Help! My Child is Self-Injuring, and I Do Not Know What to Do!

Jessica del Rosso, Registered Social Worker #834108 is a Registered Social Worker at MyLife Counselling in Guelph. She works with adults and youth to support them with ADHD, Autism, Trauma, Self-Harm, Eco Anxiety. Learn more about Jessi here.

Help! My Child is Self-Injuring, and I Do Not Know What to Do!

If you are a caregiver who has discovered your child is self-injuring and you are unsure of the next steps, this article is for you. You are already doing the right thing by learning and asking questions. Especially in a situation where you may feel afraid or even a little bit frustrated and helpless.

Self injuring among pre-teens and teens is not an uncommon behaviour and unsurprisingly, researchers and mental health facilities saw a steep incline during and after the Covid -19 pandemic. Often times, self injury is not about the injury itself. Self-injurious behavior is often coping strategy teens develop as a means of trying to manage an internal or external trigger (a stimuli that causes significant emotional stress that overwhelms the nervous system). Self-manipulation releases several different hormones, adrenaline and endorphins being the two most well known. These hormones can help reduce feelings of numbness or anxiety in the short term. However, the individual will then often feel guilt or shame, which can continue the cycle of self injury.

Examples of external triggers may include; bullying at school, struggling to keep up with peers, not having many friends, being involved in too many after school activities, high external pressures, high conflict in the home, abuse or trauma, overwhelming social and/or political events that are not discussed or processed.

Examples of internal triggers may include; undiagnosed mental health struggles, gender identity and sexual orientation processing, emotional impact of isolation or bullying, abuse, or trauma, feeling “not good enough,” feeling chronically disassociated, feeling abandoned, experiencing suicidal ideation

Humans will often return to patterns of behaviour that serve them in some way. Even if the behaviour causes long term complications or repercussions, if it offers short term ease, our brain will lead us to thinking about using that coping strategy first before other ones. In addition, if we try to change coping behaviour, but do not have another behaviour to swap it out with, we set ourselves up to regress on the behaviour we are trying to move away from. While the long-term goal is to assess why your child is self-injured in the first place, there are other priorities that need to be managed first.

The most ordinary form of self-injury is known as cutting (taking a sharp item against parts of the body to make scratches or cuts). However, other forms of self injury may include; over or under eating, excessive working out, burning, pulling out hair, risky behaviour that can lead to injury, self hitting or hitting self against hard objects.

It should be noted that social media has been linked to an increase in self injury among teens. In addition, LGTBQ+ youth are at a higher risk of self injuring than the average youth.

STEP ONE: Do not respond with anger or shame.

It can be scary when your child discloses to you that they are self-injuring. Or, if you accidentally discover that they are doing so. However, it is particularly important not to respond to the situation with anger or by shaming the child. Neither of these responses create an environment for discussion and curiosity. In order to understand what is causing the youth to feel overwhelmed to the point of self injury, caregivers need to approach the conversation with understanding, not making it about themselves and their feelings about the child self injuring (utilize partners, friends or a therapist for this processing) and genuine curiosity. It is important to acknowledge and validate the feelings your child is communicating to you. If they disclosed their self injury to you, provide praise for this act of vulnerability and trust on their end.

STEP TWO: Ask Questions and Assess Immediate Safety

All caregivers should have basic first aid training. If your child is willing to show you their injuries, assess the cleanliness of the wound and if it needs medical attention. If they are not willing, taking the child to the ER may be needed. If you are in a situation in which the child refuses to show you the injury and refuses to seek medical care, police may need to be called a last option. There may be a friend or other trusted adult or parent who can convince the child to seek medical attention before police need to be called.

Gather all sharp objects and items that could lead to harm. Ask your teenager if they are experiencing suicidal thoughts and if they want to further hurt themselves. THE ANSWER MAY BE NO. This is because, self injury is not always indicative of suicidal ideation. As mentioned above, there may be other triggering stimuli leading the youth to self injuring as a form of coping.

STEP THREE: If Safety is Established, Create a Safety Plan

Before delving into creating a safety plan, it is good to use H(hungry), A(angry), L(lonely), T(tired) acronym to assess if other basic needs to ensure the best possible headspace to have the continued difficult conversation.

A safety plan is a plan that is agreed upon and shared between the kiddo, caregivers and/or other trusted individuals when the teen is wanting to self injure in the future. There are several safety plan-outlines available online for free. It is important for the youth to be a part of the process of creating the safety plan, so they feel like they have responsibility for their own safety.

In general for a safety plan it is helpful to have it include easy access to: phone numbers to call or text when the youth feels like they are struggling, several options for safe locations for the youth to physically go to if they want to change their environment, A list of coping strategies to try and a plan of what to do if self injury occurs.

STEP FOUR: Follow-Through

It is important as a caregiver; you follow through with the agreements of the safety plan. It is also important to establish, communicate and follow-through when it comes to nonnegotiable safety concerns such as deep cuts, increased or worsening self injury or self injury that is combined with suicidal ideation or attempts.

Following through with safety plans and safety protocols communicates to your child that they can trust you to step in and be competent. It teaches them to know what to expect based on conversations had with you and the safety plan agreed upon. If follow-through does not happen, it can add increased stress. This is because it creates a level of unknown for the youth as to what the next steps are. It also undermines the point of a safety plan, making the child less likely to take it seriously.

STEP FIVE: Get Support

A trained mental health support person is one of the best supports to add to the toolbox of supporting your child with self injury. Meeting with a therapist who specializes in self injury and working with youth is a good starting point. Book yourself and your child an introductory session with the therapist first, to ensure your child connects with the therapist.

A good therapist will be able to provide additional resources and support for you and your child. No parent or child needs to navigate this alone.