“Self-harming or what we in the mental health world label as Non-Suicidal Self Injurious (NSSI) behaviors are unfortunately very common,” says Dean Aslinia, PhD, LPC, NCC, the associate dean at the University of Phoenix College of Social and Behavioral Sciences Psychology and Human Services. “Research has indicated up to 20% of adolescents engage in these behaviors. While these behaviors tend to start around the age of 13 to 14, broadly speaking the greatest risk comes when the child is old enough to have access to or purchase the means of self-harm.” Most experts agree that the topic of self-harm is not something you should ignore—especially if you suspect that your child might be at risk for self-injury. But that can feel difficult when you’re not sure what self-harm could even look like. “What I can’t stress enough is the need for honesty and awareness,” says Laurie Singer, MS, LMFT, BCBA, a licensed psychotherapist, a board-certified behavior analyst, and a family/child therapist. “Many of the children I’ve worked with have been self-harming for years—yet their parents never noticed.” Here’s how mental health professionals suggest talking about self-harm with your kids based on their age.
What Parents Need to Know About Self Harm
For most young people, self-harm is an attempt to interrupt strong emotions and pressures that feel overwhelming or impossible to tolerate. In most cases, kids who self-harm have not learned other coping strategies so they turn to self-injury as a form of release. It also can lead to intense feelings of guilt and shame. “Self-harm can serve several different functions [for kids],” explains Leslie Crea-Kammerer, PsyD, a clinical psychologist at Advanced Psychology Services. “One of the most common is it serves as a release for tension or intense feelings. On the flip side, others use self-injury because they feel numb and it is a way for them to feel something. It can be a relief to feel anything, even something painful, versus feeling numb or disconnected.” Young people may even use self-injury as a way to feel more in control, says Leigh McInnis, LPC, a licensed professional counselor and executive director of Newport Healthcare Virginia. Triggers for self-harm can include things like exam pressures, attempting to cope with difficult family relationships, caring for siblings with physical or mental health issues, bullying, abuse, trauma, or exposure to self-harm by peers, she says. “Parents need to know that self-harm is not a mental illness, but rather a maladaptive behavior resulting from a lack of healthy coping skills,” says McInnis. “Self-harm is a child’s way of communicating that they are in emotional distress and that they need to learn healthier coping skills.”
Should You Talk to Your Kids About Self Harm?
When it comes to talking to kids about self-harm, parents sometimes worry that bringing up the subject will put the idea in their child’s head. The truth is, though, your child is going to hear about self-harm at school, through their peers, and on social media. But, if you are the one talking about the topic, you can debunk any myths, make sure your kids have the facts, and establish that they can talk to you about anything. “Kids are going to have access to social media and friends at school even if we try to shelter them from unpleasant topics,” says Kristen Souza, LMHC, a licensed mental health counselor with experience in parenting, anxiety, trauma, panic attacks, and more. “Letting your kids know that they can come to you about anything is the moral of the story. You also want them to come to you if they suspect a friend or peer engaging in self-harm and know that you will be able to help.” Keep in mind, though, that self-harm does not necessarily mean a person is suicidal or wants to die, says Dr. Crea-Kammerer. Likewise, she says this is not often a behavior that kids will “grow out of.” “People who self-harm frequently think about doing it or feel the urge to do it, even when they are not engaging in the behavior,” she says. “Also, the more shame and guilt they feel around it, the more likely they are going to be to want to keep it hidden and not address it.” For this reason, parents need to not only talk about self-harm in an open and honest way but also learn to recognize the signs of NSSI behavior, says Dr. Aslinia. Sometimes parents do not realize their kids are engaging in self-harm until the injuries become severe and require hospitalization, he adds. Talking about the topic may help prevent kids from self-harming. It can also give you a chance to bring the issue to the surface, allowing you to connect your child with a mental health professional.
Talking About Self Harm With Preschoolers
Preschoolers may not understand the concept of self-harm, so you need to consider your word choice and opt for age-appropriate terms. For instance, you might talk about the idea that sometimes people hurt themselves when they are upset—like a classmate that bangs their head against the wall or pulls their own hair.
