Confusion, anxiousness, hurt, disappointment, and anger may be among the feelings parents experience if they discover that their teen is self-injuring. The teen, too, is likely experiencing negative thoughts and emotions. The following provides a description of non-suicidal self-injury, risk and protective factors, and suggestions for how parents can and should not respond after discovering that a teen is engaging in self-injurious behavior.
1. What Is Non-Suicidal Self-Injury?
Non-suicidal self-injury (NSSI) is an intentional injury to one’s own body with the absence of suicidal intent. People who engage in self-injury typically do not intend to die by suicide and tend to deny suicidal ideation was present while engaging in a self-injurious act. It may also be called self-harming, self-injury, or self-mutilation. It is a coping skill often associated with depressive symptoms, self-criticism, and difficulty accessing or regulating feelings. It exists in different forms, including burning, cutting, biting, hair pulling, scratching, or pinching the skin to obtain a sense of relief from strong emotions that may feel overwhelming. The self-injuring behavior creates a release of endorphins, the “feel-good” neuropeptide sometimes associated with “runner’s high.” Although NSSI is distinct from suicidal behavior, it is a risk factor for possible suicide attempts.
2. How Does NSSI Begin and Who Is Most at Risk?
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) says that NSSI tends to start during the early teen years, generally peaks by late twenties, and then declines. Research shows mixed results regarding risk factors, such as trauma, that may lead to NSSI, and protective factors that may help prevent it. The DSM-5 suggests that individuals often learn of self-injuring behaviors from someone they know and may try the behavior themselves. People using self-injury may be doing so as a form of self-punishment for something they feel is deserved, because the behavior reduces upsetting feelings or reduces upsetting thoughts, because the behavior results in desired attention from a specific person, or to demonstrate feelings that are difficult to express. One protective factor is providing adequate social support from friends and family. Increases in negative self-talk and a depressed mood suggest greater risk of NSSI and suicidal behavior.
3. What Can I Do to Help My Teen If He or She Self-Injures?
Parents of a teen who self-injures can:
- Ask the teen if he or she is self-injuring if you suspect the behavior but are unsure if it’s happening.
- Tell your teen you’re concerned about the behavior.
- Talk to your teen about getting help from a counselor or finding a mental health professional.
- Reassure your teen that asking for help is OK and it doesn’t mean he or she is weak or crazy.
- Let your teen know you love him or her; you may not approve of the behavior, but you love your child for who he or she is.
4. What Should Parents NOT Do When They Learn Their Teen Is Self-Injuring?
The following behaviors can lead teens to shut down or escalate an already tense situation:
- Don’t shame or criticize your teen by saying things like, “What’s wrong with you?”
- Don’t accuse your teen of self-injuring for attention.
- Don’t minimize the problem by saying it’s just a phase.
- Don’t buy your teen expensive items because he or she tells you that’s the only way he/she will stop self-injuring.
- Don’t hurt yourself in front of your teen trying to make it understood how much it hurts you knowing he or she self-injures.
- Don’t punish your teen; self-injuring is its own form of self-punishment or self-abuse.
5. How Can Professional Support Help?
A professional counselor can help address and reduce self-injuring behaviors. Focusing on building new coping and problem-solving skills helps someone who self-injures increase his or her repertoire of behaviors used to manage distressing emotions. Processing traumatic experiences that may be associated with self-injuring behavior can help validate feelings about the event.
Having a strong therapeutic relationship between a therapist and the person self-injuring is also important since it can help create a collaborative and safe environment to practice new skills. A collaborative therapeutic alliance can be a necessary first step to begin identifying patterns of thoughts, feelings, and behaviors that lead to a self-injuring incident or may be maintaining a self-injuring behavior.
© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Marjie L. Roddick, MA, LMHC, CTTS, therapist in Vancouver, Washington
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