When you find out that your teen has been self-harming there are a flood of emotions that parents may have:
Fear for your teenager's safety,
Worry about the depth of the depression or anxiety that has led to self-harming,
Feelings of pain or hurt for your teenager and the struggles they may be experiencing,
Possible guilt for not "seeing the signs" or knowing just how to help them in the right way, and other thoughts and feelings.
Self-harming has become more common. A study conducted by the American Public Health Association in 2018 studied high school age boys and girls in 11 states. The study found that:
Self-harm among boys ranged from 6.4% (Delaware) to 14.8% (Nevada).
Self-harm among girls ranged from 17.7% (Delaware) to 30.8% (Idaho).
And we know that the pandemic has only increased the number of teens experiencing depression and anxiety and the increase in the severity of depression and anxiety.
What Self-Harm Is
Self-harm is often referred to as "para-suicidal" behavior. It may look like a suicide attempt (cutting) but often it's just the opposite (but not always). Teenagers who engage in self-harm behavior are trying to find a way for the emotional pain to stop. Not being able to find a way for the hurt to go away, they turn to physical pain.
While they may not be trying to commit suicide, it doesn't mean that they don't have suicidal thoughts. Self-harm is an outward indication that there are serious and complex internal challenges that your teenager is trying to work through and resolve.
Parents should always err on the side of safety. If there is any question or indication that your teen may have suicidal ideation, plan, and/or intent, take them immediately to the nearest hospital or dial 9-1-1. A mental health professional can assess the safety needs of your teen and make recommendations including possible short term hospitalization.
It seems counter intuitive to relieve emotional pain by causing physical pain. Self-harm can act as a sort of pressure release valve. When the emotional pain gets too much, the physical pain can overshadow the emotional pain and create some relief.
What happens in the brain when a person self-harms, is that brain goes into protection mode. When we get injured whether intentional or not, the brain releases endorphins. These are the chemicals in the brain that help relieve pain which also can include emotional pain.
While self-harm is not a healthy coping skill, it works in the moment. And it can become habitual. Because of the powerful neurochemicals released in the brain paired with the relief from emotional pain, self-harm can become addicting.
The time to catch and treat self-harm is at the start. There are often heavy and intense emotional challenges that drive the self-harm behavior like depression, anxiety, panic attacks, social anxiety, trauma, among others.
Nipping it in the bud is the ideal. Seeking help before it gets to the point where the self-harm becomes reinforcing and starts to enter the area of being an addiction.
Suggestions for Parents When You Have a Teenager Who Self-Harms
First and foremost, err on the side of safety. If you believe your teen may be experiencing suicidal ideation and intent, take them to the nearest hospital or dial 9-1-1. The hospital can provide an assessment to determine the risk and provide acute, temporary hospitalization to ensure safety.
It's safe to say that each of our teen therapists at Katy Teen & Family Counseling have a teen we work with who either currently self-harms or has in the past. Not all teenagers do of course, yet it is becoming more of an issue among teenagers.
In working with teens who self-harm, there are suggestions we have for parents of teens who may be engaging in this behavior.
1. Be a Safe Landing Place
This suggestion comes first for a reason. It is probably the most important suggestion out of them all. And probably the most difficult to do.
Often, when a teen goes to their parent to let them know they have self-harmed OR the parent discovers they are self-harming, it comes as a surprise. It's difficult to prepare for how one will manage something that comes as a surprise.
If you have a teen who has been self-harming and they come to you to talk about it, be ever so grateful that they have. It's not a comfortable or easy thing for a teenager to do. In fact, it can be very scary for them. But what an opportunity it gives you to help.
It is very important that your teen not feel judged or shamed for self-harming. Your teen is very likely scared to tell you because they don't want you to be disappointed in them, worry for them, or be angry or upset.
How you respond in this moment will dictate whether they remain open with you and talk with you about self-harming in the future should it happen again.
To the best of your ability, remain open, non-judgmental, and contain your emotion. Listen to your teen and what they are saying. Your teen knows that you will ask questions and questions are okay, as long as they do not lead to shaming or judging.
