Self-Injurious Behaviors
Parent Handout

By Karyn Grove-Bruce, Psy.S.

What is cutting or “self-injury”?

Self-injury is the deliberate and repetitive action of harming one’s body without intending to cause death.  It can be cutting, burning, repeatedly hitting your head, scraping, scratching, biting, or even picking at scabs so that wounds will not heal.  This behavior is usually done secretly and often in a way that wounds can be concealed afterwards. 

How can you identify this behavior? 

There are several things to watch out for that may indicate your child is engaging in self-injuring behaviors.  Some of them are:
-more frequent injuries
-excuses for injuries
-secretive behavior
-wearing more covering clothing (such as long sleeves or pants in warm weather)
-the presence of secondary behaviors (such as drug abuse, alcohol use or eating
disorders)

Does this mean they are suicidal?

Although some self-injurers have committed suicide, either deliberately or inadvertently due to the seriousness of their injuries, most of the time, a self-injurer actually harms himself or herself to feel better and to continue living.  Sometimes the harmful behaviors are described as “bringing them back to reality” and stopping disassociation (detachment from one’s actions).  There are some theories that suggest that endorphins released when self-injuring behaviors occur actually make the person temporarily feel better. 

Why would they do this? Why won’t they talk?

Often, self-injurers harm themselves because they are unable to express their feelings and emotions verbally.  They dislike confrontation and they are not acknowledging the problem. 

What should I do?

You need to act immediately if you suspect your child is self-injuring.  This is not something that can be handled without outside professional support.  Reassure your child they will not be punished for this, but express your concern for their safety.  Don’t be accusatory or judgmental.  Self-injurers engage in this behavior because they already feel bad about themselves.

What do I say? How do I stop them?

As a concerned parent, the best thing you can do is to listen to what your child has to say.  Don’t feel like you have to provide answers.  Be there for them to talk to without being judgmental or angry over what has happened.  You cannot control their behavior, and in trying to do so you may actually make the situation worse.  Don’t get into a power struggle or think you have to “stay up all night” and sit vigil over them.  This communicates that there is a crisis, and you don’t trust them.  If you think they may be in danger of attempting suicide, you should get them to an appropriate emergency care facility (dial 911 immediately).

What if they refuse help?

Part of the reason a child may resort to self-harm is frustration over not having control over events in his or her life.  Forcing a self-injurer into treatment without making them a part of the process will only make them more anxious.  As much as you can, involve them in decisions about their treatment.  That may mean choosing between different treatment plans, or deciding which therapist to see.  However, it is not their decision whether or not to seek treatment.

Who needs to be notified?

It can be difficult to decide how much information needs to be given out about the situation.  Part of the difficulty is that it is important not to portray the situation as one that is shameful and must be kept secret.  But at the same time, some people in the child’s life may be unable to be supportive and may actually sabotage the healing process.  For this reason, it is important that anyone who is told about the self-injuries also is given information about what it means and how they can help without doing more harm. 

What about being avoided by others - like being told she can’t be trusted around younger children?

The main thing is to be honest.  People who don’t know enough about self-injurers tend to be frightened by this behavior.  The self-injurer needs to feel that they can control themselves and act appropriately in front of other people.  There is no reason to think that the self-injurer will harm anyone else, as the behavior is usually secretive and not done in front of others.

What do I do about how I feel?

Dealing with the anger, fear and frustration over what is happening to your child and how this is affecting your family’s life is a normal and natural reaction.  The best thing you can do is seek out support for yourself.  Find ways and time to take care of yourself (exercise, massage, a quiet latte at the mall, or whatever works for you).   Recognize that you need to hand control over to the therapists, and that the self-injurer is ultimately responsible for their own safety. 

Should I blame myself as a parent?

The injurer has to take responsibility for their behavior, but for healing to occur, family members must accept their part in the development of the problems too.  Often a family who has processed through the therapy needed to cure the self-injurer will come out stronger and more supportive for all members.

How long will healing take?

Dealing with someone who self-injures takes time.  Treatment is a slow and gradual process.  Just as it took many years for them to get to this point, it may also take many years to recover.

Resources:

Books:
Alderman, T. The Scarred Soul.  Oakland, CA: New Harbinger Publications Inc., 1997.
Conterio, K. and W. Lader Bodily Harm.  New York: Hyperion, 1998.
Strong, M A Bright Red Scream.  New York: Penguin Press, 1998.

Website:
www.selfinjury.com

Phone number:
1-800-DON’T CUT (Informational - Not for emergencies)
Local Emergencies call Anchorage Community Mental Health 24-hour line:  563-3200