What to Do When Your Teen Is Self-Harming … A Parent's Guide
Finding out your child is hurting themselves is devastating. Whether you discovered cuts, found hidden blades, or they told you themselves, you're likely feeling shock, fear, and confusion. Know that you're not alone – about 15-20% of teens engage in some form of self-harm.
When parents call me or Rebekah and say that their child is struggling with their mental health, one of the first questions we ask them is, “Are they self-harming?” It’s so very common. However, the good news is that once we help these kids and they learn better coping skills, they most often stop the behavior altogether.
Why Do Teens Self-Harm?
When your kid is self-harming, it doesn’t mean that they have suicidal tendencies or that they want to die. For the majority of kids, cutting is just an attempt to feel better, to cope with emotional pain that feels unbearable. Teens self-harm for some of the following reasons:
A way to feel in control when everything else feels chaotic
Making emotional pain physical so that it feels more manageable
A way to feel something when depression makes them numb
Communication when they don’t know how to express their pain
Self-punishment when they are feeling shame or guilt
What Makes Teens So Vulnerable to Self-Harm
Adolescence creates a perfect storm of risk factors:
Developing brains: The parts responsible for emotional regulation are still being formed (and won’t be complete until their mid-twenties), so teens’ emotions feel more intense to them
Everything feels permanent: Without life experience, teens can't see past current pain
Intense social pressure: Peer relationships become everything, amplified by social media
Mental health issues emerge: Depression, anxiety, and trauma often surface during these years.
Academic pressure: The stakes around grades and future success feel impossibly high
How to Speak To Your Teen About Self-Harm
Before You Start: Process Your Own Emotions
Your teen needs you to be calm and collected, even if you feel overwhelmed by your own emotions around your child’s struggles. Speak to your own therapist to learn how to best support your child.
Setting the Stage
Whatever you do, don't ambush your kid with: "I need to have an important conversation with you, that’s going to take about 45 minutes. Would you like to walk and talk or sit in your bedroom?" You might as well say … I’m going to talk to you about this in a prison cell for an eternity.
Your child will need to feel safe in the conversation, not ambushed or trapped. Give them time to prepare, and more importantly, set a time limit of a few minutes.
Opening Lines That Work
"I'm concerned about you."
"I want you to know I'm here if you want to talk."
"How can I best support you right now?"
Questions to Guide the Conversation
The most important thing is that you express curiosity over judgement!
Questions that reflect curiosity – ask these:
"My biggest concern is supporting you. How can I do that?"
"Help me understand self-harm. How does it make you feel better?"
"What time of day are you struggling most?"
"How well are you sleeping?"
"Would seeing a therapist be something you'd be open to?"
"At your worst moments, how bad are your feelings? Could you give me a rating out of
Questions that reflect judgment – DO NOT ask these:
· "There must be something wrong with you."
· "I think you're doing this for attention."
"If you don't stop, I'll punish you."
"Lots of people go through bad stuff and don't cut."
"Tell me where you're hiding your blades."
"Why do you want to kill yourself?"
How to End the Conversation
"This isn't the last time I want us to talk. I'll check in with you in a few days, and I'm always here if you need me sooner. The most important thing is that I love you, and there's nothing we can't get through together."
Building Better Coping Strategies
Work together on healthier alternatives:
Physical alternatives: Ice cubes, hot/cold showers, intense exercise, stress balls
Emotional expression: Journaling, art, music, talking to trusted people
Mindfulness: Deep breathing, grounding exercises (name 5 things you see, 4 you hear, etc.)
Problem-solving: Breaking big problems into smaller pieces, improving communication skills
When to Seek Professional Help
If your teen is self-harming, it's time for professional help. Look for therapists specializing in adolescents with experience in:
Dialectical Behavior Therapy (DBT)
Cognitive Behavioral Therapy (CBT)
Family therapy
Don't wait for things to get worse. Early intervention makes a huge difference.
Creating Support at Home
Stay connected: Keep having check-in conversations
Reduce judgment: Criticism will make them less likely to come to you
Address safety: Work together to remove/safely store items used for self-harm
Focus on positives: Help them reconnect with things that used to bring joy
Take care of yourself: You can't help them if you're not okay (think of the airlines’ safety instructions: “Put your oxygen mask on first.”)
The Bottom Line
This is not your fault. Good parents have children who struggle with self-harm.
Your teen can get better. With support, teens can learn healthier coping mechanisms and stop engaging in self-harming behavior.
You're not alone. Resources and professionals understand what you're going through. Please reach out to us if you need assistance locating these.
If you’ve gotten your child help, and they continue to self-harm, contact us. Your child may need more support than outpatient therapy can provide. Your child’s safety is paramount!
Cutting can be life-threatening. It may be a sign of severe emotional trauma that can eventually lead to suicide. We will put you in touch with programs that have experience in understanding and treating the underlying cause of cutting and other self-harmful behaviors.
Let’s Talk: We are here to support you!
In crisis? Contact 988 (Suicide & Crisis Lifeline) by phone or text, or go to your nearest emergency room. Help is available.
