My Child Hurts Themselves When Upset. What Can I Do?
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Worried that your child is hurting themselves? You’re not alone. While this behavior is relatively common, that doesn’t make it any less challenging. In this post, you’ll learn what might be driving the behavior, and what to do if your child self-harms.
This post is part of our Ask a Child Psychologist series, where we answer anonymized questions submitted by readers like you. This post deals with topics related to self-harm. Please take care when reading.
If you’ve discovered that your child is self-harming, know that you’re not alone in feeling worried and even overwhelmed. This is a challenging, and relatively common, situation for families to navigate.
Over the years, we’ve received questions like, “Why does my son bite his hands when he’s upset?”, “Should I worry about my 6-year-old pinching herself and saying negative things when she struggles with schoolwork?” or “My son is emotional - I am, too - and he’s started hurting himself. I think he’s trying to punish himself, and am starting to worry. What can I do?” If you’re hearing statements like these, this article aims to provide guidance for your family.
We know it’s upsetting and stressful to hear your child make self-defeating statements, or engage in behaviors that are potentially hurting their body. The silver lining is that, with this knowledge, you can take action to help your child get the support they need.
In this article, you’ll learn answers to important questions like:
What is self-harm?
Self-harm in children can be understood as any behavior where an individual purposely hurts themselves. It can look like self-inflicted scratching, cutting, burning, hitting, punching, slapping, or other ways of causing pain or injury.
Research suggests that as many as one in five adolescents will self-harm.
Keep in mind that many children who are engaging in self-harming behaviors do not want to end their lives. If you are ever concerned that your child is in crisis or may be considering suicide, it’s important to take action. Please know that the following resources exist for you:
Call 988 (National Suicide Prevention Hotline).
Call 1-800-273-TALK (8255) to reach a 24-hour crisis center.
Text 741741 to reach the Crisis Text Line.
Call 911.
Go to your local nearest emergency room for an assessment.
Resources exist to support you. You’re not alone.
What are signs of self-harm in children?
If you’re concerned that your child might be hurting themselves, here are some signs to look out for:
Unexplained cuts, marks or scars. They may be in different places on your child’s body, or clustered together.
Often having, appearing to collect, or hiding dangerous instruments, like lighters, razors, safety pins, or scissors.
Wearing clothing that covers their arms and/or legs, even on warm days, or lots of bandages.
Spending time isolated in their room or bathroom.
Hiding parts of their body that would usually be exposed.
Bloody bandages or tissues, which may be hidden at the bottom of the trash bin.
Expressing their sadness, worthlessness, or emptiness.
Big mood swings.
Pay attention to your instincts. When parents sense that something is off, they’re often right.
It’s important to remember that children and adolescents may feel shame about the self-harming behavior, and try to hide it or be reluctant to talk about it. When you talk to your child, try to do so with as little blaming and shaming as possible. We’ll share a few tips in the “how to respond to self-harm” section later.
Why do children hurt themselves?
There’s no single, universal reason why children hurt themselves. However, in many cases, children and adolescents use self-harm to cope with “big feelings,” such as sadness, anger, frustration, numbness, shame, or loneliness. Self-harm can be a way to deal with these emotions, because to them:
It provides some (temporary) relief from the intensity of the emotions they’re experiencing.
They’d rather hurt themselves than take these feelings out on others.
They feel they need to punish themselves, because they’ve been “bad," or because they don't see themselves as “good” or “worthy.”
It can also be a way for children to get their needs met.
Self-harming can happen at almost any age. A lot of stressors could contribute to a child feeling emotionally overwhelmed, including (but not limited to) trouble at school, relationship difficulties with loved ones and friends, a recent loss, major lifestyle changes like a move.
Imagine if a child accidentally makes a mistake on schoolwork. This could provoke frustration. Instead of seeing it as a little thing that can be fixed, the child may start to think, “I made a mistake, I must be a bad student,” or worse, “I must be a bad kid.”
When children have such an internal dialogue with themselves, they can self-punish as a way to cope with these thoughts. For example, “I will pinch my arm to teach myself a lesson because I am a bad student.”
How to respond if your child self-harms?
If you’re worried about the frequency, severity, and type of self-punishment you’re observing, it’s important to speak with a child mental health expert. While we know it can be scary for parents to see their children managing such intense emotions, you’re doing so much for your child by connecting them with support early. Early intervention is the best form of prevention.
Here are a few additional guidelines for how to respond:
Become a detective: We encourage you to be your child’s own mental health detective and think about the following: what happens right before your child engages in these behaviors? (For example, is it after they get home from school? Gets something taken away? After an argument?) Some families have found it helpful to track these behaviors over the course of a week to see if they identify any patterns in behavior.
