Understanding Adolescent Self-Injury and Accessing Help

When a parent learns that their teen is cutting themself, they are typically as confused as they are heartbroken. They are often aware their teen is "having a tough year" or "is a little out of sorts." Some parents report they had thought their teen was experiencing typical teen angst, and describe the emotional challenges they faced during their own adolescence. Nearly all the parents I have worked with feel ill-informed or equipped to parent a child who has cut themself, and are eager to better understand why their child has begun to intentionally self-harm. 

A recent article in the New York Times, Why Teenagers Cut, and How to Help , interviews Dr. Michael Hollander, director of Training and Consultation on the 3East Dialectical Behavioral Therapy Program at McLean Hospital in Massachusetts. In the article Dr. Hollander describes the function of self-harm. Specifically he reports that self-harm is a highly effective and dangerous coping skill used by individuals who are intensely emotionally dysregulated. Research indicates that adolescents most frequently self-harm either to sooth intense emotional distress or to "feel something" when they feel numb or empty. Although parents often fear cutting is an attempt to "get attention,"  this is rarely the primary motivation for an incident of self-harm.

The most critical response when an adult becomes aware that a child is self-harming is to ensure the child attains professional treatment as quickly as possible. Inform the child's parents, guardians, or social services immediately. Anything which delays treatment increases the risk for additional incidents of self-harm. "Do not suggest substitute behaviors for self-injury. Offering such advice, Dr. Hollander explains, can slide into the territory of treatment, and laypeople are not qualified to counsel or treat kids who self-injure, no matter how many books and articles they read."  

When looking for appropriate clinical services, be aware that the only evidence based treatment for adolescents who self-harm is Dialectical Behavior Therapy (DBT). Adolescent DBT not only provides comprehensive treatment for the adolescent, it also provides intense training and support for the parents. Parental involvement in the treatment of adolescents who are self-harming is critical, as it provides parents with the knowledge and support they need to help their teen begin to heal, physically and emotionally. 

To learn more read Why Teenagers Cut, and How to Help by Jessica Lahey at The New York Times. For a more in-depth understand of adolescents who are engaging in Self-Injurious Behaviors, I recommend Dr. Hollander's book, Helping Teens Who Cut: Understanding and Ending Self-Injury.