Is your child:
Sometimes children intentionally hurt themselves. Childhood self-injury can present at very young ages. The most common forms of self-injury are scratching, cutting, and hitting (particularly in younger children). Parents often feel frightened, shocked, angry, sad, or guilty when they discover or observe their child to self-injure. Certain acts of self-injury, such as cutting, are particularly upsetting to parents. If your child’s attire changes, particularly toward longer sleeves or more layers, this change may be evidence of cutting.
Unexplained scratches that frequently appear may be suspect. If you observe small, linear cuts, know that this style of injury is the most common presentation of cutting behavior.
In our clinical work, we have seen some adolescents cut words into themselves.
If your child has generally struggled with stress, he or she may be vulnerable to self-injury. If you have not observed your child to self-injure or have not witnessed signs of injury, it is important to verify your concerns.
If your child has recently experienced a new, negative emotional event (e.g., a social rejection, a breakup, teasing/bullying, parental divorce, death/loss, or academic failure) and has become more withdrawn, the risk for self-injury increases.
For children with developmental delays or impairments, self-injury may occur during the toddler years. The most common behaviors observed in this young population are hairpulling, headbanging, eye gouging, and slapping around the head or arms.
These behaviors are outwardly evident and often coincide with a negative emotion aroused by a denial of something desired, change in plans, or anxiety.
Clinically, self-injury is associated with many psychological conditions. However, self-injury is separate from suicidal behaviors. Self-injury does not mean your child wants to die. Rather, self-injury is tied to a relief of emotional pain, intense feelings, emotional numbness, or anxiety. Sometimes, the behavior is short-lived, but, particularly with cutting and scratching behaviors, the behavior can escalate if left untreated.
The most common reasons for self-injury are as follows :
Self-injury is a behavior that can be initiated by any number of factors. Self-injury can arise when your child has not found an adequate means of expressing their emotional pain or when your child experiences low self-esteem or physical discomfort.
It may come about as a result of emotional, sexual, or physical abuse. However, children from healthy homes may also self-injure. Research shows that cutting behaviors have an element of contagion, so peer pressure may be a factor . Most often, self-injury serves as a vessel for emotional relief.
The act of harming one’s self provides a feeling of control and can release endorphins, much in the same way drugs can. Thus, the cutting behavior creates an experience that releases the pressure of negative emotions and provides the reward of relief. This experience of relief may feel like a warm wave of calm that washes over the individual, and it can become addictive.
Because self-injury can be an addiction, some of the treatment strategies are similar to those used for other addictions. For example, psychologists help children identify triggers, understand the emotions related to those triggers, provide distraction during the ‘tension’ phase, and develop positive coping strategies to manage strong emotions . Often, if the child finds a way to distract herself during the ‘tension’ phase (the part where the body is gearing up to self-injure), the urge can be averted, and a positive coping strategy can take place instead.
Terms that are synonymous with self-injury are ‘self-harm,’ ‘self-mutilation,’ or ‘cutting.’ Self-injury occurs more often among females. Many individuals who self-injure report histories of abuse, coexisting disorders (e.g. eating disorders, substance abuse), and home environments that punished negative emotional expression (e.g. anger).
Mental health professionals are the most qualified to evaluate your child’s self-injury. An evaluation can offer important information about the cause and course of treatment. Self-injury may indicate that your child struggles with a psychological issue, such as depression, posttraumatic stress disorder (PTSD), borderline personality disorder, or bipolar disorder, and that the self-injury may be a method of coping with intense emotions.
If you have suspicions or have confirmed that your child is self-injuring, it is best to address the behavior immediately. While some children and adolescents self-injure because they want to fit into a peer group, self-injury should not be treated as a ‘phase’ or as something that can be ignored.
A misconception among many adults is that self-injury is a ‘cry for attention,’ which is generally not the case. Most likely, your child is experiencing difficult emotions, and the act of self-injury provides a legitimate relief.
The most effective way for you to help your child is to validate their feelings and understand their self-injury. To achieve both, you will need to be present and available to your child.
Even if you do not feel it, provide a calm and comforting environment. The very fact that your child is intentionally hurting herself is an indication that she is not coping well with stressful situations. Try not to make interactions more stressful. Offer your love and support, and reassure your child that you want to help.
Do not assume you know what your child is feeling; this assumption can create distance and misunderstanding. Ask your child to describe his experience. You have your own emotions in this experience, so it is important to use them productively.
Rather than saying something like, “How can you do something so crazy,” a better way to express the fear and shock you feel would be, “Seeing you hurt yourself is hard for me. I want to get you help, but I also want to understand how self-injury makes you feel better.”
Power struggles, ultimatums and your own emotional outbursts will be unproductive. If your child does not want to engage in a discussion, let him or her know that you will be there when the time is right.
Children who self-injure typically lack coping mechanisms and skills for discussing their inner experiences, so they may need time to figure out how to talk to you about their emotions.
One powerful strategy for self-injuring adolescents is the idea of a Sensory Box or a Comfort Kit . You and your child can seek to discover a set of objects and thoughts that bring a feeling of comfort and relaxation.
In this box, you and your child would collect positive sights (post cards, greeting cards, pictures), sounds (music, ocean sounds, meditation sounds), smells (essential oils, aromatherapy), and tactile objects (blankets, towels, stuffed animals).
The Comfort Kit  might include a set of index cards that lists specific strategies and positive phrases the child will use instead of resorting to self-injury.
Your child’s improvement may take a while. Remember your child is working hard to change a behavior that has been effective in the past. You can help by making time for relaxation. It can be helpful to remove some pressure or responsibilities from your child as he or she works to end self-injurious behaviors.
As your child learns self-care skills and improves self-esteem, self-image, and emotional coping, you can expect the self-injury to diminish. While your child is working to be mentally healthy and stable, it can be helpful to seek your own therapy in an attempt to ensure that your home is a safe haven and a refuge for your child.
If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.
Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.
If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.
These professionals may recommend or administer the following tests for this symptom:
 Dialectical Behavioral Therapy: What is DBT?
 The Cornell University Research resource on self-injury, a comprehensive website for parent, caregivers, and mental health care providers. https://www.amazon.com/Kitchen-Table-Wisdom-Stories-Anniversary/dp/1594482098/ref=asap_bc?ie=UTF8
 If you think your child needs intensive support, SAFE Alternatives is a nationally, research-supported, program with resources for those who injure and their networks. https://selfinjury.com/
 A touching reflection of a mother whose daughter was self-injuring. https://mobile.nytimes.com/2015/03/01/style/bringing-a-daughter-back-from-the-brink-with-poems.html
 Bowman, Susan & Randall, Kaye (2012). See my pain: Creative strategies for helping people who self-injure. Amazon: https://www.amazon.com/See-Pain-Strategies-Activities-Self-Injure/dp/1598501259/
 Randall, Kaye (2017). Critical Mental Health: A conference on suicide and self-injury. Accutrain: Developmental Resources. www.dev-resources.com
This article was contributed by guest author and subject matter expert:
Chesleigh Keene, MA
Chesleigh is a doctoral candidate in Counseling Psychology at the University of Denver. She is a predoctoral intern at the University of Utah Neuropsychiatric Institute. She has clinical and research training in traumatic brain injury, developmental disorders, child/family therapy, serious mental illness in adults, and topics of diversity.
Description: A bunch of colorful bandages on child’s leg
Stock Photo ID: #133959743 (Big Stock)
By: DV Studio
Cutters self injury
Previously Licensed on: May 21, 2017
Stylized by Katie Harwood exclusively for Clear Child Psychology