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Understanding Self-Harm: What Parents and Caregivers Need to Know

What is self-harm? Why would anyone hurt themselves? What do you do if someone you care about is self-harming?

Understanding self-harm is difficult for most people. Often, those engaging in self -harm, keep it a secret, because it causes them to feel shame and they are afraid of the reaction they will get if they share it with someone. The behavior is quite common with adolescents and young adults. Self-harm is confusing to parents and if they discover their child is self-harming, they don’t know how to react and don’t know how to deal with it properly. This is understandable, as it is difficult to understand why our loved one would want to hurt themself.

These are things I want to address in this article.

Hurting/Injuring yourself on purpose is the definition of self-harm. The most common method that comes to mind is cutting with a sharp object. But any time someone purposely hurts themself it is classified as self-harm. Other common methods of self-harm are burning, scratching, pulling hair, and banging the head against something such as a wall. Less common forms of self-harm are poke and stick tattoos, self piercing and even purging after eating.

Hurting yourself—or thinking about hurting yourself—is a sign of emotional discomfort. These emotions may grow stronger if a person continues to use self-harm as a coping mechanism. Self-harm is not in itself a mental illness; it is a need for better coping skills when emotional discomfort arises. It can however, indicate mental illness, such as bipolar disorder, borderline personality disorder, depression, and trauma to name a few. It is important that the root of the behavior is addressed and the person learns other methods of coping with their emotional pain.

Shame typically accompanies self-harm. People who self-harm may frequently have bandages, or bruises and may wear long sleeves, even when it is warm in order to hide their injuries. Having friends and family see scars caused by cutting or burning can be embarrassing. It can ultimately interfere with work, school and social events because trying to prevent people from seeing injuries can cause a person to pull away from those around them and avoid going to school, work and other social events. After self-harming, the guilt and shame can lead to more negative feelings, which may result in the person injuring themselves again. This kind of harm, shame, guilt cycle can become a dangerous pattern.

Self-harm typically occurs during adolescence and young adulthood and is more common than it may seem. It can happen at later stages in life, but is less common. People who have experienced trauma, emotional or physical abuse are more likely to self-harm. The urge to self-harm may be a result of anger, pain, anxiety or loneliness. When a person hasn’t developed the tools to deal with emotions, self-harm can become a coping mechanism. The pain of physical harm that occurs with self-injury stimulates the body’s endorphins (pain killing hormones), thus causing a rise in mood. Also, if a person doesn’t feel many emotions, they may use the pain caused by injury to feel something to replace emotional numbness.

Self-harm doesn’t automatically indicate someone is suicidal, however it is a sign of significant emotional pain that needs to be addressed. It is important to get treatment to address the underlying emotional pain. The behavior may be part of a serious condition. If someone you know makes comments about being hopeless or worthless, the comments should be taken seriously. If you are concerned a friend or family member is hurting themselves, ask them how they are feeling and make sure you are ready to listen. Be patient if initially they don’t want to talk about it, but don’t stop checking in with them to ask about their feelings. Self-harm is hard to talk about, but it is critical to let your friend or family that you want to help. It is very important that you do not dismiss the emotions or try to joke about it out of discomfort. Encourage them to get treatment and offer to help them find care if you can. Be gentle and try to not cause them to feel guilty, as that will increase the shame they are already experiencing.

There are effective treatments for self-harm that can help a person feel more in control of their emotions. Psychotherapy (talk-therapy) is part of the plan, but there are other therapies that may be recommended as well. Depending on the diagnosis, the following are some therapies that have shown to be recommended.

  • Psychodynamic therapy focuses on exploring past experiences and emotions
  • Cognitive behavioral therapy focuses on recognizing negative thought patterns and increasing coping skills
  • Dialectical behavioral therapy can help a person learn positive coping methods

In addition to therapy, medication may be prescribed to help with depression or anxiety. For example, someone suffering from depression may find that an antidepressant can lessen harmful urges. If symptoms are severe, your physician may suggest a stay in a psychiatric hospital for stabilization and allow time to focus on healing.

The first place to start in getting help is talking to a trusted person such as a parent, friend or counselor. They can help schedule time to talk with a medical professional who will discuss the self-harm behavior and the emotions driving the urge. Through a diagnostic interview, a treatment plan will be recommended for the individual to work on learning better coping mechanisms.