Worried About Self Harm
I think my teen may be self harming – should I be worried or is this just a phase he is going through?
Signed: A Worried Parent
Dear A Worried Parent,
Thinking that someone you care about is self harming can be a frightening experience. Deliberate Self Injury (or Non-Suicidal Self Injury – NSSI for short) is a very serious indicator that your teen is struggling with some emotional issues. People of all ages sometimes hurt themselves, and for a variety of reasons – sometimes they feel overwhelmed and don’t know how to deal with the situation differently; or they may be numbed out emotionally and just want to feel something again; or they find themselves struggling with low self esteem; or perhaps it is more of a peer pressure issue; or they could just be curious because people they know are doing it; etc.
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, it is never a safe or appropriate means of handling emotional issues.
There are many forms of self injuring behaviours, so it can be tricky to know for sure 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. 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 clothing). They might wear a lot of jewelry/bracelets or bandanas wrapped around their wrists. They might complain of frequent sore tummies or headaches or other types of body pain. 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 its own, self injury behaviours are not the same as the 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 be a dual mental health issue for anyone dealing with NSSI issues; and the risk of serious physical injury or even accidental death is also very real.
It’s important to have some very open and frank discussions with your teen about NSSI behaviours (this can also help preventatively, or 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 worried 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 teens life and how they are dealing with it. 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 always 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 there is nothing high risk that has developed (it is likely that you are not a trained medical professional, so don’t take any chances –underlying health problems can develop with many NSSI behaviours). Offer to talk to someone yourself or together with your teen, so you can understand their behaviours better and learn how to support them 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 united team with your teen, and you will both get through this time stronger, together, as a result.
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