The number of teenagers visiting emergency departments for self-harm has doubled in the last decade in Canada. Yet, I don’t hear parents talk much about it.
I think, in part, it is because we don’t know how to talk about it.
First, the terminology is confusing. While I’m using the term ‘self-harm’ throughout this post, what I really mean is Nonsuicidal Self-Injury (NSSI).
It is defined by the International Society for the Study of Self-Injury “as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned.”
There are many forms of NSSI, including hitting, scratching, burning or bruising oneself.
Second, there is a lot of stigma associated with self-harm. I think that’s the main reason parents don’t talk about it. But maybe we should.
Stigma only dissipates with understanding, and understanding requires communication.
My daughter self-harmed
If you suspect your teen may be self-harming, there are signs you can look out for: isolation, secretive behaviour, avoiding activities, wearing long sleeves or long pants in warm weather, suspicious looking scars or wounds that don’t heal.
It was much easier for me–my daughter told me. We had just started to look for professional help for what she thought might be depression, when she came into my room one night, crying, and lifted her shirt-sleeve. It was raked with thin red lines.
“I’m sorry,” she said.
On the outside, I was calm. I hugged her, and thanked her for telling me, and asked her if she felt suicidal. I told her there was nothing to be sorry about. That we’d get help.
On the inside, I was freaking out. When she left my room, I Googled cutting. I knew nothing about it. I had not even heard of such a thing.
What follows is what I’ve since learned about self-harm and also what it was like as a parent, knowing my child was self-harming. Just remember, I’m not an expert. If you think your child needs help, seek out a professional.
Self-harm is more common than you think
According to Self-Injury Outreach and Support (SIOS) a leading authority on NSSI, 14-24% of teens report self-injuring at least once. About one quarter of those teens have done it many times.
Both boys and girls self-harm. It most commonly starts in adolescence and can occur with or without mental illness.
SIOS reports most people who self-injure do it to feel better or to stop themselves from acting on thoughts of suicide.
Still, self-harm, I learned, should be taken seriously. It’s not a phase or a fad and it’s not done for attention. Quite the opposite: Most people who self-harm do it in private.
“Most teens who engage in self-harm are just as afraid of their behaviour as you are. Many feel guilt, shame and deep remorse after they self-harm.”–Psycom.net
Self-harm is serious
On November 4, 2019, The Globe and Mail reported the results of a study published in the Canadian Medical Association Journal:
- The number of teenagers seeking help for self-harm in the emergency department has doubled in the last decade
- Teenagers who self-harmed were eight times more likely to die by suicide and three times more likely to die of any cause within five years; and
- Teens who visit the ER with self-harm injuries were five times more likely to return to emergency departments.
It’s important to note that the article also says only 1% of the teens in the Ontario statistics died from suicide within five years.
Some researchers think self-harm can be socially contagious.
The Globe, in 2015, wrote about this in an article entitled, The Cluster Effect, saying “Those who deliberately hurt themselves tend to report having friends or online social networks who do it, too.”
While I’m the farthest thing from an expert, I do know that my daughter learned about self-harm from a friend who did it. She told me so. And once she was self-harming, her Instagram feed became full of images of others who did it.
Thankfully, I don’t think this can happen as easily anymore. Instagram and Facebook banned images of self-harm and suicide in February 2019 and just recently extended that ban further to include comic graphics.
People often need professional support to stop self-harming
NSSI is thought to be a maladaptive coping mechanism, a behaviour that relieves symptoms but does not address the root cause of the stress.
SIOS advices “most people do not grow out of self-injury without finding healthier ways to cope.”
My daughter was already in therapy. Her therapist advised me on what to do and what not to do: Don’t be judgemental. Be patient. Listen actively. Stay emotionally neutral. Go to the hospital if things escalate or she needs medical treatment for her injuries.
As a parent, you may need professional help, too
Her therapist didn’t tell me to get help for myself. I wish she had.
Instead, I bought Polysporin and rubbing alcohol and anti-scar cream, thinking, “I’ve got this.” I didn’t have it.
Despite what I knew about self-harm, and what the professionals told me, I wasn’t prepared mentally or emotionally.
I lost a lot of sleep. Not days, or weeks, but months of sleep. I became obsessive about monitoring her garbage bin for bloody tissues, keeping tally in my head on some sort of imaginary star chart. There were more bad days than good, it seemed.
Some days, when my thoughts got the best of me, I’d take her razors. (For the record, SIOS recommends against this.)
I’d hide them under the towels in my bathroom dresser. Often, she’d confront me, ask for them back and I’d sheepishly hand them over. One day, I drove halfway to work with them only to turn around and put them back in her room.
Either way, it didn’t matter. more razors would always appear. She bought them at the dollar store.
Why is self-harm so distressing?
I’ve thought about it a lot over the last couple of years. Cognitively, I understood self-harm, but I didn’t understand why it made me obsessive. Or why it caused me to unravel. I’ve come up with three reasons.
1. When my daughter started self-harming, I could finally see her pain.
Up until that point, her depression was intangible, a fuzzy sort of shape I couldn’t quite make out. The invisible illness.
Her cuts, on the other hand, an outward sign of her distress, were abundantly clear to me.
Plus, knowing that cutting helped to make her feel better was a hard pill to swallow.
2. It made me feel like a failure
As her mom, I am hard-wired to want to keep her safe from harm.
For most of her life, I had patched up scraped knees and kissed boo boos, and, for the most part, a Disney band-aid and a hug seemed to do the trick.
This was different. She didn’t want my hugs or kisses. She barely wanted to talk to me. I felt useless as her mom. Like a failure.
I told myself we were good–she had confided in me and I was helping her get help, but I didn’t believe it.
3. It required a mental and emotional stamina I didn’t yet have
I was failing repeatedly. Daily. Over and over and over again.
News articles like the one in The Globe makes it seem so finite. Like self-harm is a one-time crisis. It’s not like that in real life. At least not in my experience.
Self-harm can continue for weeks or months or years. It can occur daily. Or it can stop for a time and then re-start.
As a parent, or friend or caregiver, relegated to the sidelines and unable to help beyond lending a compassionate ear, it wears you down a bit if you’re not prepared. Seasoned. A master of your own mind.
Therapy can help
The good news is people can and do stop self-harming.
My daughter stopped. The change in behaviour coincided with an overall improvement in her mental health, which was the result of a lot of therapy, a lot of hard work on her part, and finding the right medication.
I, too, eventually learned how to get better control over my own mind through therapy, daily journaling, writing this blog, and self-help podcasts.
I learned to accept it, as a symptom of her illness, beyond her control. To see it as neither an indication of the past or future, but of the here and now. A moment in time.
Having not asked for help when I needed it, I can see now what an extraordinary amount of courage it takes to lift ones shirt-sleeve and say, “Help, I can’t cope.” To see and trust in the my daughter’s strength.
I’m getting better at talking about it, too, to both my daughter and to other parents. I like to think that’s a good thing. That we’re not all suffering in silence or silos. That one day, people will talk about self-harm openly and without apology.
- Self-Injury Outreach and Support
- The Mighty’s Guide to Understanding Self-Harm
- HealthyPlace When Self-Harm is for Attention
- TeenMentalHealth.org Understanding Self-Injury
- CNET Instagram expands ban on images that depict self-harm and suicide
- Telegraph Blog Post: One day I found out my daughter was self-harming
- Blog Post: Depressed Teens Do Not Walk Dogs
- Blog Post: How to Stop Feeling Guilty about Your Teen’s Depression