Discovering that your child is so unhappy they have literally cut, stabbed, or burnt themselves is heartbreaking, and parents naturally feel they have failed them. In fact, self-harm often has nothing to do with the parents at all.
First, it may be reassuring to know that self-harm is common. For example, around one in 12 young people in the UK regularly self-harms, though the true figure is certainly higher – after all, most feel ashamed and keep it hidden. Statistically, girls are much more likely to do it than boys, though, oddly, boys are more likely to commit the ultimate act of self-harm and take their own lives. And it can start young. Indeed, children as young as seven or eight have been known to do this.
As for the physical act itself, this can range from merely rubbing or picking at one's skin to cutting, stabbing, or burning oneself. Self-harmers are usually conscious of the scars and make an effort to hide them. The act can also be done either in a moment of heightened emotion or as a result of careful planning. Unbelievably, there are also websites on which people compare techniques and even encourage one another.
The most obvious sign would be scars or burn marks. Also, when you mention these cuts and burns, note their reaction. If they blush or mumble, they clearly have something to hide. Another sign is constantly pulling their sleeves down over their wrists and wearing long, dark clothes, even in warm weather. Keep an eye out for knives or lighters in your child's bedroom as well. Also, make a point of counting the number of sharp knives in the kitchen and where you last put them. Are there blood stains on the child's sheets, or on the bathroom towels? Finally, has your child given up some kind of sport that they used to love, especially one that involves exposing their naked flesh, like swimming or gymnastics?
Along with the obvious physical signs, there may be changes in personality. Self-harm is often accompanied by low mood and withdrawal from the family unit (not wanting to come on vacation, refusing to eat with everyone else, etc). This can be difficult to spot, since most teens distance themselves from their parents, or become moody and sullen. Indeed, you would not be the first person to mistake a serious mental or physical illness for "being a typical teenager."
Pay attention to the things they say as well. The journalist Allison Pearson, author of How Hard Can It Be?, a novel about raising difficult teens, said in an interview that her daughter once exclaimed "I'm not the prettiest, I'm not the cleverest...I'm not the anythingiest!" Thankfully, Pearson's daughter was not self-harming, but these are the sorts of statements that should ring alarm bells.
Finally, be pleasant and approachable with their friends. Don't try too hard, but do be friendly and open. Talk to their friends as equals, with interest and respect. That way, if they notice something you have not, like a fresh scar, they will be more likely to approach you. And their friends are more likely to spot such things than you are. Not only do they spend more time with your child, they also see them when their guard is down. That said, be very careful about asking their friends directly. Your child is sure to find out and is likely to be furious. If they are self-harming, they are vulnerable, and the last thing you want to do is drive a vulnerable child away.
To an adult, who has never experienced the urge to self-harm, this can all seem disturbing and bizarre. A father, for example, may be astonished to learn that his 14-year-old daughter, to him so beautiful and precious, hates herself so much that she literally slashes her arms with a kitchen knife.
The first myth to dispel is that the child is somehow showing off. There is a widespread, and idiotic, belief that self-harm is a form of attention-seeking: the teenage equivalent of a child throwing tantrums or pulling faces. This is nonsense. And so is the idea that by ignoring it you'll shame them into stopping, or that they'll get bored. Anyone, no matter what their age, who cuts or burns their own skin, is seeking more than a bit of drama or fuss. This theory also ignores the fact that many self-harming teens try to hide the scars.
A teenager who cuts himself may indeed be looking for attention, but that is because he or she is desperate. Self-harming can be a cry for help, just like many suicide attempts. And they may not even realize that this is what they are doing; they have simply reached a point of unbearable pain and are unconsciously crying out for help – but crying out as a drowning man would cry out, not like a spoilt child who knows his mother will fuss him every time he bumps his knee.
