My teen is hurting themselves. What do I do?
As a therapist, I have encountered many challenging and heartbreaking situations throughout my career, but one issue that is uniquely distressing for families is self harm behaviors. It's a distressing and complex phenomenon that demands our attention, understanding, and compassion. In this blog post, I aim to shed light on self-harm in teens from a therapist's perspective, offering insights, guidance, and hope for those who may be struggling with this issue.
The Reality of Self-Harm
Self-harm refers to deliberate acts of inflicting physical harm on oneself as a way to cope with emotional pain, overwhelming emotions, or distressing situations. It's important to understand that self-harm is not a suicide attempt, and is not necessarily correlated with suicide risk. Rather, self-harm is often a misguided coping mechanism. Common methods of self-harm include cutting, burning, scratching, hitting, or biting oneself. It's crucial to recognize that self-harm is a symptom of underlying emotional turmoil, and addressing the root causes of these behaviors is key to helping our teens find better alternatives.
Understanding the Triggers
To effectively help teens struggling with self-harm, therapists must delve into the underlying triggers and emotional struggles that lead to these behaviors. Self-harm is often a desperate attempt to release emotional pain, regain control, or communicate distress when words fail. Common triggers include:
Emotional Pain: Many teens who self-harm are grappling with intense emotional pain, such as depression, anxiety, trauma, or unresolved grief. They may lack healthy coping mechanisms and resort to self-harm as a temporary release.
Low Self-Esteem: Teens experiencing low self-esteem may use self-harm as a way to punish themselves for perceived failures or inadequacies. It can be a way to reinforce negative self-beliefs.
Communication Difficulties: Adolescents may struggle to express their feelings and emotions verbally. Self-harm can become a non-verbal way to signal their distress to others. It also can be a complex way that teens try to get their needs for connection met.
Peer Pressure and Bullying: The pressures of fitting in and dealing with bullying can be overwhelming for teenagers. Some may turn to self-harm as an outlet for their pain and frustration.
Control and Release: Self-harm provides a sense of control in moments of chaos. For some teens, the act of self-inflicted pain offers a fleeting sense of relief and clarity. Having control over hurting themselves, as strange as it sounds, can be a way that some teens are able to exercise control over their bodies.
How Do We Treat This?
As therapists, our primary goal is to create a safe and non-judgmental space where teenagers feel comfortable being able to openly and honestly report both their self harm behaviors, and discussing their struggles and emotions. Here are key components of our therapeutic approach:
Building Trust: Establishing trust is paramount. Teens must feel that they can confide in their therapist without fear of judgment or reprisal.
Psychoeducation: Educating teens about self-harm, its consequences, and healthier coping strategies is essential. This can empower them to make informed choices.
Exploring Emotions: Encouraging teens to identify and label their emotions can help them better understand their triggers and develop emotional regulation skills.
Family Involvement: In many cases, involving the teen's family in therapy can be beneficial. It can help address family dynamics and provide a supportive environment for healing.
Safety Planning: Collaboratively developing a safety plan is crucial. This plan should outline alternative coping strategies and emergency contacts in case of relapse.
The Role of Self-Harm Alternatives
As therapists, we guide teens toward healthier coping mechanisms to replace self-harm. Encouraging them to explore and implement these alternatives is essential:
Mindfulness and Relaxation: Teaching teens mindfulness and relaxation techniques can help them manage emotional distress without resorting to self-harm.
Creative Expression: Encouraging creative outlets like art, journaling, or music can provide a safe and expressive way to process emotions.
Physical Activity: Engaging in physical activities like sports, yoga, or hiking can release endorphins and serve as a constructive way to cope with stress.
Healthy Social Connections: Encouraging teens to build positive social connections can be immensely beneficial. Friendships and support networks provide emotional support.
Therapeutic Tools: Providing teens with tools such as a journal for emotional expression, a stress ball, or a fidget toy can help redirect their immediate impulses toward self-harm.
The Importance of Patience and Resilience
Navigating self harm with your teen can be exhausting and scary. Progress may be slow, and setbacks are common. Here are some tips to keep in mind in discussing these behaviors with your teen:
Non-Judgment: While easier said than done, parents should try to avoid judgment and maintain a compassionate stance, even in the face of relapse.
Set Realistic Goals: Progress may be incremental, and it's crucial to set realistic goals while celebrating even small achievements.
Addressing Underlying Issues: Continue to support your teen while they explore and address the underlying emotional struggles, as they are key to long-term recovery.
Collaboration: Collaborate with your teen’s care providers. Helping you teen get set up with a therapist who specializes in risky behavior in adolescents is key to your child receiving evidence-based, effective care.
Self-harm among teenagers is a challenging issue that requires empathy, understanding, and professional guidance. As therapists, our role is to create a safe and supportive space for teens to explore their emotions, develop healthier coping mechanisms, and ultimately find a path to recovery. We also get to support parents in navigating their emotions regarding these scary behaviors, and provide tools and skills that parents can implement at home. It's a journey that demands patience, resilience, and unwavering support, but with the right therapeutic approach, teens engaging in self-harm behavior can learn to navigate their emotional struggles and build a brighter future.
Here’s to recovery,
Dr. Ann