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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