Responding to Your Teen’s Self Harm

“I wish he would just tell me it’s all my fault. Then I would know I could fix it.”  This is what a shocked and saddened father told me recently when he found out his teenager was self-harming. How do we process the fact that our adolescent is purposefully choosing to physically wound him- or herself?  How do we fight the panic as we wonder if this is a suicide attempt? How do we answer the ensuing questions: “Does my child want to die? What did I do wrong? How do I make it stop?”

I have been that parent. I have asked those questions. I have cried in bewilderment and fear, wondering just where I went wrong and how I can back up and make it right again. I have pondered what happened to that toddling child who looked to me to make the world right, just as I have wondered what has happened to me, the mother who lived in the illusion that I could do just that.

Mom and Toddler from Stock.xchng
(Photo source: stock.xchng)

There is a deep and abiding sadness when we realize that what we are dealing with is well beyond the scope of our knowledge or experience, and also has the potential to be dangerous and destructive in the long-term.

IS IT A SUICIDE ATTEMPT?
Many parents wonder if their teen is harboring a death wish, if self-harm is a suicide attempt gone awry. I certainly wondered this. It made no sense to me whatsoever. The good news is that the vast majority of adolescents who self-harm fall into the category of non-suicidal self injury (NSSI).

If the emotional struggles that prompt one to self harm are ignored or left untreated, it stands to reason that this could eventually lead to a higher risk for suicide. And certainly there is cause for concern that self injuries could become more severe and dangerous than intended. This is not a behavior to be ignored, but non-suicidal self injury is just that, self injury without the intent of suicide.

I sometimes explain it this way to friends or parents who are as baffled as I was: When I was young, back in the olden days, and someone was having a tough time, they might get drunk, smoke pot, or engage in promiscuous and risky sexual behaviors in an attempt to relieve their anxiety and sadness, or just to get their minds off their problems. Granted, those are pretty poor coping skills, and self-injury can be classified as that as well, as a poor coping skill.

Like other poor options, it doesn’t mean kids want to die. It means they want the pain to stop; they want a distraction from whatever is causing them distress. Ironically, they are causing themselves physical pain in response to emotional or psychological pain.

But more often than not self injury is a non-lethal attempt to escape distress.

WHY SELF HARM?
Why would anyone choose to carve their own skin to the point of pain and bloodshed? Why do some teens intentionally burn or bruise, pick at, puncture, scratch, pinch, embed foreign objects into, or otherwise harm their bodies? When I was in high school, self injury was simply nowhere on our radar. It just wasn’t thought of. Southern Comfort, joints, and parking cars in dark deserted areas were, but purposefully harming oneself was not.

In today’s culture, estimates say that 1 in 8 to 1 in 5 teens hurt themselves physically on at least a somewhat regular basis. Some numbers indicate that 1 in 3 to even 1 in 2 adolescents have tried self harm at least once. It may be unknown to us parents and other adults, but it’s quite well known among the kids themselves. It’s not an unusual phenomenon to them and science shows the release of endorphins (a ‘feel good’ chemical our bodies produce) when one self injures can in fact give temporary emotional relief. This can lead to repeated acts of self harm, as teens look for a continuing, albeit short-lived, reprieve.

Some teens say they practice NSSI in order to “feel anything at all”. This may not be typical risk-taking behavior as we think of it. For instance, if I wanted to really feel something, I might take a bungee jump off a land bridge just to feel the adrenaline rush. (Thankfully, I don’t need that much adrenaline to get through my days.) Sometimes the rush of self harm can feel addicting. It can be devastating to hear your child say they are engaging in ongoing self harm or other risky behaviors just to feel anything at all. In my experience, this is a clear sign that there are some serious concerns to be addressed.

Self harm is not so much the problem as the symptom.

IS IT MY FAULT? DID I CAUSE THIS?
Short of being an abusive/neglectful parent or person in your teen’s life, I would advise you to not point a finger at yourself or even at a spouse, ex-spouse, grandparent, or anyone else you might like to lay blame on for what your child is experiencing. Of course we have said and done things that have caused our children angst, anger, embarrassment, and exasperation. (Isn’t that our job??)

We live in an imperfect world filled with imperfect people, and neither we nor our children are exceptions to that. We can second guess ourselves until we run out of breath and life, and we will always come up with things we should have or could have done better. Welcome to The Wonderful World of Parenting.

Here is an example from my own experience: My first husband left our family when our kids were 7, 4, and 2 ½. As time went on, it became clear that our parenting styles were very different. By observation as well as admission, it was obvious he was quite permissive, and I felt the kids were exposed to things that they weren’t ready for (such as R-rated movies in elementary school).

In response to this, I chose to be a more structured and sheltering parent, which most likely came across as overprotective and controlling. And perhaps in response to that, their dad became even more permissive. Were we trying to offset one another’s perceived parenting flaws? In doing so, did we cause confusion and frustration for our children? Of course. (And there are plenty of things I did just plain wrong on my own, regardless of my ex-husband’s actions and choices).

