What You Need to Know About Self-Injury

By Mark Luzader, LCSW, Courier & Press, Jan. 5, 2016 – Self-Injury, or “non-suicidal self-injury” (NSSI), is a behavior that has gained some increased awareness in recent years. Despite increased awareness, many still don’t know much about NSSI.

So what is NSSI? According to the “Diagnostic and Statistical Manual of Mental Disorders (DSM) Volume 5,” a person engaging in NSSI has engaged in at least five days of self-injury over the past year, with the anticipation that the injury will result in some bodily harm without suicidal intent. The acts are not socially acceptable and cause significant distress.

Behavior can include, but is not limited to, cutting, burning, scratching, punching hard objects, pulling hair or carving into the skin (usually in a superficial manner).

Why do children engage in self-harm? There is no definitive answer. Most children who engage in NSSI are ages 12-24. Of the adults who self-harm, nearly all started in their early adolescent years. There is a social factor; many children who experiment with self-harm have a friend or relative who has engaged in the behavior.

Similar to any modeled behavior, a child may try the behavior and continue, or they may not like the behavior and discontinue. If the child continues to self-harm, the behavior can develop into an addiction.

There are several risk factors that go along with self-harm. Being female is certainly No. 1. Most studies agree that females are much more likely than males to engage in self-harm as a way of coping.

Other risk factors include:

Age — Early teens and young adults are most frequent self-harmers

Peers — Friends or siblings who self-harm

Life issues — Those who were neglected, abused or have experienced other traumatic events (i.e. death); are in an unstable family environment or who may be questioning their personal identity or sexuality

Coping skills — Children who are impulsive, explosive, highly self-critical or poor problem-solvers

Mood — NSSI is commonly linked to depression and anxiety

Certain situations within families can lead to NSSI as well:

Parental difficulties dealing with normal human emotions or expressed needs (too distant, too reactive or too close)

Pressure for perfectionism or to “be strong”

Poor communication/problem-solving

Sexual, physical or emotional abuse

So what can parents do to reduce risk factors?

1. As children get older and friends become more of a priority, maintain good, open communication.

2. Spend time together doing things your child chooses. If you have a large family, taking one-on-one time with each child as they get older is critical. Even if it’s not every day or every week, “check-in time” is important.

3. Get to know your child’s friends. The stereotype of the “emo” or “goth” kid who cuts themselves is just that — a stereotype. Most children who engage in NSSI are middle to upper-middle class, clean-cut kids who know how to present well.

4. Be on the lookout for unseasonable dress. Wearing long sleeves and pants when the weather is hot is often something more than, “I’m cold.”

If you suspect your child is engaged in NSSI, finding a professional therapist is absolutely essential. Seeing one that specializes in self-harm is always the best course.

In therapy, your child will develop better ways of coping with problems before they become unmanageable. Family therapy will also be a part of this process so that change can be reinforced at home. Having a counselor or Youth First Social Worker to talk to for support at school is crucial too.