By: Stephen Scherer, Ph.D.
Licensed Clinical Psychologist
Self-harm, the act of deliberately hurting oneself, is a concerning trend among teens. It's a complex issue with various factors driving it and is often misunderstood as "attention-seeking." It can range anywhere from inflicting physical harm on oneself through cutting or burning, to unsafe sexual behavior, to substance abuse. This blog post explores the drivers behind self-harm in teens, offers guidance to parents, and insights into therapy approaches that may help you and your teen recover.
Why Do Teens Self-Harm?
Generally, there isn't a single reason that causes teenagers to turn to self-harm. It can be a complex interplay of emotional distress, social pressures, and a lack of healthy ways of coping with difficult experiences. Often times, several factors converge and a teen will develop self-harm behaviors after other attempts at manage ongoing overwhelming and seemingly impossible experiences fails. Below are some common triggers:
Emotional Dysregulation: Teens may self-harm to manage overwhelming emotions like shame, sadness, anger, anxiety, or loneliness that seem to have no end in sight. It may be difficult to understand why your teen has started engaging in self-harm to cope and it's important to remember that this is an unhealthy attempt to shift focus off of emotional pain to physical pain. This this will often provide a temporary sense of control and release for them.
Mental Health Conditions: Self-harm is often linked to an underlying mental health issue. Depression, chronic anxiety, or trauma are common, in addition to borderline personality disorder. It can be a way for them to express the emotional turmoil they're experiencing without using words.
Social Pressures: There is a deeply concerning trend for teens to exhibit self-harm behavior through social media and advertise it as normal (especially on TikTok). Peer pressure can play a role, particularly if a teen and/or their peers are viewing social media content where self-harm is seen as normal, trendy, or "cool." They might engage in it to fit in or feel a sense of belonging.
Trauma: Traumatic experiences like abuse, neglect, or bullying can lead to profound emotional suffering. Teens who haven't addressed these traumas may turn to self-harm as a way to cope or may use them as a form of punishment due to false beliefs that they are unlovable or deserving of suffering.
Parenting Skills for Supporting Teens Who Self-Harm:
If you suspect your teen is self-harming, it's important to approach the situation with a calm demeanor, empathy, and non-judgemental understanding. It is common that as a parent, your emotions and thoughts may be overwhelming. It is okay to experience these emotions and you will want to identify someone you can discuss them with. Be aware of what actions your emotions are urging you to take before you have a conversation with your teen. You will want to make sure that when going into a conversation with them about self-harm, you are ready to listen.
The initial conversation about self-harming may not be the ideal time to problem solve or offer suggestions and your teen may be hesitant to engage in the conversation. Don't take this as an offense, as they may need time to process their experience and be ready to discuss it. Instead, you will want to create an atmosphere that lets your teen know that you want to understand their experience and give them whatever support they are willing to accept. Even if their rational for self harm doesn't make sense in the moment, the last thing you want to do is invalidate or judge. Invalidation or sudden problem solving (even if it's from a place of love) may cause your teen to shut down in the moment and make it harder for them to discuss the topic of self-harm in the near future. Consider using these strategies instead:
Open Communication: Create a safe space for open and honest communication. Let your teen know you're concerned because you care about them, listen actively without judgment, and validate their feelings: Ex: "It sounds like there is a lot going on for you and things have been really overwhelming. I can see why you're trying to find something that can make you feel better."
Focus on Understanding: Don't jump to conclusions about why they have started to self-harm. Instead, ask questions to understand why. This helps them feel heard and encourages them to open up more to you. Remember, not offering solutions does not mean you approve of the behavior, the first step is to understand the cause and function of self-harm. Ex:Â "I want to understand what's going on for you so I can support you through this in whatever way you may need. Please tell me about what's been going on for you."
Avoid Shame and Blame: Shaming or blaming your teen will only push them further away and will result in them hiding the self-harm from you instead of opening up about their struggle. Focus on offering support and finding healthy coping mechanisms together. Ask them what you can do to support them and if they are unsure, ask if you can offer suggestions. By getting their permission, you increase the likelihood that they will be willing to collaborate with you. If they are hesitant to talk about the situation you can validate how challenging it is and encourage them to speak with you when they are ready. You can also use this as an opportunity to engage in a shared activity such as watching a movie or going out for a walk to help them feel more supported. Ex:Â "It's ok that you don't want to talk about these things right now. I do want you to know that I'm here to talk about them when you're ready."
Seek Professional Help: Therapists trained to deal with self-harm can equip parents and teenagers with healthy coping strategies and address any underlying mental health issues. They can also provide parent coaching to help you support your teen through the difficult process of finding alternatives to self-harm.
What Does Therapy for Self-Harm Look Like?
Therapy provides a judgement-free space for teens to explore their emotions, thoughts, behaviors, and develop healthy coping mechanisms. Below are several highly effective therapy approaches that can address self-harm:
Cognitive-behavioral therapy (CBT): CBT helps teens identify negative thought patterns contributing to self-harm and replace them with more positive, helpful ones.
Dialectical behavior therapy (DBT): DBT teaches teens emotional regulation skills, distress tolerance techniques, and how to build healthy relationships.
Family therapy & parent coaching: Family therapy can help address family dynamics that might be contributing to the teen's distress and improve communication within the family unit. Parent coaching will target specific strategies and parenting approaches that you can use to help your teen in a fine-tuned way. Contrary to what most parents understand, there is no one-size-fits-all approach to parenting. Each child requires a nuanced approach to parent them effectively, depending on their personality, motivations, and relationship with their parent.
Remember, self-harm is a sign of struggle, not a character flaw in your adolescent. It's important to be patient with your teen and let them know you are there to support them the best that you can. By continuing to build your relationship with them, fostering open communication, avoiding judgment, and seeking professional support, you can create a safe and supportive environment for your teen to heal and overcome the challenge of self-harm.
*Disclaimer: This blog post is intended for informational purposes only and does not substitute for professional medical or mental health advice. Always consult with qualified healthcare professionals for personalized guidance.
Additional Resources:
The National Alliance on Mental Illness (NAMI): https://www.nami.org/Home
The Jed Foundation: https://jedfoundation.org/
The Trevor Project: https://www.thetrevorproject.org/ (For LGBTQ+ Youth)
The Crisis Text Line: https://www.crisistextline.org/topics/self-harm/#what-is-self-harm-1
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