Avoid things like:
Making assumptions about the reason for the self-harm.
Often teens are worried that their parents will think they are just doing this for attention. Sometimes they are. Sometimes they aren't. This can be addressed later on if it is but in the moment, take them seriously.
Guilt them about how their self-harm affects you as a parent or the family as a whole,
Remind them of what others will think of them when they see the self-harm marks,
Threaten or use consequences as a motivator to stop them from self-harming.
Do things like:
Show compassion and love for them,
Be open to what your teen is saying even if you don't understand in the beginning,
Remain emotional neutral and non-critical/judgmental,
Ask them what they believe has led to them self-harming,
Talk with them about what they were experiencing and what their thoughts were just prior to the self-harm,
Ask them if they have thoughts or have had thoughts about suicide (and if they currently do, taking them to the hospital may be the best course of action),
Ask them what they need from you as parents,
Seek professional help from a specialist in teen therapy.
If your teen has the experience where they felt safe, accepted, and loved when they tell you they have self-harmed, they are likely to talk with you again. If they feel shamed, judged, or that they overwhelmed you with the information, they are less likely to talk with you in the future.
And you want them to come talk with you when they are struggling.
2. Familiarize Yourself With the App "Calm Harm" & Provide This as a Resource For Your Teen
First, I have no association with the app Calm Harm. It is an app that I have found to be very helpful in working with teens who self-harm.
Calm Harm is a free app that uses Cognitive Behavioral Therapy (CBT) principles in a very easy to use way. Cognitive Behavioral Therapy is one of the more effective approaches in treating depression, anxiety, panic attacks, social anxiety, trauma, and self-harm.
Calm Harm uses a CBT principle called "Ride the Wave". This principle is helpful for anything we may have an unhealthy urge to do. Riding the wave suggest that for 15 minutes, do something that will help to:
Comfort you,
Distract you,
Express yourself creatively, and/or
Something to help release tension in the body.
Under each of these categories, Calm Harm provides A LOT of various options in activities to do.
The teen can select one or more of these activities that they find helpful. And for the next 15 minutes, engage in one of these activities.
Often, after the 15 minutes is over, the urge to self-harm either goes away or is diminished greatly.
There may be times where your teen may only need to ride the wave once and they've overcome the urge. There may be other times where they need to ride multiple waves during the day to help overcome the urge.
But when they do, it can be very effective in helping to prevent self-harm at the same time teaching them new, healthy coping skills to replace self-harm.
The app also includes breathing activities that help as well as a journal that they can choose to keep password secure should they choose.
3. Check in From Time to Time
It's natural as a parent to worry and have fears and concerns for your teen. As a parent, you may want to check in with them every moment of every day to see how they are doing. Try to resist this urge.
While you don't want to overwhelm them with check-ins, you also don't want to avoid checking in with them. When you have "the talk" with them that first time, many times when parents ask if they can check in with them from time to time, the teen will respond positively to this.
You may have to feel out the appropriateness of the frequency of the check ins. You can always ask your teen as well if you are checking in too frequently and what they prefer.
When you do check in, it's important to remain emotionally neutral. It's important to remain that safe landing place with your teen.
When your teen knows that you won't overreact, judge, be critical, etc., often they will be more open with you and talk with you candidly about their self-harm.
Other times, even if you remain a safe landing place, it can still be uncomfortable for your teen to talk openly about it. In these cases, you can use a rating system to communicate urges to self-harm.
A 0-10 scale can be helpful where zero is no urge to self-harm and a ten is a strong urge to self-harm. Other families use a color-coded system with "Green" being no urges, "Yellow" some moderate urges, and "Red" strong urges.
It's okay to ask how they have done with self-harm for that time period between check ins. They will either tell you directly or they may hint around that they have self-harmed without telling you directly. It's important not to push them too far outside their comfort zone or they may resist talking with you about it in the future.