Life is challenging, and we all do the best we can with what we have. This applies to our children as well. Sometimes our best efforts fall short of the highest good. We keep trying, but we are far from perfect. Some teens (and some 50-year-olds!) are at a lower spot on the learning curve, and this can be part of the bigger picture of one’s choice to self harm. Sometimes mental health or emotional issues are involved, and sometimes we just need help learning healthier ways to cope.

Usually there is not one specific incident we can point to and name as the cause for self harming behavior.

WHAT DO I DO NOW? HOW DO I FIX IT?
Like the father mentioned above, we parents often question our own responsibility when it comes to our kids choosing to self harm. And like him, we may wish to have the blame placed squarely on our own shoulders so that we can guarantee the result: “I broke it, so I can and will fix it.” We hope to regain something we never really had in the first place: complete control. That control would seem to remove the possibility of an unknown outcome, eliminating worry and pain for both ourselves and our adolescent children.

But it really doesn’t work like that.

Remember that self injury is a poor coping mechanism in response to some kind of emotional difficulty (anger, sadness, anxiety, fear, and many others). Recall also that NSSI is more often than not the symptom, not the problem. We cannot go back and undo the many things that have caused our child’s struggle, nor can we wish into sudden existence the ability for our teen to skillfully and maturely deal with difficulties.

We cannot learn what our adolescents need to know; they must learn it for themselves. They must take in the possibility of acquiring better ways to cope. Then they must actually practice those better ways. Ongoing NSSI issues can, and often should, be addressed with the help of a trained mental health counselor.

This doesn’t mean we renounce the responsibility we have as parents, though. It means we don’t blame our kids or others, especially not in front of our kids.  It means that we take an honest look at things we ourselves could do better, that we have the courage to face the things that frighten us, and that we choose to enter in to the process of becoming as emotionally and mentally healthy as we can be.

The road to wellness can feel challenging and overwhelming. As my late husband used to say, “That’s why parents get paid the big bucks!” (Funny guy, he was.) But as difficult and scary as it may be, facing those big issues is the best road to health for all of us, and we give our children a great gift when we choose to offer such an example.

Threats and intimidation of your teen will do more harm than good, as will pretending everything is fine. Continuing self injury is a sure sign that some emotional distress needs to be tended to. Parental negligence or fear caused by threats will not serve our kids well in any way. While the majority of adolescents practicing NSSI may outgrow the behavior on their own within 5 years, receiving help is still encouraged. If we can offer our growing children better alternatives to handle pain and anxiety, why would we not?

Let go of the concern that your child’s struggles will reflect poorly on you as a parent. Choose instead to seek and make available the best help and support you can find.

And if contributing factors indicate that your teen will not be in that 80% who may eventually stop self harming on their own, then seek immediate help. If you see behaviors that concern you (such as depression, anxiety, substance use/abuse, change in personality or behavior) please be courageous enough to intervene on behalf of your teenager.

Oftentimes, in order for a self harming teen to change and heal, the family must change and heal as well. A good therapist – and a good parent – will look at the family system and help to identify areas that may have contributed to the difficulty. This is not a blame game, this is an opportunity to step up and learn healthier ways of relating to yourself and each other. It’s not a matter of “fix this kid”. It’s more a matter of “how do we all learn and heal and grow healthy together?”

Winter Walk from Stock.xchng
(Photo source: stock.xchng)

My daughter shares that her high school dance teacher used to tell her students, “Practice doesn’t make perfect. Perfect practice makes perfect.” Not that we will ever be perfect parents, but we can learn to use better, wiser skills, and to model them for our kids. My formerly self injuring daughter adds her own concluding thought: “In rehearsal, on the stage, and in life, we need to give it our all to expect rewarding results.”

We learn better so we can do better.

© Monica Simpson and Help To Hope, 2013

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15 thoughts on “Responding to Your Teen’s Self Harm

  1. self harm is so difficult to understand. The reaction to it too, is so important. we can not just say do not do that, for they would rather not be in a place where they feel the need to do so. The key is to find the need, the why and work from there, with love and support.. and if you can.. and it is very hard… understanding. Hugs not frowns.

    • Very well said, Amber. I believe there is great difficulty and pain on both sides – for both those who self harm and those who love them. Oftentimes a self injurer may not really know the “why”, and certainly the people in their lives can have many misconceptions about the reasons. Thankfully, we don’t need to understand someone to behave in an understanding way towards them.

      Thanks for reading and commenting.

      • No they will unlikely know the why and will not likely ask, the stigma goes both ways, the lack of understanding, and the not wanting to ask.

        So it is with blogs like yours, to make the understanding more possible through teaching. 🙂

        Love first, and understanding after.

