the complicated nature of self-harm, it is best if your child is treated by a trained therapist. It is not advised that you wait to see if it gets better first or simply take away their self-harm tool hoping that this will get them to stop. Your teen needs to learn replacement coping strategies for managing strong emotions. If you teen is refusing therapy at first, see if they’ll commit to just 2 sessions to begin, reminding them that therapy is going to help them feel better. You may also need to shop around for the “right fit” between the therapist and your teen, as not all therapists are skilled at treating self-harm.
Consider talking to your family doctor or paediatrician. They may recommend a psychiatric assessment to see if there are underlying mental health issues that are fueling the self-harm behaviours. There are usually significant wait times to see these specialists, and it’s advised that you don’t want for a doctor’s assessment to begin therapy.
What can we expect in teen therapy for self-harm?
Typically, self-harm is looked at as an unhealthy coping skill for managing strong, uncomfortable emotions. A trained therapist will often use principles of Dialectical Behaviour Therapy for increasing the client’s ability to be aware of their triggers, emotional and behavioural patterns and learn new and better skills for tolerating distress. This is sometimes done in individual sessions with the teen, but depending on the nature of family dynamics, the parents may be involved in some sessions as well. Typically, teen self-harm is best treated when caregivers are involved and parental involvement is the gold standard for treatment.
Progress can be slow, which is sometimes hard to tolerate as a parent. It’s important to remember that any mental health treatment is non-linear and there may be ups and downs along the way. Self-harm must be replaced by a coping strategy that works just as well for your teen and this can sometimes be tricky to find at first. Sometimes a “harm reduction” approach is used, that is, replacing the self-harm behaviour with something that is still uncomfortable (for example, cold showers, snapping a rubber band on your wrist) but does less (or no) damage to the skin than the original self-harm behaviour. This can help slowly ween your teen off of self-harm.
Because self-harm can be dangerous, increasing your teens risk of infection or hospitalization, a therapist will likely put together a safety plan for your teen and the family. The nature of the safety plan depends on the circumstances, but might include removing or locking up all sharps in the house, more frequent check-ins at home or with the social worker at school. Safety plans are designed to not “punish” your teen, but help them mitigate strong urges to self-harm and reduce the risk associated with the behaviour.
If you have found out that your teen is self-harming, reach out to Brookhaven today for a free consultation. Visit our Teen Therapy page for more information on what treatment could look like.
