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See My Pain: When Teens Self-Harm

According to the Centers for Disease Control and Prevention (CDC), one in four teenage females participates in self-harming behaviors in any given year; for males the rate sits at one in 10. As defined by the Mayo Clinic, self-harm or self-injury is the act of deliberately harming one’s own body, such as cutting or burning and is typically not meant as a suicide attempt. While it is not considered a disorder, self-harm is a sign of emotional distress. This March, as part of Self-Injury Awareness Month, it is important that parents educate themselves on self-harm and ways to help children who are struggling emotionally.

“When we see kids in the clinic who self-harm, the first thing we try to establish is the ‘why,’” said Caleb Cauthen, LPC, outpatient therapist for Canopy Children’s Solutions. “Some say it is a way of feeling in control when they are surrounded by a chaotic situation, others feel numb and self-harm allows them to ‘feel’ something. Others have used it as self-punishment or a distraction from something they are having trouble dealing with in their life. Some self-harm simply because they can’t find the words to express the pain they feel inside so they injure to replicate it on the outside. It is different for each person.”

The National Alliance on Mental Illness (NAMI) says that common acts of self-harm include cutting with sharp objects such as a knife or razor blade, as well as burning, picking at wounds to prevent healing, and pulling out hair. In extreme cases, injuries can result in broken bones and even death. These types of behaviors are often the result of a lack of appropriate coping skills and can be an indicator of underlying mental health challenges such as anxiety, depression, eating disorders, or post-traumatic stress disorder (PTSD). Because self-harm is an impulsive act, it is most common among teenagers and young adults because their prefrontal cortex—which controls judgment, impulse control, emotional regulation, planning, and reasoning—hasn’t fully developed. During these formative years, it’s increasingly important for parents to be aware of potential signs and create open lines of communication with their child to know when he or she is in distress.

Warning Signs of Self-HarmSelf-harm can be difficult to overcome without professional help because of the way self-harm affects the brain. When the body sustains injury, the brain releases endorphins to combat the pain—similar to the effects of substance use. With each injury, the body becomes more resilient to the injury requiring more significant harm to receive the same endorphin outcome. Self-harm provides a short-term relief of tension or emotional pain but regularly returns which perpetuates the cycle of self-injury.

If you suspect that someone is self-harming, the way you respond is critical. Take the threat seriously but avoid lecturing, yelling, blaming or put-downs. Allow the child to speak openly and honestly with you and take time to listen without interruption. Don’t ignore these behaviors as a ploy for attention. Even in attention-seeking events, the child is resorting to dangerous measures to get someone to see and listen to them. Thank the child for being open with you and assist them in seeking professional help. Remind the child that no matter what, you are always there to protect and support them.

Avoiding self-harming behaviors starts by creating positive coping skills in children at a young age. Make open conversation about good and bad feelings a regular occurrence. Model appropriate coping skills for children such as exercise, meditation, deep breathing, writing or drawing. Above all as parents, remind your child that it’s “ok to not be ok,” and work with them to connect with appropriate help that meets their emotional needs.

ABOUT CANOPY CHILDREN’S SOLUTIONS Canopy’s mission is to help children thrive and families overcome extraordinary challenges by providing a comprehensive continuum of behavioral health, educational, and social service solutions. To learn about Canopy’s array of child-focused programs, call 800-388-6247 or visit mycanopy.org.

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