  2. When I first self-harmed (at 17), I didn’t know why I was doing it. I just knew I was miserable and had to do something. I’d never even heard of self-harm; I wasn’t pushed into doing it by anyone or anything. It just felt like the “right” thing to do. I then forgot all about it for eleven years, until the next time I felt THAT bad. I was hospitalised for 2.5 years after repeated self-harm by cutting/overdose which then, once I was hospitalised and lost all hope of recovering, led to repeated suicide attempts. The worst nursing staff were those who said “why do you do this” in a snarky tone of voice. The best were those who weren’t afraid to admit they had problems of their own.
    Be there for your kids. Listen to them. Don’t judge them. Don’t force them to stop because it will drive the problem further underground. Make dressings and sympathy freely available. Don’t try to hide the sharps or the lighters or the ligatures. If they’re going to do it, they’re going to do it. Taking away their choice of coping mechanism will only make them more determined to hurt themselves more. Let them know there are other options and make those options available; but at the end of the day, however hard it is to hear this, it’s THEIR choice. THEIR life. They need help in unravelling the chaos of their minds before they can make the decision to stop and have the necessary mental tools to be able to do so.

    • Stacey,

      Thank you so much for sharing your story.

      Self harm can be such a terrifying phenomenon for everyone involved. There are not always mental health issues involved, but when there are it adds another layer of difficulty and fear.

      Speaking as a parent of a daughter who was obviously clinically depressed plus had other issues and extenuating circumstances, all I wanted to do was hide everything sharp until she was more stable! But it’s true, she had to get to a place of even ground before she could make the decision to stop the NSSI.

      Once I came to understand that she wasn’t trying to kill herself (until the time came that she was), it was less scary and easier to see it as a poor coping mechanism. (When she became suicidal – which does NOT happen to the majority of teens who self injure – things changed drastically, of course.) I agree that the internal struggle must be addressed before the external (self harm) can be resolved for the long term. It truly must be the choice of the the self injurer to choose a different way.

      I so appreciate you reading and sharing your thoughts.

      Monica

  3. I have often wondered how I would react if I found out my future child self harmed. I probably at first would be very upset, not at them but because I know what they’re going through. I would be supportive and make myself available I would encourage harm reduction and exploration of alternatives (lots of them). I guess what ever I felt I needed when I was actively self harming is what I would want my child to have.

    • I must admit that I have thought of this type of scenario myself ~ since the generation that has really “made self harm known” (for lack of a better phrase) will before too long likely become parents themselves, I have wondered just how they may react if they find their own kids self injure. You indicate what I have surmised, that the level of understanding and empathy will be great. (Although I don’t know that this will happen for someone who has NOT taken the time and effort to work toward health and better options than NSSI, as you have courageously done.)

      There is the opportunity for great compassion and connection when we walk alongside someone who is experiencing what we have known and lived ourselves. I try to practice this when it comes to my own kids, for instance when dealing with issues regarding divorced or absent parents. I will always say it: Compassion is a powerful tool. And it’s one you seem to use well.

      Take care,

      Monica

    • Oh Gaye, your kind words mean so much to me! I know you know this type of situation well. Thank you for your faithful heart and labor on behalf of those who are hurting. (And if you want to direct some of the parents of ‘your kids’ to this blog, maybe they could find some encouragement and hope; that’s my deepest wish for the parents of kids who are hurting. It can be such a lonely and frightening journey.)

      I miss you, my friend! Love you too!

      Monica

  4. Well this made me cry. Having just come out of a self harming phase with my now 17yr old, and heading into what I anticipate might be another one with my 12 yr old ( who also suffers from high anxiety)..I can SO relate to this post. Thanks for sharing.

    • Big Sigh. I understand. I do. All 3 of mine self harmed. Again, I had to take a deep breath and remember it was a poor coping mechanism that they and so many of their peers used, not a suicide attempt. Still, every fiber of my being rebelled against it. Every. Single. Fiber.

      We have faced anxiety, panic, disordered eating, depression, self harm, death and grief … to name a few. 😉 Please make sure you have some good support for yourself. Have you considered NAMI? I believe the program I am thinking of is called Family to Family, and it’s to support people just like us. (I didn’t know it existed when I needed it.) There is a link to NAMI on my Resources page.

      Thank you for reading and sharing; you are doing very hard work. Sending you much courage and support,

      Monica

      • my youngest ( so far) is my little Buddha…so different from the other two, but yes I, too, have dealt with depression, eating disorders, anxiety, panic attacks, self harm,…what a journey. I’ll check out that resource page, though to be honest, it all begins to blur together after awhile…we try everything and have tried everything. Things stick for a while, then they go through another stage of it. Hormones shift, etc. I’m looking for a support group here in town…even if only to hear other stories and know I’m not as crazy or horrible a parent as I sometimes feel. Just keep movin forward as best we can.
        thanks 🙂
        Kim

  5. Very well said, Kim – it does all blur together! I learned that I had to take copious notes becs my brain cells just could not keep up! It can be exhausting, which is why I love that you are looking for a local support group. (NAMI Family to Family does offer local groups; you may be able to find something by contacting NAMI in your state if you don’t see anything listed in your city. Another option is to check out adolescent psychiatric facilities, whether in a hospital or a stand-alone facility. They may have local NAMI contacts and groups, or know of other support groups in the area. And take notes! 😉 )

    It can be so hard to continue to offer a good example and offer good and helpful options when kids go through those transitional phases. It’s also hard to remember that it isn’t a sprint, it’s a marathon. All we can do is the next, best thing. We simply can do no more than we are able (which I both love and hate!).

    You are not crazy. Parenting can just be crazy hard.

    Take care,

    Monica

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