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What to do When a Child Self-Harms?

What is self-harm? Self-harm usually refers to non-suicidal self-injury. Common forms of self-harm include cutting, scratching, or burning the skin, as well as banging/punching objects or oneself. Self-harm can be done on any part of the body but is often done on the wrists and thighs. While it’s hard to know the exact prevalence, research indicates that about 17.2% of adolescents, 13.4% of young adults, and 5.5% of adults have engaged in self-harm. Self-harm behaviours are most common among youth.


Self-harm doesn’t always mean that a person is suicidal. Most often, children and youth self-harm as a way to cope with big emotions like sadness, anxiety, and anger. It’s hard to know what to do with big emotions. Sometimes, self-harm helps people distract themselves, other times, it’s used to externalize big emotions that are otherwise difficult to express.


The most common way parents find out children are self-harming is by noticing something like a cut or a scar. Sometimes, youth hide self-harm by wearing lots of jewelry or long sleeves, so marks might not be visible.




So, what if your child is self-harming? If you find out your child is self-harming, you’re likely going to experience a wide range of emotions. These feelings might range from shock, anger, and denial, to empathy, guilt, and sadness. All of these feelings are totally normal and valid.

Shock and denial. For many parents, it’s a shock to find out your child is self-harming. Children and youth who engage in self-harm are often secretive. At first, you might deny that this is something they’ve done. But, many people who self-harm already feel isolated and to deny that your child is self-harming is to deny them a chance to talk about it.

Anger and frustration. It’s normal to feel frustrated. Likely, that feeling comes from a place of love for your child. It’s tough, but it’s important to remember you can’t control another person. Likely, trying to do so will just make things worse.

Sadness and guilt. It can be hard to accept that your child might be experiencing physical or emotional pain. You might even feel like it’s your job as a parent to shield them from pain. Painful experiences are, however, part of life. All we can do is try to learn from experiences like these.


If we want to help children deal with big emotions, we need to deal with our own first. So whatever your initial reaction is, know that it’s okay. Consider taking a day or two to process your emotions. Addressing a child’s self-harm might feel urgent, but big emotions like shock, anger, and guilt can get in the way of healthy conversations.


How might my relationship with my child impact their self-injury? No person is responsible for another person’s behaviour and often, self-harm is the result of more than one factor. It is, however, important to recognize that parent-child relationships influence self-harm behaviours. Many youth who self-harm report that their parents are either unavailable to them, or that they invalidate their emotions. Alternatively, parents who seek to closely control their children’s behaviour risk undermining their children’s capacity to cope with adversity. So, it’s important to maintain open lines of communication, respect your child’s autonomy, and try to model healthy ways to cope.


How should I talk to my child about self-harm? Ask your child if it’s a good time to talk. Tell your child what it is that you noticed, then express your concern calmly. For example, by saying “I noticed some marks on your wrist and I’m worried that you might be self-harming”. Let them know you want to support them. Try your best to speak in a calm non-confrontational tone. If your child chooses to open up to you, validate their feelings. If they don’t, try not to pressure them. Instead, offer to connect them to resources and let them know you are available to talk when they’re ready.


What should I say? Asking direct questions can feel uncomfortable or even invasive, but it’s important to try to understand why your child might be self-harming. Some helpful questions include:

  • How does self-harm help you to feel better?

  • How do you usually feel before you self-harm?

  • How do you usually feel after you self-harm?

  • Is there anything that is stressing you out right now that I can help you with?

  • Do you know how to keep yourself safe when you self-harm? (e.g. aftercare).

If your child doesn’t wish to talk, let them know you are available when they’re ready. If your child expresses that they don’t feel comfortable talking to you, ask if they’re interested in speaking to a counsellor. This doesn't mean you've done anything wrong. Sometimes, it's hard to talk to the people we care about the most. 


What not to say? Try your best to avoid yelling, lecturing, threats, ultimatums, and privacy invasions. No matter how difficult it is to accept, demanding that your loved one immediately stops self-injuring is likely to be unrealistic and counter-productive. It might increase their negative emotions and make them feel more isolated.


Second thoughts mean a lot! If you mess up, it’s okay. You love them so much and the fact they are hurting is going to bring up big emotions for you. It makes sense. You can explain why you acted the way you did and apologize. This is a great way to model healthy communication skills. For example, a parent who yelled at their child about self-harm might say “I want to apologize for yelling earlier. When I found out you self-harmed I felt scared because I care about you. If you’re willing to talk, I‘d like to try again”.


For more information and resources on self-harm, please visit Cornell University's Self-injury & Recovery Resources (SIRR)


Consider seeking support, there are a lot of great resources in the community to help you and your child.

Tandem is a 24/7 child, youth, and parent mental health and crisis support line that supports families across Ontario.

CMHATV Crisis Centre provides walk-in support 24/7 to individuals (16+) experiencing a mental health and/or addiction crisis. They are located at 648 Huron Street in London.

Kids Zen offers specialized counselling services for children, youth, and families. Student sessions are offered at a discounted rate for families with financial need.


References

Laye-Gindhu, A. & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34, 447-457.

Valencia-Agudo, F., Burcher, G. C., Ezpeleta, L., & Kramer, T. (2018). Nonsuicidal self-injury in community adolescents: A systematic review of prospective predictors, mediators and moderators. Journal of Adolescence, 65, 25-38.

Swannell, S.V., Martin, G.E., Page, A., Hasking, P., & St. John, N.J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 2, 1-31.

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