Self-Harming Behaviors in Children and Teens

What does it mean when children self-harm?

Children who self-harm deliberately injure their bodies in a way that leaves marks or causes damage. It may also be called self-injury, self-mutilation, self-inflicted violence, self-destructive behavior, and self-abuse. Children who self-harm do not want to die. They just want to hurt themselves. Examples of self-harm include:

• cutting, biting, or scratching until their skin is broken and bleeds
• head banging or hitting themselves hard enough to cause bruises
• burning their skin using heat, chemicals, or cigarettes
• pulling hair from their scalp or eyebrows
• pulling off their fingernails or toenails
• picking at scabs continually until they bleed and the sore does not heal
• putting foreign objects under their skin
• swallowing poisons

Why would my child self-harm?

Children may be trying to:

• distract themselves from something that they feel they cannot stand
• express feelings they can’t put into words
• feel something, instead of feeling numb
• help them feel in control
• release stress and tension
• relieve guilt or get revenge by punishing themselves

This sense of relief does not last long. The next time they are faced with intense emotions or emotional numbness, they are likely to self-harm again to escape and feel better. Children who self-harm may be at a higher risk for suicide due to acting on impulse and the danger of certain self-harm behaviors.

How are self-harming behaviors treated?

The following can help reduce symptoms:

• medicines, especially for symptoms of anxiety, panic, depression, or obsessive thoughts
• short-term, structured time in the hospital if your child is seriously hurt or thinking of suicide
• day treatment programs, including structured activities and group therapy
• therapy that helps your child identify, express and manage feelings
• therapy that helps your child feel cared about and understood
• learning different ways to cope, such as things to do other than self-cutting when under stress
• treatment for any alcohol or drug abuse problems

One type of therapy that may help is Dialectical Behavior Therapy (DBT). DBT teaches how to manage unbearable situations in a healthy way instead of self-harming. DBT teaches children how to deal with stress, regulate their feelings, and how to validate their feelings. Many mental health centers and therapists provide DBT. The therapist can help your child learn safer, alternative ways to communicate, self-soothe, and cope. Journaling, art therapy, relaxation techniques, and physical exercise may be useful to replace self-harm behaviors.

What can I do to help my child?

Here are some things that you should avoid:

• thinking that your child is just trying to get attention
• yelling or shouting at your child
• blaming or insulting your child, such as "Why are you being so stupid?"
• saying "You wouldn't do this if you loved me"

The following behaviors could be helpful if your child has self-harmed:

• Develop trust by not judging your child. Quietly listen to what your children tell you and try to understand what they are feeling. Repeat back what you are hearing them say to you. Tell them that what they are feeling is understandable. Tell your children you want to help them and support them.
• Give your child information about places such as local community mental health centers, therapists, or online support sites that can help them.

If children threaten to commit suicide, do not leave them alone. Seek help immediately.