Self Harm
Self Harm
Dear Tacit,

I think my teen may be self-harming – what should I do?

Signed: A Worried Parent

Dear A Worried Parent,

This question has been asked a few times, over the many years of our Dear Tacit article – and I am always very glad when it is!  Thinking that someone you care about is self harming can put a knot of anxiety and worry in the pit of your tummy.  Some people might respond to the situation by ignoring it or pretending it just isn’t happening because they just do not know what else to do (and are afraid they might make it worse by trying to discuss it).  But being open to talking about your worries is so very brave and healthy – for both you and for your son!

Deliberate Self Injury (or Non-Suicidal Self Injury – NSSI for short) is a very serious issue.  It is an indicator that your teen is struggling with some emotional issues and that he is at a loss for how to communicate/share his needs with others.  But NSSI behaviours are NOT just a pattern that we see in our teens – people of all ages can find themselves being drawn towards self-injury. And there are a number of reasons for this (I am only mentioning a few in this article).

Sometimes a person can feel really overwhelmed with everything that is happening to them in life.  Acts of self harm might make that person feel (albeit short-lived) like they have some control over or choices in their world – self harm can also act as a release for all the emotions that the teen is drowning in.   Or a person may be going through a really painful, dark time and they might have disconnected from their feelings/numbed out in order to not hurt so much.  The physical pain sensation that comes with acts of self harm can sometimes seem very similar to the emotional feeling of pain, which reassures the person that they are not completely broken inside (that they can still feel something).   Or the person may be struggling with low self esteem; or perhaps a peer pressure issue or even just a sense of curiosity because people they know are self-harming.  Acts of self-harm help that person feel more like they fit in/belong and are as “normal” as the other people in their life.

No matter what the reason might be, any person who hurts themselves intentionally needs someone to talk to about what they are going through.  Even if the person who is self-injuring is not worried or feels it’s no big deal, these actions are never a safe or appropriate means of handling emotional needs/issues.

There are many forms of self injuring behaviours, so it can be tricky to know if it is happening.  Try to notice if there are any possible physical warning signs – cut marks on your teen’s arms, legs, hands; sores (burn marks) around or in their mouth; any repeated and/or unexplained bruises and injuries; etc.  Keep in mind that the results of the NSSI behaviours will not always be visible on the outside of your teen’s body (they may be ingesting substances that cause the pain internally).  And your teen will likely be hiding the physical indicators of their self-injuring behaviour – they might wear long sleeves and long pants, even when it’s warm outside (or refuse to participate in gym class because they don’t want to change into more revealing workout clothing).  They might wear a lot of jewellery/bracelets or bandanas wrapped around their wrists.  They might also complain of frequent sore tummies or headaches.  They might be sneaking away or spending a lot of time alone in their room or in the bathroom.  They may seem more sullen or depressed or they may appear to be perfectly happy and well adjusted – NSSI behaviours don’t just happen with people who look obviously upset/stressed out or who are noticeably struggling to cope.

On their own, self injury behaviour patterns are not the same as having a desire to kill one’s self.  In fact, people who self-injure typically do NOT want to die – they just want to find a way to handle whatever they are struggling with, and they don’t know how else to do it – they are actually fighting to survive.  But, having said that, thoughts of suicide certainly can certainly develop as an additional mental health issue for anyone dealing with NSSI issues.  And even without there being any suicidal thoughts, the risk of serious or permanent physical injury or even accidental death is also a very real concern.

If you suspect that someone you care about is self-harming, you will need to have some very open and frank discussions with them about NSSI behaviours (this can also help them if they have friends who might be going through this kind of issue).  You won’t cause self-injuring behaviours to begin just by bringing it up.  Be vulnerable with your teen – let them know how scared you are and how helpless you feel about what you think they might be doing – don’t shy away from talking about what you are seeing (if you can’t talk about it, he/she certainly won’t feel they can).

Broach these conversations regularly – it’s never a one-and-done kind of discussion.  Find out what is happening in your teen’s life and how they are dealing with it (so they have healthy coping skill options?).   Make sure you let your teen do most of the talking so you can tell if they truly know what to do when they get overwhelmed or feel lost in life.  Check-in with your teen and get to know who he/she feels they can talk to about the different problems and challenges they face (because it might not be you – but as long as it is an adult you feel would help protect them, it’s still a good thing).

Make sure your teen is not taking on too much – often, kids who are the main support for their friends or who feel they need to help others before they take care of themselves have a need to appear strong and cannot tell anyone what they are going through themselves.  Notice if there are other worrisome changes in your teen’s life (problems with school or friends, pressure from extra curricular activities or work, or just a lack of focus on themselves).  And above all else, make sure your teen knows that they can come to you with anything they do in their life without fear of anger or judgement or blame.

If you notice signs of self-injury, get your teen some medical help to be sure nothing high risk has developed (it is likely that you are not a trained medical professional, so don’t take any chances – underlying physical health problems can develop with many NSSI behaviours).

Consider talking to a mental health professional who is trained in these kinds of behaviour patterns – on your own or together with your teen – so you can better understand what is happening and learn how to support your loved one in the way that they need.  It’s okay to admit that you don’t know what to do – it’s likely that your teen feels the same way.  Be a team with your teen, and you will both get through this time stronger together as a result.

Take care!

Have a question? Please feel free to reach out to us at Your answer will be provided confidentially. 

Want to start your counselling today?
Make an Appointment

Add Comment

Your email address will not be published. Required fields are marked *

Tacit Knowledge Logo

Sign Up For Our Newsletter