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What to Do If Your Child Self-Harms

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.


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!


Sally O'Reilly

Sally O'Reilly

Sally O’Reilly is an IAHIP, ICP and EAP accredited Counselling Psychologist, Psychotherapist and Clinical Supervisor with nearly twenty years of professional experience. Her particular area of expertise and interest is work with teenagers. She enjoys a busy full-time private practice and has developed and facilitated a personal development, substance misuse and sexual health programme for teenagers for over 15 years. She is a regular contributor to national print and radio media.
Sally is also the co-author of Two Wise Chicks.
Feel free to follow Sally on: Facebook | Twitter | Linkedin


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  • I have worked with adults who have self harmed and it was such a challenge for me. I just wanted to hold them and take the suffering away. To have a child do this – I really have no clue where I would start. 🙁 Thanks for this very important message.

  • You have brought up some very important details about self harm., though I wouldn’t contribute to the narrative that self harm is “trendy.” While some kids may learn it from their friends, self harm is often a very solitary issue and a coping mechanism for those who have no other way of dealing with their emotions, trauma, a change, or a larger mood disorder. Bringing in a physician and therapist who specializes in troubled youth could really bring clarity to a child in need of guidance, coping skills, and an extra helping of unconditional love and attention.

    • Hi Holly and thanks for weighing in. Yes indeed I agree with you that often it is a solitary behaviour and we need to be careful about the words we use – hence my distinguishing between the words ‘trendy’ and ‘trend’ – a subtle but important difference! The word ‘trendy’ implies ‘less important’ doesn’t it? Akin to “just for attention”.
      Thanks so much for taking the time to read both the piece and the comments:)
      Warm wishes,

  • Yes, this is very sensitive issues, I have a friend before she’s self harms, she is depressed that time with her family. All parents should read this.

  • Oh yeah, full disclosure in a situation like this is mandatory. It is very serious and I hate that it’s become sort of ‘trendy’ in the high schools. It’s very alarming to me.

  • From my limited understand of cutting it actually releases endorphins which somehow makes the person doing it feel better. Usually a person who cuts has an imbalance in their chemical make up and may need meds. This is not always done for shock value so your advice to parents is solid!

    • Hi Joely and thanks for leaving such an interesting comment. The chemical imbalance theory is just that, and is losing credibility in the field of neuroscience. For a really interesting read that’s perfectly layperson friendly yet rooted in solid research and scientific method read Cracked by James Davies. You sound like the kind of person that might enjoy reading it! Thanks again, Sally

    • Absolutely Dominique – that’s it, parents aren’t always able (or allowed by the child) to be of direct assistance so outside help is then appropriate. I think knowing that that’s not a ‘failing’ is really, really important.Thanks for taking the time to read and comment! Warmly, Sally

  • This is a sensitive issue and even if we deny this, a lot of teens are harming themselves. It really important that we listen and understand and not that we don’t show anything that could trigger them to do more harming or anything that could make them think that you are against them.

    • Thanks for joining the conversation Elizabeth – I think its great to have a forum like this for parents to discuss and share information and tips. And thank you for reading and commenting! Warm wishes,

About Author

Sally O'Reilly

Sally O'Reilly

Sally O’Reilly is an IAHIP, ICP and EAP accredited Counselling Psychologist, Psychotherapist and Clinical Supervisor with nearly twenty years of professional experience. Her particular area of expertise and interest is work with teenagers. She enjoys a busy full-time private practice and has developed and facilitated a personal development, substance misuse and sexual health programme for teenagers for over 15 years. She is a regular contributor to national print and radio media.
Sally is also the co-author of Two Wise Chicks.
Feel free to follow Sally on: Facebook | Twitter | Linkedin