Unexplained cuts, scratches, bruises, or other wounds, often on the wrists, arms, thighs, or torso, which they may explain as the result of accidentsWearing clothes that cover up the skin, such as long sleeves or long pants, even in hot weatherImpulsive and unstable behaviorExpressing feelings of hopelessness or worthlessnessBlood stains on bedding, clothing, towels, or tissuesHaving sharp objects in their possession, including razors, safety pins, nail scissors, knives, needles, shards of glass, or bottle capsSpending long periods of time alone, often in the bathroom or bedroomIncreased isolation and social withdrawalAvoiding situations in which they need to reveal skin, such as swimming or changing in a locker room
Explain that there are other ways to deal with these big emotions rather than hurting themselves. Then, talk about strategies for coping with their feelings in a healthy way. You may even try role-playing how to handle something that makes them angry or sad. “[With preschoolers], I recommend starting with basic conversations about feelings—what we feel and how we feel it in our bodies, how we express feelings, and how we try to manage feelings in different ways,” says Dr. Crea-Kammerer. “If preschoolers engage in self-harmful behaviors when upset or observe another child doing so, it is a great opportunity to acknowledge that sometimes people do that because they have very big feelings.” It is also important to be honest with your child—never lie or hide pertinent information, even though they are young, says Dr. Aslinia. This doesn’t mean that you scare them or provide more than they need to know, but you should not try to shelter them. “While a parent may feel they are ‘protecting’ their child from unhealthy information, they are likely to come across this knowledge from their peers. Unfortunately, this information is often laced with misinformation,” says Dr. Aslinia. “It’s much more productive for parents to provide correct and helpful information [in an age-appropriate way].” Where you can make the biggest difference at this age is teaching your child how to handle feelings like sadness, anger, loneliness, and frustration, says Singer. Also, let them know that having emotions is part of being human. “When we’re young we often feel that everything that’s happening to us is only happening to us,” she adds. “We don’t have the breadth of experience to understand that certain feelings aren’t unique. Oftentimes, it’s just a matter of providing [your] child with the tools to calm down when they’re feeling out of control and [teaching them] to put things in context.”
How to Talk About Self Harm With Grade Schoolers
By the time your kids are in grade school, they may have heard about self-harm on the news, on the Internet, or through a friend. With this in mind, you can test out the waters. Broach the topic by asking your child if this is something they have heard of or seen, says Singer. You also could try reading something together on the topic and then discussing it in a non-judgmental way, she says. “If you want to assess their awareness about [self-harm], approach the topic with curiosity and questions,” suggests McInnis. “Choose a time and place when you know your child is comfortable talking freely, such as during a family meal or while in the car after school pick-up.” She also recommends bringing the topic up more than once so your kids have time to think about it and process their own reactions. Use terms that your child can understand and discuss self-harm in a nonjudgmental and caring way. “Maybe say that some people engage in self-harm because they don’t know how to manage what they are feeling inside,” she suggests. “Then, discuss the ways you and they can deal with unpleasant emotions in a healthier way, like taking deep breaths or going for a walk outside.” With grade schoolers, Dr. Aslinia recommends parents establish a routine practice of asking their children how they are feeling and what they are hearing or learning at school. Doing so may open the door to a deeper conversation. It also allows you to gauge how your child is feeling and if there is anything that needs to be addressed. “I always say a good time to bring up tough topics is when a real-life example presents itself,” says Souza. “If you notice your child experiencing big feelings and you feel comfortable with their level of understanding, bring it up. [Say something like] ‘I know you’re feeling sad right now and it’s OK to feel sad sometimes. What can you do when you’re sad to feel better?’”
Talking With Your Preteen or Teen About Self Harm
By the time your child is a preteen or teen, they are likely familiar with self-harm. They may have even considered it themselves. Consequently, when talking to them about the behavior, limit the lectures and judgment. Instead, strive to be calm and conversational, says McInnis. Lead with curiosity and ask questions. “Tell them you read an article about self-harm and wondered if they knew what it was,” she says. “Talk to them about why people do this and [offer] some of the healthier ways we can manage our feelings and emotions. Ask them what they do when they get upset.” Also, actively listen to what your child is saying, avoid interrupting them, and let them speak freely without reacting, says Singer. This approach is especially important if your child has thought about self-harming or if they admit to self-harm. “The most important part of any conversation from a parent to a child should always communicate care and love,” says Dr. Aslinia. “Meaning, whatever questions or information the parent is sharing with their child, it should always communicate to the child that the parent loves them and wants to ensure their safety and healthy environment [so they can] continue to thrive.” He also suggests being careful not to shame or bring about feelings of guilt. Validate their feelings and refrain from punishing them. Instead, find them the help they may be seeking. And, do not be afraid to ask hard questions or even talk about self-harm, he says. “[But do not] ask ‘why’ questions, as they will seldom produce the explanations you are looking for,” Dr. Aslinia says. “Instead, ask what you can do to help them feel better.” And finally, remember that avoiding conversations about self-harm is unlikely to shield your preteen or teen. It’s more likely to allow them to develop more difficult feelings or beliefs related to the practice on their own, adds Dr. Crea-Kammerer. Not talking about it could lead them to view it as something shameful to keep hidden. “It is always better for a child to learn from their parent about the risks of self-harm and alternatives to this form of coping than to learn from a peer who may be engaging in this behavior, or from social media where the behavior may be glorified,” says McInnis.
A Word From Verywell
Discussing self-harm can feel challenging and overwhelming at times. But rest assured that it is not what you say as much as how you say it. As long as you are communicating love and support to your child as well as establishing that you are someone they can trust, you will accomplish your goal. Likewise, you may be able to prevent self-harming behaviors in your kids by having conversations early and teaching them to recognize their feelings and cope in healthy ways.
Is anything worrying you?Is there anything making you scared or concerned?Are you feeling sad?Have you been or seen someone be bullied?Do you feel safe?
If despite your efforts, you find that your child is still struggling with managing their emotions, you may want to talk to their pediatrician or connect them with a mental health professional. These practitioners can help your child learn healthy methods of coping so they do not resort to harming themselves in some way.
