Non-suicidal self-injury (NSSI), also known as cutting, is more common than you might think. People who engage in this behavior most often start as teens, with teenage rates of NSSI being anywhere from 15-40%. That’s a pretty high number. But what should a parent do if your kid is cutting?
While usually depicted as a more female activity, boys and girls suffer about equally from NSSI. Recently (and unfortunately) romanticized as a dramatic device in the miniseries Sharp Objects, in which the protagonist has carved words related to her dysfunctional childhood all over her body, NSSI is often overlooked and misunderstood.
NSSI Is Not a Death Wish
Don’t confuse self-injury with suicide; people with NSSI are generally not suicidal.
“Cutting can be an especially frightening experience for parents because of how much it looks like a suicide attempt. In less common cases, it very well could be,” Angela Caldwell, MFT, founder of The Self Injury Institute, explains to Parentology. “More common, however, are instances of what we call ‘non-suicidal self-injury.’ These are often attempts, however alarming, to cope with emotional distress.”
According to the Crisis Text Line, which corresponds with thousands of teens anonymously every year, NSSI serves a number of purposes. None of these directly correspond to suicidal ideation. The list includes:
- To cope with stress or negative feelings
- As a distraction to deal with overwhelming emotions. Deliberate self-harm is used by some people as one method of taking their minds off overwhelming emotions.
- To feel something physical
- To develop a sense of control over their lives
- Self-punishment for perceived wrongdoings or deserved pain
- Expressing emotions that they are otherwise embarrassed to show.
And, while these injuries are sometimes alarming, they’re generally done in private rather than as a public display.
The Canadian Journal of Psychiatry published a review in 2014. Entitled “Nonsuicidal Self-Injury: What We Know, and What We Need to Know,” the conclusion remarked:
“It is true that NSSI sometimes serves interpersonal functions; however, across studies by diverse investigators using diverse methods and populations, it has become clear that NSSI is infrequently attention-seeking. Instead, NSSI is most often performed in private as a way to quickly alleviate intense negative emotions.”
Still, with almost two million cases of NSSI reported annually in the US, the problem can become life-threatening and severe. While teens with NSSI might not want to commit suicide, terrible injuries that might end lives do happen. If you think your teen is cutting, it’s important to pay attention so that an accident doesn’t occur.
What Are The Warning Signs of NSSI?
The Mayo Clinic lists a number of common types of NSSIs. These include, but are not limited to:
- Cutting
- Scratching
- Burning
- Carving words or symbols into the skin
- Hitting or punching oneself
- Piercing the skin with sharp objects
- Pulling out hair
- Picking at wounds/interfering with healing process
With a list like this, it would seem noticing NSSI in your teen would be easy. It’s not. Due to the private, secretive nature of NSSI, many teens hide it extremely well. It’s not just about wounds, but also about certain behaviors. The Crisis Text Line suggests looking for these signs:
- Scars
- Fresh cuts, burns, scratches, or bruises
- Rubbing an area excessively to create a burn
- Having sharp objects on hand
- Wearing long sleeves or long pants, even in hot weather
- Difficulties with interpersonal relationships
- Persistent questions about personal identity
- Behavioral and emotional instability, impulsiveness, or unpredictability
- Saying that they feel helpless, hopeless, or worthless
What to Do if Your Kid Is Cutting
Understand, first off, you cannot be your teen’s therapist. Even if you happen to BE a therapist. Encouragement to find help should be understanding and gentle. Looking for help together can be useful; finding a friend to listen to and encourage your teen might work, too.
“When parents discover that their son or daughter has cut, the first step is to remain calm — a tall order for a parent who is probably trembling inside,” Caldwell tells Parentology. “That calm demeanor, however, can be the difference between a teenager opening up and a complete shutdown of communication. Once parents have gained control over their own emotional response, they should try to resist making demands.”
Once the initial shock is over, Caldwell gives further guidance.
“Begging for answers or pressing for information makes a parent look incompetent and out of control — something that a child will read as a danger signal, and probably react by withholding any information that they think will upset the parent further,” Caldwell advises. “Instead, parents should approach their child with the same concern they would show if they discovered their child had gotten injured at school. In those cases, parents typically approach the child with concern tempered by a sense of competence and control–a comforting attitude of ‘I know what to do.’ Children read this as reassuring, are more likely to feel safe and blame-free, and therefore are more likely to share.”
So, if you discover your child is engaging in NSSI, get help.
“Identify a therapist with some experience in treating self-injury. Therapists who are skilled in family counseling are even better,” Caldwell says. “Self-injury often stems from problematic family dynamics that can be addressed, and fixed, in family therapy.”
What to Do if Your Kid Is Cutting — Sources
Angela Caldwell, MFT, founder of The Self Injury Institute
The Self-Injury Institute
Crisis Text Line
Canadian Journal of Psychiatry
Cornell Research Program on Self Injury and Recovery