Questions Parents May have About Nonsuicidal Self-Injury and Their AdolescentBy: Gina CiprianoSelf-harm can entail behaviors such as cutting, burning, banging head against wall, scratching oneself, etc. People who engage in nonsuicidal self-injury (NSSI) may use behaviors, such as these, to harm themselves without having suicidal intention.Why is my Child Engaging in Self Harm?There are numerous reasons that an adolescent may potentially be engaging in NSSI:Biological Reasons: Each half of our brain’s houses something called the nucleus accumbens, which is a fancy word that describes an area of the brain that is sensitive to predicting reward (Casey et al., 2008). In adolescents, this portion of the brain is more sensitive to the thought of a perceived reward versus adults or children, which can make adolescents more likely to engage in risk-taking behaviors (Casey et al., 2008). Ultimately, adolescents have not developed the part of their brain responsible for impulse control, but they are sensitive to engaging in behaviors that are risky, increasing the likelihood they will engage in NSSI.Social Reasons:Adolescence marks the period of identity development leading increased interaction with peers and more time away from the home environment. Being around peers who engage in self-harm increases the likelihood that an adolescent will act on these urges themselves (Hawton et al., 2012). Additionally, people who are struggling socially (such as enduring bullying, being confused or made fun of due to their sexual orientation, and difficulties at school), may be more likely to engage in self-harm (Hawton et al., 2012). Finally, difficult life events, such as adverse childhood experiences and parents getting divorced, may increase their use of NSSI (Hawton et al., 2012).Mental Health Reasons:NSSI can serve as a means to escape difficult emotions, which may indicate underlying mental health issues (Hawton et al., 2012). These are examples of mental health issues can increase an adolescent’s risk to engage in NSSI (Hawton et al., 2012):
- Depression
- Substance Use
- Anxiety
- ADHD
Can This Lead to Suicide?The answer is not a straightforward yes or no; it depends, which is why it is vital to have your adolescent evaluated by a mental health professional. Klonsky (2014) state that Joiner’s Interpersonal Theory of Suicide explains “people must possess both the desire for suicide and the capability to act on this desire for one to make a potentially lethal suicide attempt” (p.567). Having a desire to die by suicide entails wanting to die or not exist anymore. However, people may fear pain associated which prevents them from ever attempting suicide. However, those who engage in NSSI may slowly build up their tolerance to pain, causing them both to have the desire and capability.How Can I Support My Child?Having a child who engages in NSSI can be extremely disheartening and scary for a parent. Here are some suggestions adapted from Berger (2013) that can help parents:
- Do not assume or label a child as suicidal or problematic who engages in NSSI. This can cause defensiveness from the child and decrease their trust in you.
- Ask them, nonjudgmentally, why they feel they are engaging in self-harm. The question can be phrased as, “I am concerned about you. I was wondering why you think you have been engaging in self-harm?”
- Talk to the child about how they think you can create a more supportive environment at home for them.
- Speak to the child about their thoughts on entering counseling.
- Let your child know you love them and are there to support them.
ReferencesBerger, E., Hasking, P., & Martin, G. (2013). ‘Listen to them’: Adolescents' views on helping young people who self-injure.Journal of Adolescence, 36(5), 935-945.https://doi.org/10.1016/j.adolescence.2013.07.011Casey, B. J., Getz, S., & Galavan, A. (2008). The adolescent brain. developmental review, 28(1), 62-77. https://doi.org/10.1016/j.dr.2007.08.003Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: What we know, and what we need to know.The Canadian Journal of Psychiatry, 59(11), 565-568.https://doi.org/10.1177/070674371405901101Hawton, K., Saunders, K., & O'Connor, R. C. (2012). Self-harm and suicide in adolescents.The Lancet, 379(9834), 23-29. https://doi.org/10.1016/S0140-6736(12)60322-5
