What to Do If Your Child Self-Harms

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Some of our teenagers are harming themselves.

Not all of them, of course, I have no wish to be alarmist. But the numbers are big enough for me to want to write this.

troubled-teen

As a psychologist and therapist specializing in work with adolescents and young people, I can tell you that barely a week goes by that I don’t hear about a client or a client’s child self-harming. For me it feels like something of an epidemic. For a parent, it feels like sheer gut-wrenching horror.

What is self-harming?

Self-harming behaviour usually takes the form of deliberately cutting, scraping, hitting or otherwise causing injury to the self.

Parents usually react in two “flavours” of feeling ranges:

1: The Shock flavour range (fear, panic, desperation, desolation, powerlessness, bewilderment), followed quickly by or accompanied by

2: The Anger flavor range (rage, annoyance, irritation, disgust), that this this might be “just” attention seeking and therefore a type of manipulation.

I want you to know that both reactions are valid.

What you can do:

1: Understand that regardless of all else, there is a reason your child has chosen this behavior. It’s real and it has a meaning.

2: Listen to your child without judging, and (this is hard) with an acceptance that they themselves may not know why they are doing what they are doing.

3: Encourage your child to seek help besides yours once you have listened to them. They might be glad that you are willing to allow them to speak to someone other than you about their deeper more intimate feelings. You are not a mental health professional, and you will probably find it very difficult to contain your own emotions around this, and therefore may not be able to be effective help. This is your child after all, terror and paralysis are absolutely to be expected!

4: If your child discloses they are suicidal, believe them, and talk to them about getting immediate professional help. Ideally don’t do anything behind their backs – this might add to feelings of mistrust and insecurity they may already have. It also reduces the chance that they end up in a situation talking to someone whom you might trust, but whom they might not…

Speak to your family physician and, if you have one, your child’s school therapist regarding referrals. Consider family therapy as a follow up to individual work. It is my experience that sometimes teenagers self harm as a way of creating a space where family dialogue has to happen, they are forcing communication where there might be none. This might seems dramatic and unnecessary to you, but in a teenaged mind, it might seem like the only likely solution.

They might be cross if you go outside for help and accuse you of betraying them, but know that you are doing the right thing out of genuine concern.

5: Let them know as calmly as you can, how you feel if you are frightened and upset (which you probably will be!). This in itself will be experienced as helpful to them – they may not realise how much you value them and their experience.

6: Get support yourself. Hearing that your child is harming him or herself is a big deal. It can be extremely upsetting and traumatic, particularly if you have previous experience of self harm yourself, or if you have lost someone to suicide. You do not have to contain this all by yourself. There are many people out there who will know how to support you as well as your child.

7: Know that in rare occasions, a child will deliberately and consciously self harm to punish or control their parents or friends. If you suspect this is the case 1-6 still apply. And again there is a reason for this dysfunctional behavior. Professional intervention will help your child become aware of their behavior, accept responsibility for it and learn to manage their emotions and relationships in a healthier way. Family work will help you all to understand any dynamics that are at best, unhealthy, and at worst, destructive in your family.

And yes, family therapy can feel like hard work, but it’s worth doing right?

Do your best to avoid:

1: Asking for the gory details. You will likely feel the need to know exactly what they did/are doing so that you can feel like you know what you’re dealing with here – but this is your need, and will not be helpful to either of you. Your child will already be feeling vulnerable and shamed, and exhausted from telling you as much as they did. Now isn’t the time to push for more.

2: Jumping to the conclusion that this is ‘just’ for attention.  The thing is: it absolutely IS for attention – we simply need to forget the word ‘just’. And wow – it’s a pretty dramatic way of getting it, isn’t it?!

So instead, consider ‘Why is my son going to such lengths to get me to take notice?’ ‘ What does my daughter feel unable to actually say?’ ‘What might this represent?’

Be aware that something bigger than simply “just” looking for attention is definitely going on here. Even if it’s that something is simply that they have not yet learned how to ask for support or acknowledgment. Again, there is always a reason.

3: Assuming that they are suicidal. I understand that self-harm looks violent and extreme, but it is not necessarily a sign of suicidality. However it is serious, and deserves to be treated as such. Feel free to ask them, to actually say the words “Do you ever feel so bad you want to kill yourself?” It might be a relief to them to be asked, to be allowed to say the words. To know that it is normal to feel really, really bad. Having a fleeting thought or fantasy of suicide is very different from planning a suicide. And naming that fantasy or thought may well take the power out of it for them.

(If they say yes by the way, check to see if they have a plan and the means to kill themselves and seek immediate professional help).

4: Don’t take it personally if they do speak to someone else more than to you. Your child might be more comfortable talking to their aunt, your friend, their friend’s parent, a teacher, a therapist and so no. While I understand that this might be hurtful and bewildering, please don’t assume that this means they no longer love you or don’t trust you. It is not a reflection on you or your parenting. In fact it may be a sign that you have taught them well that it is healthy and normal to seek help outside your immediate family.

If there really is a serious trust or communication issue, outside intervention can assist you with this.

5: Insisting that they stop for your sake. Understandably, parents and carers often fall into this trap – the “Please don’t do this – it’ll kill your Dad / Mom / Gran / Sister and they’ve already gone through so much etc”. Again, I understand that this might feel like the truth and that you are coming from a place of panic. But it’s unlikely to bring about a lasting change. More likely this will be experienced as blackmail or that you are more concerned about your own upset than you are about theirs. They are already vulnerable and will see and hear everything through that lens, for now. Expect a certain amount of what looks like paranoia.

6: Keeping it secret from their other parent: Agreeing to keep the behavior secret from your partner (including ex-partners if they are still involved) is, generally speaking, not a good plan. When we do this we might think we are earning trust. However, what we are also doing is teaching the teenager that we are not taking this seriously enough to share with a significant other and that you are willing to carry this load by yourself. This is an opportunity to teach your child two things: One is how seriously you take him/her. The other is how to seek help when we are in distress. And the most effective tool for teaching anything is to model that behavior. And so say something like:

“I understand that you’re embarrassed / or unable to talk to X about this, but we are your parents and it’s our job to mind you, together. And so I’m going to tell X today”.

Again, this might be met with rage, but secretly, your child might be relieved. Maybe even impressed. I’ve seen that too!

If however, you believe your child’s relationship with their other parent is abusive or unsafe then feel OK about supporting them by not disclosing this private information to that person.

7: (Repeating myself…) Dealing with this by yourself. If your child is self-harming due to a crisis, outside help will be effective. If the crisis involves you or your marriage or another family member outside help will be effective. If they are self harming to punish you or control you in some way, outside help will take the power out of that, and so will be effective.

Whatever the issue, outside help is the way to go!

Remember to mind yourself – we cannot effectively support anyone if we are not supported ourselves.

Thanks for reading this – I do hope it was helpful. Please feel free to follow me on @psychosal or sister site @twowisechicks. I’d be delighted to hear from you!