Self-injury

Sometimes children and teens face emotions they don’t know how to deal with. They may feel alone, embarrassed, angry, or hopeless. When they can’t talk about their feelings, they may end up finding painful ways to try to alleviate their emotional pain, such as self-injury.

Self-injury can be scary, and it’s normal for people to avoid talking about it. But talking about self-injury doesn’t make it worse. In fact, it can help us understand the problem and find ways to help those who hurt themselves.

Self-injury means hurting yourself on purpose to feel better emotionally. It’s common for people to cut or scratch their skin with sharp objects like razors, paperclips, or pen caps. Some people also burn, hit, or bite themselves, or pick at their skin or wounds.

Self-injury happens more often in girls than boys and usually begins around puberty. For caregivers, it can be difficult to notice this behavior or know how to respond, but it’s important to know that this isn’t just “drama.” It’s something that deserves attention, patience, and care.

Is self-injury typical?

No.

There is no “typical” self-injury behavior. But to prevent it or help when it happens, we need to understand certain things about it. Some children and teens hurt themselves because it distracts them and helps with intense emotional pain. Others say they do it because they feel numb and hurting themselves lets them feel something.

Self-injury is often kept secret. However, for some children and teens, it can be a way to ask for help since it shows their distress in a way they cannot express otherwise. When found out, it usually makes caregivers and adults feel concerned and want to help.

Self-injury is what experts call a “maladaptive coping tool.” This means it’s not the best way to handle problems, but it might bring temporary relief. Sadly, this makes it easy for children to rely on it to deal with or show their painful feelings.

The longer a child or teen practices self-injury, the harder it is to stop. Many who self-injure feel ashamed and say they want to stop, but without proper help, it can be very difficult to quit.

When should I be concerned about a child’s self-injury?

If caregivers know their child is self-injuring, they should ask for help right away. But it’s not always easy to be certain. Caregivers should be concerned if they see these signs:

• Talking about self-injury
• Suspicious-looking scars, especially on the arms, legs, or belly
• Wounds that do not heal or get worse
• Cuts in the same place
• Collecting sharp objects like glass pieces, safety pins, razors, etc.
• Wearing long-sleeved clothes in warm weather
• Avoiding social activities
• Wearing a lot of bandages
• Refusing to change clothes at school or in front of others
• Avoiding wearing swimwear
• Visiting websites or social media about self-injury
• Having friends who self-injure

Behavioral changes, such as isolation, declining academic performance, insomnia, or a lack of interest in activities previously enjoyed, do not necessarily indicate self-injury, but they are also warning signs. If you notice any behavior that involves harming one’s own body, it is crucial to take it seriously.

Even if the intention is not to end a life, these behaviors demonstrate suffering that requires immediate attention and help.

What can I do to help a child with self-injury?

While caregivers know their children best, dealing with self-injury isn’t easy. Here are some things you can try:

1. Be empathetic.If your child talks about self-injury, provide a safe space for them to express their feelings. Avoid judging or punishing them, as this can worsen the situation. Listening with empathy helps build trust and understanding.
2. Approach gently.If you suspect self-injury, approach your child with care. Let them know you’ve noticed something is wrong and that you care about their well-being. This gentle approach can encourage them to open up.
3. Be supportive.Reassure your child that you are there to help in any way you can. Let them know they are not alone and that you are willing to support them through their struggles.
4. Create a safe environment.Make your home a safe space by removing or securing items that could be used for self-injury. This proactive step can help prevent further harm.
5. Reduce immediate risks.If your child is self-injuring, it’s important to remove or limit access to the tools they commonly use. This doesn’t solve the cause, but it helps reduce the risk of further harm. Always do this carefully and explain that your intention is to protect them, not punish them.
6. Encourage healthy coping strategies.Help your child find alternative ways to cope with their emotions, such as engaging in creative activities, physical exercise, or relaxation techniques. Encouraging positive outlets can reduce the urge to self-injure.

Do not try to “fix” the self-injury on your own. It’s best to seek help from a mental health professional who can understand why your child is self-injuring and what emotional problems they are facing.

Caregivers should work with the mental health professional to learn how to talk to their child, make their home safe, and know what to do if the behavior continues. Don’t hesitate to seek professional support, even if the behavior seems to have diminished.

What kind of professional support can I seek out?

Some caregivers might feel embarrassed, inadequate, or guilty if their child is self-injuring. But it’s important to seek help if you are concerned.

Talk to your child’s pediatricianor family doctor. They can refer you to other specialists, such as mental health professionals. Mental health professionals can help both the child and the caregivers. They can work with you to support your child at home and in therapy.

In more serious cases where there is an immediate risk to physical or mental health, hospital emergency rooms can provide immediate support. If a child is at immediate risk or in need of urgent help, emergency services like SAMU (192)can be called.

You can also find free support through the Unified Health System (SUS). Care often begins at your local Basic Health Unit (UBS). Other services include Child and Adolescent Psychosocial Care Centers (CAPS i), specialty centers, and clinics at university hospitals.