How Can Adults Approach Self-Harming Behaviour in Children

What are Self-Harming Behaviours?

As previously illustrated by the seminal literature published by NICE Clinical Guidelines (2004), self-harm has been defined as an act of self-poisoning or self-injury, whereby

“an individual deliberately initiates a non-habitual behaviour that, without intervention from other, will cause self-harm, or deliberately ingests a substance in excess of the prescribed or generally recognised therapeutic dosage, and which is aimed at realising change which the subject desired via the actual or expected physical consequences”.

Some children may intentionally hurt themselves if they are experiencing difficult emotions, or if they are looking for a form of emotional release. Some self-harm behaviours include:

• Cutting
• Scratching
• Hitting themselves or banging their head against a wall
• Pulling out hair
• Biting, burning, or picking skin.

Over recent decades, a multitude of literature published by mental health professionals has contemplated the physiological components and causes of self-harming behaviour in children.

Research by the National Alliance on Mental Illness (NAMI) surmised that self-inflicted injury may promote the release of “feel-good” transmitters such as endorphins and endogenous opioids which not only temporarily boost their mood, but also physically distract their emotional pain.

Signs of Self-Harming Behaviours

Covert Signs

• Recurrent bloody tissues or clothing
• Scars or wounds that do not heal, or new scars or wounds without a cause
• Separated razors
• Internet search history about self-harm or suicide

Emotional Signs

• Depressed mood
• Periods of excitability
• Irritability
• Desiring more time alone than usual
  Seeming less interested in usual hobbies
• Changes to their sleep pattern

Behavioural Signs

• Decreased academic performance
• Avoiding activities that skin, such as swimming
• Making excuses for cuts, bruises, burns, and marks
• Hiding injuries with excessive clothing
  Keeping a stash of sharp objects
• Locking themselves in the bathroom for long periods of time
• Increased interest in risk-taking activities

There is an abundance of potential causes of self-harming behaviour

• Abuse or neglect
• Family dysfunction
• Divorce
• The death of a loved one
• Witnessing or experiencing a crime
• Substance use
• Domestic violence in the home
• Bullying at school
• Cyberbullying
• Difficulty with emotional regulation
• Low distress tolerance
• Persistent pressure to perform
• Mental health: anxiety, depression, BPD, eating disorders, PTSD.

How can you approach your child?

1. Regain Composure – Whilst you may feel a range of emotions as a parent, you must try to gain control over your emotions before you approach your child about self-harming. You could try different techniques such as deep breathing exercises, participating in self-care activities, journaling your thoughts and feelings, or talking with a trusted mental health professional.
2. Plan an Intervention – When you prepare to speak to your child, you should try to approach the situation with an open mind, and avoid criticising, blaming or judging them. Try to understand the underlying cause, and normalise their feelings. For example, expressing empathy and a willingness to learn and understand about what made them want to self-harm originally.
3. Get them support – Since self-harm is a sign of emotional distress or underlying mental health conditions, it may be useful to work with mental health professionals to seek support for your child.

There are a range of different therapies that tackle the underlying causes behind self-harming behaviours, such as Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), Psychodynamic Therapy, Group Therapy, Family Therapy, or Youth Support Groups.

There is also a multitude of different agencies and organisations that can provide both online and in-person sessions to help develop healthier coping mechanisms and helplines that can provide support for children struggling with self-harm or suicidal tendencies, such as:

• National Suicide Prevention Lifeline – 800-273-8255.
• Text HOME to the Crisis Text Line at 741741.
• The Trevor Project for Under 25’s LGBTQIA+.
• MIND.
• Support Line.