Understanding self-harming behavior in tweens and teens

Written by: Michael Bizzarro, Ph.D., LCSW

Although it is rarely talked about, nonsuicidal self-injury, or NSSI — a behavior in which a person purposefully harms himself or herself physically to inflict pain but without the intention of committing suicide — is a somewhat common behavior and is rapidly increasing, particularly among tweens and teens.

Some adolescents try it once and never do it again, but there are others who adopt and then begin to rely on this unhealthy coping strategy as a way of dealing with stress and their emotions. For them, it can become a more ongoing unhealthy pattern of behavior that needs intervention.

Why self-harm?

NSSI, including (but not limited to) cutting, burning, scratching, blunt force injury, is sometimes used to inflict physical pain in response to emotional pain. In other words, a person self-harms to escape painful emotions, punish themself, arouse feelings when they are feeling emotionally numb, or communicate with others.

Self-harming behavior generally starts between the ages of 10 and 14, but the most common time when self-harming begins his freshman year of high school. That’s when adolescent pressures tend to reach a point where self-harming becomes more prevalent.

Though NSSI can occur with a range of mental health disorders, including major depression, anxiety, and PTSD, this behavior can impact any child or teen. Some characteristics of those who may turn to self-harm include:

  • limited ability to regulate intense emotions
  • difficulty tolerating distress in healthy ways
  • challenges with communicating needs or feelings

Treatment and coping

If you discover your child is self-harming, it’s important to keep communication open through validation and approach their emotional pain with compassion. Simply telling them to stop the behavior is not the answer. Instead, you need to show an interest in understanding what is causing them to resort to the behavior. Open communication and validating their emotional pain can help encourage them to develop healthier coping strategies.

If self-harming persists, Princeton House Behavioral Health can provide professional help through its group-based Adolescent Dialectical Behavior Therapy (DBT) Program, offered in Princeton, Hamilton, New Brunswick, and Moorestown. Treatment focuses on teaching emotional regulation, mindfulness, distress tolerance skills, and communication effectiveness to help reduce unhealthy coping such as NSSI. A family support component is also included to help family members provide support in developing and maintaining healthy coping skills.

For more information about Princeton House Behavioral Health’s adolescent programs, call 888-437-1610 or visit www.princetonhouse.org/teens