Non-Suicidal Self-Injury: Information for Parents and Caregivers

Heather  Randolph, Psy.D

In my work with children, adolescents and families, few events create more confusion, concern and fear for parents/caregivers than discovering that their child engaging in self-injury.  I frequently meet with parents who express dismay that a teenager would purposely hurt themselves, and are at a loss as to what to do to help their child.  Let’s take a few moments to talk about what Non-Suicidal Self-Injury (NSSI) is, and is not, and what parent and caregivers can do if they determine their adolescent is self-harming.

First, I referred to individuals who self-harm as teenagers or adolescents several times.  While NSSI can occur in children, even very young children, or once a person has reached adulthood, the highest percentage of self-harm is being done by adolescents.  Self-injury can take many forms including cutting, burning, scratching, hair pulling or pinching/punching oneself.  Most adolescents are secretive about the self-harm, and will attempt to cover the injuries with their clothing.  When the injuries are discovered it is not unusual for excuses such as a scratch from a pet, or bruises from “clumsiness” to be given as explanations.  If parents notice that their children are wearing clothing that doesn’t fit the weather (long sleeves in summer) or bruises/cuts/scratches that don’t seem consistent with daily activities, it is time to ask more questions.

The number one concern I hear from parents is that their teen has tried, or is going to try, to commit suicide.  This worry in understandable, and anyone who is self-harming should be assessed for risk of suicide.  This being said, most adolescents who self-injure are using this as a way, although not a very good one, of dealing with tension and emotional distress.  It is also often said “he/she is doing this for attention.”  That may be true, and we should honor these “distress signals” and give attention to the teen and the behaviors.  Anyone who is self-injuring is struggling with how to manage strong emotions and stress effectively, and needs support, guidance and assistance from family and professional treatment providers.  Demands that the teen simply stop what they are doing, or punishment for the self-injury is rarely effective and can lead the adolescent to feel even more withdrawn, alone and upset.

So what is a parent or caregiver to do if they find their child is self-injuring?  First, it is important to manage your own strong emotions that may occur in reaction to this discovery.  Fear, anger, dismay and confusion are natural responses for parents, the calmer you can remain; the better able you are to assist your teen during this time.  Second, seek professional assistance; most teens that self-injure have difficulty stopping the behaviors on their own.  A therapist can be a vital member of the child’s support network to learn new ways of managing strong emotions, depression and stress so the self-harm is no longer necessary. Additionally, the therapist can help the family system during what can be a very upsetting period. 

A great resource for more information for parents, caregivers, friends and treatment providers is http://www.selfinjury.bctr.cornell.edu/  

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