My Teen is Self-Harming and I am Scared. How Do I Talk to Them About It?

Finding out your teen has intentionally hurt themselves can be an unnerving, perplexing and scary experience. When you realize self-harm is taking place, it can be easy to connect it to concerns around suicide, and our minds often go to the worst case. This fear is instinctive and biological. Our parental concern, combined with teens’ occasional colloquial use of language around suicide, for example, “If I don’t pass this test I will kill myself,” can make these moments all the more confusing.

If this resonates with you, I encourage you to keep reading to find tips on how to navigate and hold space for conversations with your teen around self-harm.

Note from Jessica Zeyl, Toronto Counseling Centre for Teens Clinical Director: Jennie has done a beautiful job covering this topic. This is an important and prevalent subject. It’s also a topic that is a bit tricky to cover well in this format. There are a lot of nuances we consider as therapists when we are assessing a teen who is self harming and/or potentially suicidal. And those nuances have a great impact on how we respond. A blog article is important to produce on this topic but it doesn’t recreate those nuances for you as a parent. So we would recommend caution as you assess this and to trust your intuition as you navigate this with your teen. Our advice is meant to come alongside your instincts as a parent and it isn’t meant to replace it.

Tip #1: Identifying Self-Harm’s Function: Suicidality Versus Coping

Seeking clarity around your teen’s intention behind their self-harm behaviour is vital. This means determining if there is suicidal intention, or if they are using self-harm as a means of coping. This conversation is best led with directness and calmness. You might consider asking, “Were you thinking about ending your life when you did this?”. If they respond with no, accept their response and focus on their emotions, or what was happening for them in the moments before self-injury.

If your teen is struggling to articulate the why, you can prompt them with the following options. Was there:

• an overwhelming pain or emotion

• a sense of numbness and a desire to feel something

• an urgent need for distraction

• a drive to punish themselves

• a need to express something they are unable to articulate

When self-injury is not connected to suicidal thoughts, we call this Non-suicidal Self Injury. But if this conversation leads your teen to share thoughts of suicide with you, a therapist can support your family through next steps, including safety planning for your child. If your teen is at immediate risk, you can take them to the nearest emergency room.

Note: Everyone from time to time is dishonest about the depth of their struggles. This can happen for a wide range of reasons. There is a possibility that your teen could be suicidal and not know how to talk about that or disclose that. Here’s where it’s really important to stay grounded (anxiety is understandable, but it can add confusion to the mix), stay attuned and trust your gut.

Tip #2: Starting the Conversation: The Power of Curiosity and Compassion

In starting conversations with teens around self-harm, my suggestion is to lead with a sense of compassion and curiosity. The reality is that your teen is dealing with something intense and painful enough for them to use self-harm to manage the situation. Using questions guided by love and curiosity can help reduce the sense of shame your teen may feel about their behaviour. This can be modeled by patience, and by reflecting back to the teen what they shared. To reflect back to your teen, you might use sentences that begin with, “So what I’m hearing from you is…” The intention is to understand how it feels for them, rather than to “fix” things or tell them what they need to do.

Conversations that come from your fear, or your desire to “fix,” though they come with good intentions, can lead your teen to mirror these feelings. This may cause more harm or shame in a teen. Remaining curious and compassionate, and practicing our reflection skills when we need more clarity from our teen, will help you navigate these emotional conversations.

Note: The first time you try to have this conversation, it is normal for a teen to walk away or get angry in the moment. It may trigger a feeling of shame, or they may be scared you will take away the method that has helped them cope. Rest assured, you have started the conversation and that is always the right first step, even if it feels like the conversation has gone south. If there has been a disconnect or a rupture, check out the blog, Rupture and Repair for more information.

Tip #3: Leaving Space for the Other Parts of Your Teen

In the initial days or weeks after finding out your teen is self-harming, it may perpetually be on your mind, which makes sense as this is new information for you. It can feel difficult to remember to distinguish between your teen’s actions of self-harm, and who your teen is apart from their risky behaviours. There may be moments when you want to bring it up, give advice or check in on the self-harm. This is understandable, but it is also important to allow space for the other parts of your teen. This may include talking about their hobby, a new show, video games, or what is going on with their friends. Another suggestion is to set aside time to be with your teen one-on-one, maybe engaging in a new hobby or activity. This ensures they have space to be with you, and allows them to set the agenda for what they would like to talk about.

Note: For more information on how to leave room for your teen’s other parts or to let your “fix it” part have a rest, check out the blog: Take a Break From Active Parenting.

Tip #4: Being There for You and Your Needs

This is important for your mental and emotional health, additionally it is an amazing opportunity to model self-care for your teens. This may include making space for yourself to externalize and process how this is affecting you with a friend, family member or professional. You might consider going for a run, walk or yoga class to help release some of the energy. It’s important to recognize and respect the space you need, away from your teen. This emphasis on your own mental health will help you to provide capacity for your teen, and what they are going through.

Tip #5: Trust Your Parental Instinct

The final tip is trust your judgment. Teens may not have suicidal intentions when they self-harm but they may unintentionally cut more deeply than they intended. If your parenting spidey senses are letting you know they are not safe, it is important to trust that instinct. This may lead to another conversation around where and how the self harm is taking place. And if you feel your teen is at immediate risk, you can call 911, or take them to the nearest hospital.

Additional Resources on Self Harm and How to Have Conversations:

• Self-injury: What it is and how to cope (Kids Help Phone)

• 6 ways to support someone who’s dealing with self-injury (Kids Help Phone)

• My Daughter is Cutting Herself: What Should I Do? (Dr. Lisa Damour)

• What Do Parents Need to Know About Suicide (Dr. Lisa Damour)

• How to Help Teens Struggling with Mental Health

• How Do You Actually Help a Suicidal Teen (New York Times)

• How to Help When Adolescents Have Suicidal Thoughts (New York Times)