What is Non-suicidal self-injury (NSSI) or self-harm? What are some signs of self-harm?
Non-suicidal self-injury (NSSI), or otherwise known as “self-harm”, is defined as “deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned (Diagnostic and Statistical Manual of Mental Disorders 5th Ed.). Self-harm covers a wide range of behaviours, including
Cutting with sharp objects - commonly razor blades or scissors
Scratching and picking skin
Pulling out hair
Drug misuse and overdose
Teens who engage in self-harm can feel tremendous guilt and shame around their behaviours. Many will attempt to hide it from loved ones, not knowing how others will react. There are some signs to be aware of if you suspect your teen is engaging in self-harm.
Cuts/scars/bruises on arms, stomach or legs
Attempts to hide the body - ex. Wearing a sweater in the middle of summer.
Finding sharp objects such as razors, scissors.
Unexplained or poorly excused injuries
Difficulties handling emotion
Change in school grades
Self-harm can be a problem for all teens. The dangers of self-harm extend beyond those teens who engage in the behaviour. Friends of those teens may feel extremely troubled by their behaviour. In addition, some teens will be more likely to turn towards self-harm if they witness their friends engaging in the behaviour.
Why do teens turn to self-harm? Which teens are most at risk?
There is a common misconception that self-harm is directly related to suicidal ideation and attempts. The key difference is the motivation. Most of those who engage in self-harm want to feel better, reduce or escape their emotions, not end their life. In some cases, especially in those with depression, they may feel worthless, and think about death but not have intentions to die. If someone is at immediate risk of harming themselves, they should be taken to the hospital.
The motivations and reason behind self-harm are complex and difficult to understand. It can vary greatly depending on the individual. In order to support someone who engages in self-harm to address the underlying issues. Some reasons behind self-harm behaviour include:
Reduce anxiety or depression
To cope with overwhelming emotions (sadness, anger, guilt, shame)
To punish self (negative view of self, self-hatred, low self-esteem)
To reduce the feeling of numbness to “feel something”
Peer pressure or modelling (learning from others who self-harm)
Reaction to trauma or painful experiences
Perfectionism - fear of and inability to deal with failure.
All teens can be at risk for self-harm behaviour. If your teen is experiencing any of the following, they have an increased risk of self-harm behaviour:
Losses (deaths, end of relationships)
Poor coping skills
Exposure to self-harm behaviour in peers
How do I help my teen?
If your teen is engaging in self-harm behaviours or if you suspect that they are, it is important to seek help. This ensures that the situation does not escalate and results in more serious injuries.
As a parent, you may feel uncomfortable when you discover this about your teen. You may feel sad, angry, shocked, scared, confused, guilty amongst many other feelings. It is important to process these feelings in order to properly support your teen.
Learn as much as you can about self-harm behaviour. The most important thing is to address the underlying issues. This article is a good place to start but be sure to check out some resources listed below.
Talk to your teen, but approach with caution. Your teen may deny the behaviour. They may become angry, or sad. Express your concerns, and ensure they have your full support. Ask them questions about why they are self-harming. Encourage them to seek professional support.
What kinds of treatment are used for NSSI or self-harm behaviour?
Sometimes self-harm behaviour is tied to a mental illness. Medication can be used as a form of treatment for symptoms of depression and/or anxiety.
Therapy is crucial in addressing the behaviour and its underlying issues. In addition, therapy can help regulate emotions, and introduce new coping skills.
Two commonly used methods of therapy include Cognitive Behavioural Therapy (CBT) and Dialectic Behavioural Therapy (DBT). CBT focuses on understanding and changing thoughts, behaviours and emotions. DBT emphasizes balancing acceptance and change.
Non-suicidal self-injury (NSSI) or self-harm is intentional self-inflicted harm to the body: often in the form of cutting, hitting, scratching of the self
Signs of self-harm include: cuts, scars, bruises, attempts to hide the body or changed behaviour.
Teens engage in self-harm to deal with overwhelming emotions, reduce feelings of numbness, or to punish themselves
Teens who face abuse, bullying, mental illness, and substance abuse are more likely to engage in self-harm
Parents can help their teens by dealing with their own emotions, learning about self-harm and having supportive conversations.
Medication and psychotherapy are two methods to address self-harm behaviours