Self-harm usually begins as a way of easing or releasing inner tension. The pain, fear, rage, or whatever it may be, has reached breaking point, and there is no outlet. Teenagers are not mini adults, remember. They often have no language for the thoughts and feelings swirling around inside them. Plus, of course, they tend to feel more intensely ashamed and self-conscious than adults. Growing up is difficult, and puberty is one of the trickiest phases of all. It is also worth stressing that self-harm is not a sign of weakness. Some people are better equipped to deal with their teenage years. A child who is by nature confident and extrovert simply finds life easier than a shy and sensitive introvert.
Your first task, therefore, is to discover just what is causing this inner tension and pain. Be careful how you approach it, however. If the average parent had a dollar for every time their teenager yells "just leave me alone," they could probably take early retirement. Teenagers do not want you prying into their world. So tread lightly.
One very common reason, especially among teenage girls, is hatred of one's body or appearance. Many teenagers hate their own body, regarding it as too short, too round, too chubby, etc. Some will hate their nose, their hips, their ankles, the list is almost endless. And do not underestimate the depth and intensity of this loathing. Even very attractive girls often feel this way. Stabbing or cutting the body is thus a way of expressing such hatred. They attack it with the same savage violence as you would attack something you hated.
But teenagers do not only hate their body. They can also hate their personality, or even their lack of intellect or artistic talent. They cannot stab their unpopularity, or their inability to play the guitar, of course, but they can stab the person who lacks these things. As people age, they care less and less what others think of them and, consequently, forget how raw and intense such concerns can be. Bullying can be especially devastating for teenagers, who take it as a form of rejection. In a teenager's mind, they are being bullied because they are unlikeable and, since they are unlikeable, they deserve to be punished.
More generally, self-harm can be a way of relieving stress. Your child may be suffering some kind of mental illness, or even personality disorder, and have no other outlet. Family breakdown can also be to blame. Are you and your partner constantly at one another's throats? Are you in the process of a messy divorce? Obviously, divorce is very common and plenty of teens whose parents split do not go on to self-harm. Worst is when one parent leaves the family home, meets someone new, and barely stays in touch with the children. The child reasons that this is because they are unloveable, or simply not smart or interesting enough to bother with. Again, this can result in self-loathing and thus self-harm.
If you have noticed scars, burn marks or, more terrible still, have walked in on your child as they inflict these injuries, the first thing to do is remain calm. Do not go into hysterics, and do not raise your voice. One of the worst things you can do is shame the child. By sobbing and screaming you will just make them feel even more odd, weird, or abnormal than they already do.
Remember, this is not about you. Any therapist will tell you horror stories of parents who attend the session with their child and spend the whole time whining about how much this has upset them, how they can't sleep, how embarrassed they feel, and so on. Indeed, such selfish lack of interest or care may even be the reason the child is doing this to herself in the first place.
A hug and a kiss is the place to start. Don't make this dramatic or over the top, but do make it loving and sincere. Though your teen may resist, they probably need it more than ever. Once you have done so, you must find out why. Unfortunately, that is probably the one thing they do not want to tell you. So begin by skirting around the central problem and focussing instead on how they feel. Once you have got that out of them, you may be able to piece together the cause.
Do not promise your child that you won't tell anyone; you may have to. A child therapist may help, but do not overestimate such people. As in any profession, there are good and bad – and some can be useless. It cannot be over-stressed that you need to uncover that root cause. It's no good having a doctor prescribe them anti-depressants, or a counsellor waffling on about "self-validation," if the real reason for all this is that your daughter is being pressured into sex by her boyfriend.
On a more practical level, be wary of leaving sharp objects laying around the house. There is a limit to what you can do here, and obviously you cannot watch them every hour of the day, but you can remove the sharpest knives or warn them what will happen if they cut an artery.
Often, the child will simply stop: their sense of fear, isolation, etc. passes as they grow and gain in confidence. Sometimes the root cause itself disappears, after they end a bad relationship or overcome an addiction. Above all, get at that root cause and reassure them of your total, unconditional love.