Understanding Self-Injury
Most of us know about teens and cutting — how some use a sharp object like a razorblade, knife, or scissors to make marks, cuts, or scratches on their own body. But cutting is just one form of self-injury. Teens who self-injure also might burn, scratch, or hit themselves; bang their head; pull their hair; pinch their skin; pierce their skin with needles or sharp objects; or insert objects under their skin.
Self-harming is a serious issue that affects many teens. Like other risky behaviors, it can be dangerous and habit-forming. In most cases, it is also a sign of deeper emotional distress. In some cases, peers can influence teens to experiment with it.
The topic of self-injury can be troubling for parents. It can be hard to understand why teens (or even preteens) would hurt themselves on purpose, and worrisome to think your teen — or one of their friends — could be at risk. But parents who are aware of this important issue and understand the emotional pain it can signal are in a position to help.
About Self-Injury
When It Starts
People who self-injure usually start doing it during their teen years. Some continue into adulthood. In some cases, there's a family history of cutting or other self-harm.
Shame and Secrecy
A sense of shame and secrecy often goes along with it. Most teens who cut hide the marks and, if they're noticed, make excuses about them. Some teens, though, don't try to hide cuts and might even call attention to them.
How It Develops
Cutting often begins as an impulse. But many teens discover that once they start, they do it more and more, and can have trouble stopping. Many teens who self-injure report that it provides a sense of relief from deep painful emotions. Because of this, it's a behavior that tends to reinforce itself.
Important Distinction
Most of the time, self-harm is not a suicide attempt. But it can be easy to underestimate the potential to get seriously sick or hurt through bleeding, infections, or other problems.
Cutting and other self-harm can become a teen's habitual way to respond to pressures and unbearable feelings. Many say they feel "addicted" to the behavior. Some would like to stop but don't know how or feel they can't. Other teens don't want to stop.
Why Do Teens Self-Injure?
Teens self-injure for many different reasons. Understanding these reasons can help you provide better support.
Powerful Overwhelming Emotions
Most teens who do it struggle with powerful emotions. To them, it might seem like the only way to express or interrupt feelings that seem too intense to endure. Emotional pain over rejection, lost or broken relationships, or deep grief can be overwhelming for some teens.
- • Many are dealing with emotional pain or difficult situations that no one knows about
- • Pressure to be perfect or to live up to impossible standards — their own or someone else's — can cause some teens unbearable pain
- • Some have been deeply hurt by harsh treatment or by situations that have left them feeling unsupported, powerless, unworthy, or unloved
- • Some teens have experienced trauma, which can cause waves of emotional numbness called dissociation
- • For them, cutting and other types of self-harm can be a way to test whether they can still "feel" pain
- • Others describe it as a way of "waking up" from that emotional numbness
Physical Pain vs. Emotional Pain
For some, the physical pain can seem preferable to emotional pain. Emotional pain can feel vague and hard to pinpoint, talk about, or soothe.
- • When they cut or self-injure, teens say there is a sense of control and relief to see and know where the specific pain is coming from
- • There's a sense of soothing when it stops
- • It can symbolize inner pain that might not have been verbalized, confided, acknowledged, or healed
- • Because it's self-inflicted, it is pain they control
A Sense of Relief
Many teens describe the sense of relief they feel as they're cut or self-harm, which is common with compulsive behaviors.
- • Some people believe that endorphins might add to the relief teens describe when they self-injure
- • Endorphins are the "feel-good" hormones released during intense physical exertion and can be released during an injury
- • Others believe the relief is simply a result of being distracted from painful emotions by intense physical pain and the dramatic sight of blood
- • Some teens say they don't feel the pain when they cut, but feel relieved because the visible results "show" emotional pain they feel
Feeling "Addicted"
Cutting, especially, can be habit forming. Though it only provides temporary relief from emotional distress, the more a person cuts, the more they feel the need to do it.
- • As with other compulsive behaviors, the brain starts to connect the injury to the momentary sense of relief from bad feelings
- • Whenever the tension builds, the brain craves that relief and drives the teen to seek relief again by self-injuring
- • So it can become a habit someone feels powerless to stop
- • The urge to cut — to get relief — can seem too hard to resist when emotional pressure is high
Other Mental Health Conditions
Self-harm is often linked to — or part of — another mental health condition. Some teens are also struggling with:
- • Other urges, obsessions, or compulsive behaviors
- • Depression or bipolar disorder — can contribute to overwhelming moods that might be hard for them to regulate
- • Mental health conditions that affect personality — can cause relationships to feel intense and consuming, but unsteady
- • Intense positive attachments can suddenly become terribly disappointing and leave them feeling hurt, anger, or despair too strong to cope with
- • Personality traits that attract them to the dangerous excitement of risky behavior or self-destructive acts
- • Posttraumatic stress — has had an effect on their ability to cope
- • Alcohol or substance problems
Peer Pressure
Some teens are influenced to start self-injuring by another person who does it. Group peer pressure can play a role too.
- • Some teens cut in groups and might pressure others to cut
- • A teen might give in to group pressure to try it as a way to seem cool or bold, to belong, or to avoid social bullying
Any of these things may help to explain why a particular teen cuts or self-harms. But each teen also has unique feelings and experiences that play a role. Some might not be able to explain why they do it.
