Introduction

Let’s talk about something that’s tough to discuss but absolutely crucial—self-harm in teenagers, particularly cutting. Imagine this: you walk into your daughter’s room, and you notice cuts on her arm. Your heart sinks. You feel a mix of emotions—fear, confusion, even guilt. Why would she do this to herself? What went wrong? As a psychiatrist and psychotherapist, Dr. Rameez Shaikh, MD, I’ve seen many parents go through this heart-wrenching experience, and I want to help guide you through understanding and supporting your child.

What Causes a Child to Harm Themselves?

Self-harm is complex, and there’s no one-size-fits-all explanation. For many teens, cutting or other forms of self-harm are ways to cope with overwhelming emotions. It might be sadness, anger, anxiety, or even numbness. Sometimes, it’s a cry for help—an attempt to make internal pain visible. Other times, it’s about control, especially when life feels unpredictable or chaotic.

Take the case of Aarushi, a 14-year-old girl from Mumbai. Aarushi was an excellent student, always striving for perfection. But beneath the surface, she was struggling with the pressure to perform, social anxiety, and a sense of isolation. When Aarushi started cutting herself, it was her way of releasing the emotional tension she couldn’t otherwise express.

Why Does My Child Scratch Herself?

Scratching, like cutting, is another form of self-harm. It can serve the same purposes—releasing pent-up emotions, distracting from mental pain, or punishing oneself. For some, the act of scratching or cutting provides a momentary sense of relief or calm, followed by guilt or shame. It’s a cycle that’s hard to break, especially if the underlying issues aren’t addressed.

Why Is My 14-Year-Old Cutting?

Adolescence is a period of intense change—physically, emotionally, and socially. Teens are navigating identity, peer relationships, academic pressures, and sometimes family issues. For some, these challenges become overwhelming. Cutting can be a way to externalize internal turmoil, a method of coping when they don’t have healthier outlets or the language to express what they’re feeling.

What to Do If Your Child Hits Herself?

If your child is hitting herself, it’s essential to approach the situation with care and understanding. The first step is to talk—gently and without judgment. Express your concern, and let her know that you’re there to support her. Encourage her to share what’s going on in her life and how she’s feeling.

In Aarushi’s case, her parents initially reacted with panic and anger, which only pushed her further away. When they sought professional help, we worked together on creating a safe space for Aarushi to open up about her feelings.

Self-Harm in Teenagers: An Overview

Self-harm isn’t just about physical pain. It’s a sign of deeper emotional distress. As a psychiatrist, I often see self-harm as a symptom of underlying issues like depression, anxiety, trauma, or borderline personality disorder. It’s important to understand that while self-harm can sometimes be associated with suicidal thoughts, not all teens who self-harm are suicidal. However, it’s a serious sign that should never be ignored.

Adolescent Self-Harm Assessment and Treatment

When treating a teenager like Aarushi, the first step is a comprehensive assessment. This involves understanding her history, the context of the self-harm, and any co-occurring mental health conditions. Once we have a clear picture, we can develop a tailored treatment plan.

Step 1: Building Trust and Open Communication

The initial sessions focus on building rapport and trust. Teenagers are often wary of authority figures, so it’s crucial to create a non-judgmental space where they feel safe to share their feelings.

Step 2: Identifying Triggers and Underlying Issues

Next, we work on identifying the triggers that lead to self-harm. Is it school pressure, relationship issues, or perhaps a traumatic event? For Aarushi, it was the combination of academic stress and social isolation.

Step 3: Developing Healthy Coping Mechanisms

We then introduce healthier coping mechanisms. This might involve cognitive-behavioral therapy (CBT) to challenge negative thoughts, mindfulness techniques to manage anxiety, or creative outlets like art or journaling to express emotions.

Step 4: Involving the Family

Family therapy can be a vital part of treatment. Helping parents understand what their child is going through and how they can support her is crucial. In Aarushi’s case, her parents learned how to communicate more effectively and provide emotional support without adding to her stress.

Step 5: Continuous Monitoring and Support

Recovery from self-harm is a journey. It’s important to have regular follow-up sessions to monitor progress, address any setbacks, and adjust the treatment plan as needed.

FAQs

Q: Is self-harm always a sign of a serious mental health issue?
A: Not necessarily, but it’s always a sign that something is wrong. Whether it’s a mental health disorder or a response to overwhelming stress, self-harm should be taken seriously and addressed with professional help.

Q: How can I tell if my child is self-harming?
A: Look for unexplained cuts, bruises, or burns, especially in areas that are easily covered. Other signs include wearing long sleeves in hot weather, secretive behavior, and withdrawal from social activities.

Q: What should I do if my child refuses to talk about it?
A: It’s important to remain patient and let them know you’re there for them. Sometimes, writing a letter expressing your concern can be less intimidating than a face-to-face conversation. If they still refuse to talk, consider seeking help from a mental health professional.

Q: Can self-harm be treated successfully?
A: Absolutely. With the right support, many teens learn healthier ways to cope with their emotions and stop self-harming. Early intervention and a comprehensive treatment plan are key.

Conclusion

If you’re a parent dealing with your child’s self-harm, remember, you’re not alone. It’s a challenging journey, but with understanding, compassion, and the right support, your child can heal and find healthier ways to cope with life’s challenges.

Disclaimer

The information provided in this blog is for educational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your mental health provider with any questions you may have regarding a medical condition.

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Dr. Rameez Shaikh, MD

Psychiatrist and Psychotherapist
[India, +91-8208823738]

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Muehlenkamp, J. J., & Brausch, A. M. (2019). Self-injury in adolescents. Current Opinion in Psychology, 22, 128-132.

Nock, M. K. (2009). Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18(2), 78-83.