Wednesday, November 20, 2013

Helping Your Child Reduce Self-Harming Behavior




PsychCentral Associate Editor


Self-harm, or inflicting physical harm onto one’s body to ease emotional distress, is not uncommon in kids and teens.

In fact, according to clinical psychologist Deborah Serani, PsyD, in her book Depression and Your Child: A Guide for Parents and Caregivers, about 15 percent of kids and teens engage in self-harm.

There are many forms of self-harm, including cutting, scratching, hitting and burning. Many kids and teens who self-harm also struggle with depression, anxiety, eating disorders, physical abuse or other serious concerns or psychological disorders.

These kids “don’t know how to verbalize their feelings, and instead, act them out by self-injuring,” Serani writes. Kids might self-harm to soothe deep sadness or other overwhelming emotions. They might do it to express self-loathing or shame. They might do it to express negative thoughts they can’t articulate. They might do it because they feel helpless.
Research has found that self-harm is an addictive behavior. “Clinical studies link the role of opiates. When a child self-harms these feel-good endorphins flood the bloodstream. The rush is so pleasing that a child learns to associate self-harm as soothing, instead of being destructive,” Serani writes.

Self-harm is called non-suicidal self-injury (NSSI) because there’s no intention to commit suicide. However, as Serani cautions in her book, self-injury can lead to deliberate suicide.
If you notice signs of self-harm, take your child to a therapist for a professional evaluation. A therapist will determine whether self-harm is suicidal or non-suicidal by administering a suicide assessment (and ascertain if other concerns are present). They’ll also teach your child healthy techniques for dealing with painful emotions or situations.

In addition to taking your child to see a mental health professional, there are other ways you can help them reduce the urge to self-harm. In Depression and Your Child, Serani lists these valuable tips.

1. Create a coping kit.
Put positive and uplifting items in a shoebox or another container, which your child can use when they get the urge to self-harm. This can be anything from a journal to art supplies to upbeat music to photos of friends, family or their heroes. Include anything your child finds calming or inspiring.

2. Model positive imagery.
Visualizing a beautiful, serene place is a great way to reduce anxiety or painful emotions. When you practice positive imagery in front of your child you help them strengthen these skills. Serani suggests talking aloud as you describe a soothing landscape – like a beach – or positive memories of a place you’ve been to. Use vivid details in your descriptions. 

3. Talk about triggers.
Help your child better understand the types of situations and stressors that trigger their negative feelings. As Serani notes, “If it’s a test coming up in school, a social event or a dentist appointment, talk about how the days leading up to it can feel stressful.” This helps your child be prepared and have the necessary skills at their disposal. Also, talk about your personal triggers and the healthy ways you cope.

4. Suggest using less severe behaviors.
If the urge to self-harm is still present, Serani suggests “using less severe activities,” such as “holding an ice cube, tearing paper, shredding a sheet, snapping a rubber band, sucking a lemon peel and pounding a pillow.”

5. Suggest engaging in physical activities.
According to Serani, the rush of adrenaline in physical activities, such as running, dancing and playing chase with their pet, actually produces the same chemical surge that self-injury does.

6. Be compassionate about setbacks.
Stopping self-harming behavior isn’t easy, and it’ll take time. Your child may have setbacks. The best approach if a setback occurs is to offer nonjudgmental support. “Research shows that shame, criticism, or overreaction when parents see a wound causes children to withdraw back into self-harming behaviors,” Serani writes.

Again, if you think your child is self-harming, make an appointment with a therapist for a professional assessment, and support them in practicing healthy coping strategies.
Overcoming self-harm isn’t easy, but, with effective intervention, your child can stop these behaviors and get better. The key is to get help.

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