4. Find a Therapist Who Specializes in Teen Therapy
Whether it's with Katy Teen & Family Counseling or another therapy practice, it's important that you find a therapist who specializes in teen counseling. Working with teens is very different than working with adults.
There are therapists who work with teens but who would not consider themselves as specialists in teen therapy. These are more generalist therapists in practice. Then there are therapists who have focused their careers on providing counseling for teens.
Think of it this way. The difference between a family doctor and a cardiologist if you are looking for help with heart problems. Your family doctor can probably help but your family doctor will refer you to a cardiologist.
If your teen is self-harming, that is an outward expression of some pretty serious internal struggles. Even IF it is attention seeking, that's a pretty extreme way of getting attention. Something is going on even if it is attention seeking.
Often depression underlies self-harm. However, things like generalized anxiety, panic attacks, social anxiety, and trauma or PTSD can be the driver of this behavior. Finding a teen counselor to address these underlying challenges while at the same time helping your teen and supporting you as parents is an important step to take.
Katy Teen & Family Counseling: 70+ Years of Combined Experience in Teen Therapy Katy, TX & Houston
As a parent of a teen who may be struggling with self-harm, finding a teen therapist who has the experience makes the difference. Things like depression, anxiety, social anxiety, panic attacks, ADHD, trauma or other challenges may be driving the self-harm behavior. times.
These challenges are complex and having someone who can help your teen and support you as parents is important.
At our Katy, TX location of Katy Teen & Family Counseling, we are ready to help. If you are ready to start, all you need to do is follow these three simple steps:
Contact Katy Teen & Family Counseling
Talk with one of our teen therapists
Begin the healing process today!
Other Therapy and Counseling Services Offered at Katy Teen & Family Counseling
At Katy Teen & Family Counseling, we provide a variety of therapy approaches that are supported by research and shown to be effective. Some of the teen therapy and young adult counseling we offer are:
Board Certified Neurofeedback Therapy
Peak performance (optimal academic brain performance)
Peak performance (optimal athletic brain performance)
Accelerated Resolution Therapy (ART)
Eye Movement Desensitization and Reprocessing (EMDR Therapy)
Group Therapy for Teens
Body Image
Cognitive Behavioral Therapy (CBT)
Couples Therapy & Marriage Counseling
Couples Therapy and Marriage Counseling can be very effective. The secret ingredients to success is each person willing to look at themselves and work to do things differently, together. When a marriage counselor or couples therapist has this to work with, the success rate can be very high.
Sometimes life will throw challenges at us that create situations that put strain on our marriage or relationship. It may be due to:
Choices and actions that have been made by one partner.
Financial downturn in the economy creating financial strain.
Feeling like you're growing apart.
Feeling like you don't have as much in common as you used to.
Whatever the reason may be, marriage counseling and couples therapy can help. Couples therapy and marriage counseling has also been found to work in less time than individual therapy.
If you've worked hard for this relationship and find that there are now barriers in the way of maintaining a healthy relationship, contact us at Katy Teen & Family Counseling.
About the Author
Jason Drake is a Licensed Clinical Worker - Supervisor (LCSW-S), Board Certified in Neurofeedback, EMDR trained, and a Certified Brain Health Professional through the Amen Clinics. He has provided therapy to teens, young adults, and families since 2003 and is the Owner & Lead Clinician at Katy Teen & Family Counseling and Katy Counseling for Men.
He specializes in leading teams of high performing therapists who also specialize in teen therapy, counseling young adults, and family counseling.
Jason is also a leader in the field of teen, young adult, and family counseling providing expert coaching and technical assistance to teen Residential Treatment Centers across the country.
Jason is also a regular contributor to various magazines and publications lending his expertise to various mental health related topics. You can check these articles out on our "Featured Articles" service page on our website.
He has also been a guest on Fox 26 Houston and on a podcast, "Grow a Group Practice" with Alison Pidgeon.
If you are ready to start teen counseling or young adult therapy call, text, or email us today!
Phone Number: 281-519-6364