Regardless of what may lead a teen to self-injure, it's not a healthy way to deal with even the most extreme emotions or pressures.
Confronting Self-Injury
Some teens call attention to their self-injury. Or an injury might need medical attention, so others find out about it that way. But many teens cut for a long time before anyone else knows.
When Teens Reach Out
Some eventually tell someone about their self-injury — because they want help and want to stop, or because they just want someone to understand what they're going through.
It can take courage and trust to reach out. Many teens hesitate to tell others because they fear being misunderstood or worry that someone might be angry, upset, disappointed, shocked, or judgmental. Some teens confide in friends, but ask them not to tell. This can create burden and worry for a friend who knows.
How Teens May Respond
If confronted about the cutting, teens can respond in different ways, depending partly on the teen and partly on how they were approached about it.
- • Some might deny the cutting
- • Others might admit to it, but deny that it's a problem
- • Some might get angry and upset or reject efforts to help
- • Some teens are relieved that someone knows, cares, and wants to help
Stopping Cutting and Self-Injury
Whether or not anyone else knows or has tried to help, some teens cut for a long time before they try to stop.
Professional Help
Teens whose self-harm is part of another mental health condition usually need professional help. Sometimes cutting or another symptom leads to a teen's admission to a mental health hospital or clinic. Some teens have more than one hospital stay for self-injury before they feel ready to accept help for it or other problems.
Stopping on Their Own
Some teens find a way to stop self-injuring on their own. This might happen if they find a powerful reason to stop, get needed support, or find ways to resist the powerful urge to self-injure.
To stop, they also need to find new ways to deal with problem situations and regulate emotions that feel overwhelming. This can take time and often requires the help of a mental health professional.
The Challenge of Recovery
It can be hard for teens to stop cutting or other self-injury behaviors. They might not succeed at first. Some stop for a while and then start cutting again.
It takes determination, courage, strength — as well as support from others who understand and care — to break this powerful habit.
How Parents Can Help
1. Stay Calm and Non-Judgmental
- • Avoid reacting with anger, shock, or judgment
- • Stay calm and show that you care
- • Let your teen know you're there to help, not to punish
- • Express concern and love
2. Get Professional Help Immediately
- • Don't try to handle this alone
- • Contact a mental health professional right away
- • Look for therapists who specialize in self-harm and teen mental health
- • Consider family therapy as well
- • If there's immediate danger, go to the emergency room
3. Create a Safe Environment
- • Remove or secure items that could be used for self-harm
- • Monitor your teen's safety without being overly controlling
- • Ensure they're not alone in crisis situations
- • Keep communication open
4. Provide Emotional Support
- • Listen without trying to fix everything
- • Validate their feelings
- • Help them understand that there are healthier ways to cope
- • Be patient — recovery takes time
5. Learn About Self-Harm
- • Educate yourself about self-harm
- • Understand that it's a coping mechanism, not attention-seeking
- • Learn about treatment options
- • Connect with support groups for parents
Frequently Asked Questions (FAQs)
Q: Is self-harm the same as attempting suicide?
A: No, most of the time self-harm is not a suicide attempt. However, it can be dangerous and lead to serious injury or infection. Self-harm is often a way of coping with overwhelming emotions, while suicide attempts are about ending one's life. However, teens who self-harm are at higher risk for suicide, so it's important to take it seriously and get professional help.
Q: Why would my teen do this if they're not trying to kill themselves?
A: Self-harm is often a way to cope with overwhelming emotions. Teens may feel that physical pain is easier to manage than emotional pain. It can provide temporary relief, a sense of control, or a way to express pain they can't put into words. It's important to understand that it's a symptom of underlying emotional distress, not a character flaw.
Q: What are the warning signs of self-harm?
A: Signs may include:
- • Unexplained cuts, burns, or bruises
- • Wearing long sleeves or pants even in hot weather
- • Avoiding activities that show skin (swimming, changing clothes around others)
- • Finding sharp objects or first aid supplies in unusual places
- • Withdrawal from friends and activities
- • Emotional instability or mood swings
- • Expressions of hopelessness or worthlessness
Q: How do I talk to my teen about self-harm?
A: Approach the conversation with care:
- • Choose a private, calm time to talk
- • Stay calm and non-judgmental
- • Express concern and love
- • Listen more than you talk
- • Avoid blaming or shaming
- • Let them know you want to help, not punish
- • Don't dismiss their feelings
Q: Can my teen recover from self-harm?
A: Yes, with proper treatment and support, teens can recover from self-harm. Recovery often involves therapy to address underlying emotional issues, learning healthier coping strategies, and developing better emotional regulation skills. It may take time, and there may be setbacks, but with professional help and family support, recovery is possible.
🚨 Remember: Help is Available
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Emergency
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⚠️ Important Note
This article provides general information and is not intended to replace professional mental health advice. Self-harm is a serious issue that requires immediate professional attention. If you suspect your teen is self-harming, contact a mental health professional, your child's doctor, or a crisis hotline immediately. If there's immediate danger, call 911 or go to the nearest emergency room.