How to Understand Teens Who Self Harm

It can be very difficult to understand why adolescent self-harm exists. It seems to fly directly in the face of the idea that we are hot wired for self-protection. For anyone to engage in this behavior, they must be under considerable emotional distress. Unfortunately, some teens who are feeling stressed or anxious resort to self-harm, which can include a range of behaviors.


What Do Teens Who Self Harm Do to Themselves?

In 2005, Janis Whitlock, Ph.D. and her colleagues conducted a study to determine, among other things, what type of behaviors young people who engage in self-mutilation do to themselves. The results were published in the June, 2006 edition of Pediatrics.

Dr. Whitlock’s research revealed that survey respondents use more than one technique, and those who self-harm engage in the following types of behavior:


Causes of Self Harm Among Teens

Why would a teen turn to harming themselves as a way of coping with the stresses of life? Many young people describe the sensation as a time when feelings get out of control and they did not know how to release them. For many, the physical pain of cutting provides a release from emotional pain.

The following are reasons for teen self-harm:03-lack-of-maturity

  • More stress than previous generations. A number of teens feel as though they are under more stress than previous generations and that they are being rushed through their adolescence. There is pressure to make choices about choosing the right career and where they are going to go to school, and to get good grades. Young people are constantly bombarded with ads and messages about how they should look, dress and act. Their online activities seem to replace one-on-one, personal relationships with family and friends.
  • Media messages. For young women, the messages they receive from the media about appearance and body image can put incredible pressure on them. These messages come at a time when teens are still growing and trying to figure out who they are. Being told that one’s self-worth is based on physical appearance and then setting the bar for being attractive so high that very few can meet the standard is a recipe for creating stress, anxiety and feelings of low self-esteem among young women. Some of them may turn to what adults would consider desperate measures in order to cope.
  • Lack of maturity. Teens feel things very intensely. As Jenna R. describes, they experience a welling up of emotions during intense times in their life, but they have not yet developed the skills to cope with them.

Maturity develops over time and with experience. As a person matures, they will hopefully learn positive coping strategies to deal with stressors in their life, such as:

  • Going for a walk or getting some form of exercise
  • Listening to music
  • Talking to a friend or seeking counseling
  • Engaging in a hobby
  • Reading or watching television
  • Meditating

A teen, not knowing what to do in a stressful situation, may be influenced by friends or what they have read online. They may try self-harming as a way to cope with emotional pain. Some young people fall into self-harming by accident. They find that the physical sensation they feel after banging into something helps to distract them from emotional issues. They start adopting it as a coping strategy for dealing with their emotional pain.

Other Unwise Coping Strategies for Dealing with Emotional Pain

The idea of feeling overwhelmed by emotional pain and wanting to find a release from it in some way is not confined to teens who do things to deliberately hurt themselves. It forms the basis for a number of drug and alcohol addictions.


The addict is looking to the chemicals as a way to numb themselves and “feel less bad.” The addiction didn’t develop in some type of a vacuum. There is always an underlying reason someone turned to a substance initially. They may have been trying to deal with feelings of:

  • Stress
  • Boredom
  • Depression
  • Anxiety
  • Low self-confidence
  • Shame
  • Anger
  • Poor body image

When someone with an addiction issue uses their drug of choice, they experience its effects and get a “high.” It allows the person to experience less of their negative feelings or completely forget them for the amount of time they are under the influence of the drug. Once its effects wear off, the user may have to deal with the after-effects of the drug use and the original feelings. During the experience itself, however, they can get a bit of respite.

An addict is no longer in control over whether or not they will continue to use their particular drug. They may have started using in an effort to feel better, but over time the drug takes over their life and they feel helpless.

What Happens When Someone Self-Harms?

When someone hits, cuts or burns themselves, their body quickly responds by releasing endorphins. The hormones rush through the bloodstream and move directly to the area to numb it or even create a pleasurable sensation.


Endorphins are known as the body’s “feel good” hormones. They are the ones that are released during exercise, when we eat chocolate or have a good laugh.

Some people who self-harm find that the rush of endorphins blocks out their emotional pain and gives them a type of “high.” It works for them in the same manner that using drugs does for an addict: It’s a coping mechanism to deal with strong emotions. When a teen feels that their emotions are building and they need to get the lid off, cutting, burning, pinching, pulling hair or whatever self-harming method they choose is a way that they can deal with their stress.

Adolescent Self Harm Statistics and Facts

It is not easy to compile hard statistics about the percentage of teens who self-harm, since few studies have been conducted on this topic, but here are a few:

  • In the U.S., between two and three million people (approximately one percent of the population) have shown some signs of self-harming behavior. This number takes into account those who have anorexia and other eating disorders, too.
  • About one in every 200 girls in the United States between the ages of 13-19 (0.5 percent of the population) cuts herself on a regular basis.
  • The British Medical Journal estimated that 13 percent of 15-19 year-olds injure themselves on purpose.
  • The results of a 15-year Australian study conducted on approximately 2,000 school children selected at random found that about eight percent of the 14- and 15-year olds reported harming themselves.


Cutting is not a phase that teens go through in adolescence and simply “grow out of” once they become adults. Without treatment, it can carry over into adulthood.

What to Do if Your Teen Is Self-Harming

You may see signs that your teen is self-harming, such as wearing long-sleeved shirts, sweaters, long pants, or tights during hot weather or spending extra time in the bathroom. You may discover razors or sharp objects in your teen’s room that make you suspicious. Another child or family member may alert you to the situation, or your child may approach you on their own to ask for help.

