While it can be painful to discover that your teen is self-harming, the behavior indicates a need for support. Nearly 20% of teens worldwide have engaged in self-harm behavior—and most teens who hurt themselves do so because they are struggling with underlying mental health issues. It is also important to know that self-harm is not necessarily a signal that your child is thinking about suicide. Self-harm is considered by many to be a cry for help.
Talking about it with your child is the first step toward healing, as open dialogue breaks down the stigma and provides a way for teens to get the support and treatment they are asking for.
How do you talk to someone who self-harms? Start with genuine concern and compassion. This guide provides a list of seven steps you can take to start the conversation.
1. Prepare for the Conversation
With a nuanced topic like teen mental health, you should prepare yourself before you start a discussion about self-harm. First, educate yourself about the issue. Self-harm is when someone deliberately harms themselves, typically through cutting, burning, or hitting.
Teens may engage in this behavior for a variety of reasons, including to:
- Express pain
- Regulate emotions
- Attempt to gain control
Though some people may view self-harm as a bid for attention, it is not. While prolonged self-harm may become a risk factor for suicide, that is not usually the primary intent of the behavior, either. Teens engage in this behavior out of distress.
If you’re not sure whether your teen self-harms, watch for these signs:
- Sharp utensils in the bedroom or bathroom
- Unexplained cuts, bruises, or burns
- Bloodstains on clothing, sheets, or towels
- Wearing long-sleeved shirts when it’s hot
As you prepare for a conversation, approach the topic with empathy and without judgment. Your teen will be more open to discussion if they know they will be supported rather than criticized, punished, or misunderstood.
2. Start a Dialogue
In order to have a productive conversation, you should choose an appropriate time and setting. Pick a time when neither you nor your teen feel pressure to rush and where you won’t be subect to interruption. You should also choose a place where your teen feels safe. Their favorite spot in the backyard or a familiar location where you’ve had conversations before are good choices.
Open the conversation with care and concern, not accusations. Use “I” statements to express your observations and concerns. This helps create trust, rather than blame. You might use statements like:
- “I’m worried because I’ve noticed the cuts on your arms.”
- “I’ve noticed that you spend more time alone in the bathroom lately.”
- “I feel confused when I don’t understand why there’s blood on your shirts.”
Follow up these statements with gentle questions that allow the teen to express their own feelings and experiences. Encourage them to tell you about the behavior but also whatever else has been happening in their life. As long as they are honest, there are no wrong answers in a conversation like this. All you want to do is listen and support them.
3. Create a Safe and Supportive Space
As your teen shares their experiences, practice active listening. Pay close attention to what they say. Maintain eye contact. Provide nonverbal feedback to acknowledge that you hear them. Repeat their words back to them or ask clarifying questions to show you understand what they’ve shared.
Stay supportive as you talk with your teen. Avoid reacting with anger or disappointment. Instead, reassure them that they are not alone and you are there to support them.
4. Offer Support and Resources
Now that you’ve prepped for how to talk about self-harm, you should be prepared to offer additional resources. For example, if your teen has used self-harm to cope with overwhelming feelings, you can discuss alternative coping strategies. In initial recovery, many people use fidget toys as an outlet when they feel the urge to harm themselves. This keeps their hands occupied while they engage in emotional regulation. Other emotional regulation techniques, such as breathing exercises, mindfulness, and exercise may help.
While your support is an excellent resource for your teen’s well-being, it doesn’t have to be the only help they have access to. Professional intervention can provide more regulation techniques and uncover the underlying causes of their distress. You can offer your teen access to:
- Support groups
- Individual therapy
- Psychiatric care
- Residential treatment
Additionally, hotlines like the one from the National Alliance on Mental Illness can provide spontaneous support in moments of crisis. Share resources like this with your teen ahead of time so they have tools to lean on if they need them.
5. Maintain Open Communication
Addressing self-harm is not a one-time conversation. Once you’ve opened the dialogue, keep talking. Regularly check in with your teen about their feelings and well-being. Follow up on the coping techniques or therapies they’re using and offer additional resources as needed.
Be patient and consistent in all the ways you support them, not just with this specific behavior. If you foster an environment of mutual trust and openness, you’ll set the stage for long-term healing.
Help Your Teen Communicate with Others
You aren’t the only one who may be uncertain about how to communicate about self-harm. Teens also wonder how to talk to their parents about self-harm and how to talk to a therapist about self-harm.
If your teen struggles to open up to other figures in their lives, provide them with resources and conversation guidance. You could teach them about “I” statements versus “you” statements (For example, “I don’t understand…”) or give them vocabulary about emotional regulation. This helps them express their feelings and get support from everyone on their care team. For example, replace instead of saying, “You don’t know…” An example is, “
6. Practice Self-Care
Helping your teen is an ongoing process. Their healing may take time and may not always show linear progress. In any case, helping someone in distress can be emotionally taxing.
It’s okay if you feel scared or sad—or any other emotion—as you navigate this. Your feelings are valid, too. Talk to a trusted friend, join a parent support group, and consider speaking to a therapist. Make time for self-care.
7. Continue the Journey
It’s a good idea to maintain open communication about self-harm and mental health, even after your teen’s initial distress is treated. This ongoing support helps them maintain mental wellness and fosters an environment where they can ask for help if they ever need it again.
Caring for a teen is difficult in any circumstance. Whether they engage in self-harm or have other concerning or risky behaviors, your compassion and understanding will give them a safe place to learn, grow, and heal. Learn more about teen mental health from Muir Wood.