Cutting, burning, and other self-harm behaviors have become a scary teen phenomenon, especially among girls. Marriage and family therapist Joy Linn explains what motivates cutters and how their parents can help.
The reason teens engage in self-harm behaviors is because they’re having trouble dealing with something—some emotion, situation, or relationship—in their lives. Self-harm often makes them feel better in the short term. It’s just not a viable solution in the long-term.
That’s why therapy—whether in the office with a therapist or at home with family members—is so important. The whole point is to teach teens how to redirect the emotions and reactions that are driving these behaviors into healthier ways of coping.
The #1 question I get from parents is, “How do I stop them from hurting themselves?” The answer is simple but hard to digest: You don’t. Self-harm can cover a wide range of behaviors, from cutting to burning to attempts by teenagers to break their own bones. That’s what makes the behavior so difficult to contain. Even if you take away all the sharp objects a teen has access to, there will always be ways a person can harm herself, whether it’s scratching herself or banging her head against a wall. If someone really wants to hurt herself, there’s not really any way to stop her. And if you try to force her to stop, she may shut down completely and refuse to talk to you.
The #2 question I get from parents is, “Does self-harm mean my child is suicidal?” Self-harm and suicidal thoughts or intent aren’t mutually exclusive. Many people are suicidal without self-harming, or self-harm without being suicidal. But studies have shown that people who self-harm for years are more likely to commit suicide, so talking to your child or taking your child to therapy is definitely a good prevention. Some teens may actually self-harm as a way of choosing the lesser evil between self-harm and suicide, which it definitely is! However, since cutting or burning isn’t a viable long-term coping strategy, there may come a point where that’s not enough and a teen may consider more drastic actions.
The best way to help is to talk to your teenager. How you talk to her (or him) will depend on your relationship, but there are a few rules of thumb. If you approach her completely caught up in your own (understandable!) fears and emotions, the conversation isn’t likely to go well. Instead, take the time to deal with your emotions first, then approach your teen with a genuine sense of compassion and curiosity. Your goal is to get your child to open up about when and why and how she hurts herself, so you can help her figure out better ways to cope with whatever the situation is she’s facing.
There’s a wide range of reasons teens harm themselves. Sometimes it’s depression. Sometimes it’s feelings of low self-esteem or worthlessness. Sometimes it’s anger, directed either at themselves or other people. Sometimes it’s bullying online or at school. Sometimes it’s a way to fit in with a certain social group.
Many parents make the mistake of assuming it’s just a way to get attention. Approaching your teen with that assumption will likely make her feel as if she’s being attacked, rejected, or minimized. Self-harm does communicate that a person is suffering from emotional pain, and it’s important to take it seriously.
Another common but mistaken assumption is that teens only self-harm in areas where it’s obvious, such as on their arms. In fact, teens self-harm anywhere on their body that seems appropriate to them, and some people go to great lengths to hide it from other people.
Self-harm is a cry for help, though. Whether your teen needs help from you or from a therapist is up for you to decide together, but self-harm clearly indicates that he or she is struggling to deal with something.
Most teens who self-harm develop a ritual around it. At the beginning, these behaviors can be triggered by any number of situations. But after a while, people develop patterns of self-harm. They might always cut themselves with their favorite razor or burn with a favorite lighter, for example. This is when the behavior takes on an addictive quality and is even more challenging to change.
It can help to ask about the various steps involved and see if you can figure out which step is the most important. Can you make small amounts of progress by changing the ritual? Again, don’t let your emotions cloud your conversation here. If your teen can’t deal with his own emotions by any other method than self-harm, he probably can’t deal with your emotions either. And if you need help with your own emotions, consider talking to a therapist or a parenting coach on your own.
I wish parents wouldn’t say, “Why doesn’t my kid just stop cutting herself?” If it were that easy, no one would be in therapy! Self-harm is an addictive process. Our bodies release feel-good chemicals when we experience a physical injury. That process—emotional pain, physical pain through self-harm, physical pleasure through those chemicals—quickly becomes something a teen may repeat whenever she feels stress or some other trigger, until she actually can’t stop herself from doing it anymore.
Even so, parents should set reasonable boundaries, especially when there are other siblings in the house. It doesn’t work to forbid a child to self-harm, and if you take away her lighter, she’ll just get a new one—and hide it better. But it’s perfectly legitimate to ask her to not talk about it or self-harm in front of her younger siblings. Self-harm can be a very trendy behavior—we often see waves of it at the same school—so it’s easy for younger siblings to pick up the same behavior. Try talking to your teen and ask her for her thoughts on ways she can prevent her little brothers or sisters from imitating her behavior. After all, she doesn’t self-harm because it’s fun. She does it because she doesn’t have (or doesn’t think she has) a better option to cope with her situation, and she probably won’t want other people she loves to feel as hopeless as she does.
There are lots of ways to help teens find better outlets for their feelings. I often suggest that my patients write a long list of positive coping tools—like using distractions, exercising, or talking to a friend—and then do at least three of those coping tools before they self-harm. Generally, they get through three and start feeling better. But if they try their positive coping skills, and end up engaging in self-harming behavior anyway, I say, “Well, I guess you really needed it.” It’s not condoning the behavior; it’s just a way of being supportive and understanding.
It’s crucial for parents to recognize that there may be relapses, even when their child is in therapy and on the road to recovery. That doesn’t mean they’re back to square one. Sometimes teens will actually make pacts with one another to stop self-harming, which sounds good but can backfire if one of them slips. It’s better to leave room for making mistakes—recognizing that your child may go back to cutting or burning now and then, when emotions are really high—than to set unattainable standards. A wide variety of things can trigger self-harm, but they usually involve the teen feeling bad about herself, which is exactly what will happen if there’s a zero-tolerance reaction to short-term relapses.
During recovery, reminders are key. One solution I’ve seen kids use that I really like is to have their best friend draw something beautiful, like butterflies, on their arm with a Sharpie. There’s a similar physical element in getting drawn on as cutting themselves, but it’s also a reminder that someone loves them and is there for them. I’ve even had teens say, “I didn’t want to cut into the image because it was so beautiful.” I then remind them that—to everyone who loves them—their plain skin is beautiful too. Another teen I know keeps an inspirational note on his lighter, so he has to see it before he harms himself. Different things work well for different teens. But however you do it, be sure to remind your teen often that you love and support him or her.“
Photo: Stewart Black/Flickr