If you discover that your teen is cutting or doing something else to self-harm, your initial response is very important. Here are a few tips to deal with the situation:07-be-supportive

  • Try not to panic. This is much easier said than done, especially when you are looking at evidence of fresh injuries. However, it’s important to remain calm.
  • Focus on your teen’s immediate medical needs. Ask your teen if they will allow you to examine their skin for signs of infection or a wound that may not be healing properly. If they agree, look for signs of redness, inflammation or pus. If you have any doubts about whether a wound is healing as it should or it needs stitches, go to the emergency room to have it assessed.
  • Don’t ask your teen, “Why are you doing this?” He or she may not be able to articulate why they are doing the behavior. They may only know that they hurt and that self-harming makes them feel better.
  • Don’t project a reason for the behavior onto your teen. Saying to your teen, “I bet you’re doing this because of…” or “You’re doing this to get back at me” does nothing to help the situation. It may not be accurate, and that type of comment only muddies the emotional waters between the two of you.
  • Don’t go into denial. This is not a phase your child is going through or something they will simply grow out of if you give them enough time, attention and love. It is a symptom of an underlying problem that needs to be addressed by a professional.
  • Be supportive. Statements like, “I’m here for you,” “We’ll figure this out,” and “We’ll find you some help” are all appropriate.
  • Hide sharp objects. When you first discover that your teen is self-harming, you may be tempted to remove anything sharp from your home. Your first instinct is to protect your child, so locking up all knives, razors, pencil sharpeners, etc. seems like a good plan. However, if your child is intent on doing harm to themselves, they will find a way. Pens and pencils can be used in the absence of something with a blade. They can even use their own fingernails or start pulling their own hair out to satisfy that urge.

A person who is self-harming isn’t necessarily trying to commit suicide. It’s perfectly legitimate to ask your son or daughter about their emotional state and whether or not they’re feeling down or low. If they are, it’s wise to take them to the emergency room for evaluation.

Help for Teens Who Self Harm

The next step is to figure out how to help teens who self-harm. The teen will need to see a therapist who can get to the root of the problem and treat it. Start by contacting your family doctor to ask for a referral to a therapist who works with adolescents. Some companies offer an employee assistance program (EAP), which offers short-term counseling.

If there will be a wait to start either individual or group counseling with a therapist, an EAP is a way to have your teen seen by a professional relatively quickly. This type of therapy can be used to bridge the gap until other arrangements can be made.

You should involve your family doctor in the treatment plan because a physical checkup will ensure there has not been any damage caused by the self-inflicted injuries. The family doctor can determine whether your teen needs to be on medication for anxiety, depression or another mental health concern. The doctor can monitor the dosage with regular follow-up visits, as required, and refer your child to a specialist if necessary.

How Therapy Helps Teens Who Self Harm

Therapy for self-harming is a long term process. The therapist presents skills that teens can learn to use to cope with stress, such as:

  • Learning how to manage moods
  • Recognizing and challenging negative thoughts
  • Practicing meditation and visualization


The therapy can also teach teens about healthy activities they can pursue to help them manage stress. It can also cover self-care as a way to keep stress levels down. Eating well, getting enough sleep, taking prescribed medications as directed, and exercising regularly are all important.

It will likely take several months for a teen to learn and feel comfortable practicing the new skills for managing stress. There will likely be some setbacks along the way, as well. The goal is to replace the need for self-harm with these new skills, not strictly to attack the cutting, hitting, or hair pulling. There may still be times when the teen feels overwhelmed by circumstances or emotions and resorts to a coping strategy that they know well: self-harm.

When that happens, it’s an opportunity to look at the circumstances and learn from them. The teen and the therapist can figure out why the teen resorted to self-harm in that instance, and then help them get back on track, using the tools learned in previous sessions.

What Family and Loved Ones Can Do to Help

Family and loved ones have a role to play in helping a teen who is self-harming. The young person needs reassurance that their concerns are valid. Don’t attempt to minimize what a teen is going through by stating that soon they will have to deal with “adult” concerns. Doing so could make the problem worse.


If the teen decides to talk about something that is bothering them, listen without judgment. Ask the teen whether they are looking for advice or simply someone to listen while they vent about the issue. They may only be looking for a sympathetic ear. If you do decide to give advice, make sure that you offer suggestions only. Let the teen decide what to do.

Don’t continually ask the teen cutting. It will only make them uncomfortable if you keep bringing it up. If they are not cutting, they will feel as though you are checking up on them because you don’t trust them. If they have slipped and have cut, they are already dealing with their own feelings of guilt or shame about it, and these questions make the situation worse. Instead, keep the discussion open-ended by saying, “I know it’s challenging to learn these new coping skills. If you ever have a slip up and cut [or substitute other behavior], I want to make sure that you are safe. You can come and talk to me about it, and we’ll make sure that you are OK.”

How to Prevent Adolescent Self Harm

Parents can play a role in preventing adolescent self-harm by taking steps to make the home a calm and welcoming environment. Parents should model good choices for dealing with the stresses of everyday life, take good care of themselves, and enjoy family life.


One of the reasons teens may turn to harming themselves is that they don’t feel connected to their families or the world around them. Parents can take steps to keep the lines of communication open and ensure that their teen is involved in family activities, whether it is choosing the film the family watches together, helping to prepare a meal, or making snacks for family game night.

Teens also need to see that their parents are modeling responsible behaviors around the use of alcohol. Drinking in moderation — up to one drink per day for women and two drinks a day for men — and not as a way to deal with a rough day at the office is a good way to show young people how manage alcohol use.

Prescription drug use is also something parents need to monitor in front of their children. Parents should be careful to use medications only as directed by a doctor and to never take a medication that was prescribed for someone else.

Teens who harm themselves growing up and don’t get proper help are at higher risk for developing a drug or alcohol addiction as adults. These teens may continue to self-harm as well. If you are concerned about your own or a loved one’s behavior, call 12 Keys Rehab today.

The Addiction Blog