Helping teens overcome self-injury

Dear Mr. Dad: I’m really worried about my daughter. She’s a sophomore in high school and until the beginning of this year she was a happy, cheerful girl. Recently, though, she’s been losing a lot of weight and is always wearing big long sleeve shirts. She won’t show her mother or me her arms or her body. She’s also very secretive and spends a lot of time alone in her room. My wife and I are terrified that our daughter is cutting herself, and we’re both really scared for her safety. What can we do?

A: Okay, the very first thing you need to do is get a health professional involved. Unexplained weight loss, sudden changes in behavior, unexplained major mood changes and weight loss are all major red flags. Keep a detailed record of what you see your daughter eating over the course of a week, as well as any behavior that concerns you. Then, take your notes to your family doctor and get his or her advice.


In addition, make contact with the folks at your daughter’s school. Her teacher and perhaps the principal should be able to tell you whether she’s behaving strangely there as well and if she’s being bullied or exhibiting any other problems you might not be aware of.
Now let’s talk about your concern that your daughter is hurting herself. If she is, she’s certainly not alone. Not by a long shot. In a study published last year in the journal Psychological Medicine, researchers found that 46 percent of teens had done some kind of non-suicidal self-injury within the previous year. The most common types of injury were biting, cutting, burning skin, and hitting—and wearing baggy clothes is a classic attempt to hide the scars.

How much do you know about your daughter’s social life? Did she recently break up with a boyfriend or have a major falling out with friends? These may seem like minor events to you, but to your average teen, they’re earth-shatteringly awful. According to the study, the most common reasons for self-injury were, “to try to get a reaction from someone,” “to get control of a situation,” and “to stop bad feelings.”

If your daughter is indeed harming herself, she needs help right now. Unfortunately, you’re not the right person for the job. You’re too emotionally close to the issue and it will be very difficult for you to maintain an objective point of view (no-one blames you for that. In fact, if you were able to remain calm and objective when your precious child is hurting herself, I’d be a little suspicious).

I suggest you start with your daughter’s pediatrician, who will refer you to an appropriate specialist if necessary. While you’re waiting to get an appointment, spend some time looking through the resources at selfinjury.com, and pick up a copy of Michael Hollander’s book, Helping Teens Who Cut.

At the same time, give your daughter an open mind and a sympathetic ear, and try not to be too judgmental. As the father of two teenage daughters, I can tell you that the fact that she talks to you at all (a) takes a huge effort on her part, and (b) is a sign that she really trusts you. Finally, keep monitoring her behavior as unobtrusively as you can (but stay far, far away from her diary—that’s the surest way to destroy that trust).

An important part of a teen’s development is pushing boundaries and making mistakes. If your daughter knows she has a safety net, she just might use it.