Self-injurious behaviors are not uncommon among adolescent males and females. Some of these behaviors include head banging, bruising, scratching, and cutting but this is not an exclusive list. There are many reasons for this behavior. Some teenagers are looking to fit-in among friends, rebel against their parents, or an attempt to express their individuality. Others, however, may self- injure out of frustration, anger, to seek attention, or to show their feelings of hopelessness and worthlessness. Below are some suggestions if you find that a teenager you love has engaged in self-injurious behaviors.
• Avoid judging and overacting. It is good that you care about your child’s harmful behaviors, but do so without expressions of shock and horror. This will only enforce their decision to keep cutting in secret and shut you out. So, refrain from yelling, or punishing your child. Cutting is a medical/psychological issue not a disciplinary issue. By taking a nonjudgmental approach, you can keep the dialogue open. Communicate to your child that you are there for them to talk to you; so, you can help them and not punish them.
• Seek professional help immediately. Occasionally adolescents who self-injure stop on their own, but parents should not bet on this. Be willing to share your feelings with your child. It is okay to acknowledge and verbalize that this topic/behavior is something beyond what you know as a parent. This dialogue can help normalize that feelings about life can be overwhelming, and re-enforce that you are willing to help work through these tough times. There are various approaches to therapy available. Dialectical behavior therapy (DBT) and Cognitive Behavioral Therapy (CBT) are good approaches which teach teens the skills to live a healthier and happier life.
• Express respectful curiosity. The goal is to keep the communication open. Don’t try to “fix the problem” or offer your opinion. Without judgment, use a matter-of fact-tone, asking leading questions to help your child increase awareness of a problem and consider that they need help. Examples of leading questions: “How does cutting make you feel better?” or “How do you feel before and after you cut?”, or “What kinds of things make you want to injure yourself?”
• Be observant. Adolescents can go through cycles of cutting behavior. When they feel angry, out of control, stressful changes or expectations, these could trigger self-harming behaviors. Some signs of cutting include but are not limited to: wearing long sleeves, jackets, pants all year-round, using other types of cover ups like tights, wrist bands, or big bracelets, spending long periods of time alone in a bathroom or bedroom, blood stains of clothes, or tissues, finding sharp objects hidden among belongings and withdrawal from friends and family. Adolescents can stop cutting during periods of calm or positive distractions with vacations or after school activities.
Finding the right therapist may take some time. It’s very important that the therapist you and your child choose has experience treating self-injury, but the quality of the relationship with your therapist is equally important. If your child doesn’t feel safe, respected, or understood, find another therapist.
There should be a sense of trust and warmth between client and therapist. This therapist should be someone who accepts self-harm without condoning it, and who is willing to help your child work toward stopping it at their own pace. The parent and the child should feel at ease with him or her, even while talking through the most personal issues.
I hope this brief article is helpful and offers some sense of hope and direction during a difficult time. If you or someone your know self-injures to cope with overwhelming feelings and wants to learn alternative ways to understand and manage emotions, please contact our office and we’ll do our best to help.