Stay calm. It’s important that you remain collected and non-judgmental during these difficult moments. By being calm, you make it possible for your child to feel safe, open up to you, and allow you to help them.
Do not punish: When children engage in these behaviors, we encourage parents to view this as a teaching opportunity and not as much as a punishment opportunity. Punishing these behaviors will unfortunately not stop them, but will only signal to your child that they aren't safe to share with you. (It’s important not to frame a doctor visit as a punishment, either.)
Focus on the feeling: As adults we often forget how hard it is to be little, and that underneath every big behavior is a big feeling. When communicating with your child, make sure that they know big feelings are normal, even if they’re not easy to navigate. This could sound like, “I see how hard of a time you’re having and am so glad you told me how you’re feeling. While all feelings are okay, it is not okay to hurt your body. Your body deserves protection and it’s my job as your parent to keep you and your body safe.”
Open lines of verbal and non-verbal communication: In moments when you both are feeling calm, we encourage you to talk with your child and take what they say seriously. You can reflect back something like, “You mentioned earlier you want to punish yourself,” or “Earlier I saw you hurting yourself. Tell me more about that.” If your child responds verbally, listen for the feeling they describe. If your child does not want to talk, that is also perfectly okay. Let your child know that you are there to listen when they do. Depending on the age of your child, art can also be a helpful way of supporting children in expressing their feelings (i.e., “I see you don’t want to talk about what is going on, that’s okay. It can be really hard to talk about your feelings, and I’m here when you’re ready. I wonder if it would feel helpful to draw together about how we’re both feeling.")
Listen without judgment: If your child is willing to have a conversation, do your best to listen without judgment. Ask open-ended questions, in other words, those that cannot be answered with a simple yes or no. Resist the urge to jump in with a solution, offer quick fixes, or reduce your child’s experiences to “being dramatic.” It will be important to validate, acknowledge, and support his feelings.
Offer different coping mechanisms: Help your child identify other ways of coping with negative emotions, like taking a break, exploring healthy distraction, working on more positive self-talk, and learning to identify and express feelings. The goal here is to help your child by increasing the time between the feeling and the behavior.
Problem-solve together. Since your parental spidey-sense is already telling you your child is having a hard time processing feelings, let them know that you’re there to figure it out with them. You all could create a calm down box for home and school, where they can have readily accessible coping skills to use in the moment. These could be deep breathing cards, a fidget toy, a calm-down bottle, or something he can squeeze!
Connect with your child’s school. It can be helpful to ask your child’s teacher or school if they’ve noticed any of these behaviors or statements, so that you have a fuller picture.
Pay attention to how you’re feeling, too. We know that parent and child wellbeing are connected. Taking care of yourself is taking care of your child. No one can pour from an empty cup. If you’re feeling stressed out, exhausted, or overwhelmed by the situation, it’s important to seek support for yourself, too.
Remind yourself you’re not a “bad parent,” and your child isn’t a “bad kid.” It can be so meaningful to hear something as simple as, “You’re a good kid, even on your toughest days.” There’s no need for shame in these difficult moments. Our behaviors don’t define us.
The goal of all of these recommendations is to help you understand what your child is trying to communicate when they make self-critical statements and/or engage in these self-harming behaviors.
What about negative self-talk?
Wondering what should you do if the self-harming behavior is accompanied by (or preceded by) negative self-talk? It’s not uncommon for self-criticism and self-harm to show up together. While we know it might be hard to believe in moments of stress, it’s a strength of your relationship with your child that they’re verbalizing to you what is going on for them.
We do want to take negative self-talk seriously. Words have meaning. Over time, a self-critical dialogue can become more of a narrative that’s difficult to break.
This negative self-talk could sound like, “I’m a bad kid,” “I’m ugly,” “I never do anything right,” “I’m the worst kid in the world,” or any number of harsh statements your child makes about themselves.
Hearing these kinds of things is incredibly difficult as a loving parent or caregiver. At the same time, how you respond to these statements and feelings matters. In these moments, it’s natural to try to mitigate these negative feelings with positive affirmations; unfortunately, this tends not to be helpful. Statements like, “Don’t worry about that, you’re a wonderful kid!” or “No, honey, you’re beautiful!” may send the signal that you don’t recognize the validity of your child’s feelings. This can cause the feelings to fester, as your child begins to feel their emotions are “bad,” too.
If you’re hearing statements like these, we recommend speaking with a child specialist.
When should you worry about self-harm?
If you notice your child hurting themselves, or you think your child is considering self-harm, it’s important to speak with a child mental health expert. (If you’re noticing more physical behavior, like head-banging or cutting, it’s important to seek a medical evaluation as well, to make sure their bodies are a-okay.) A mental health evaluation can help rule out any underlying mood, sensory, or behavioral challenges.
The recommended path forward will depend on the frequency, severity, and type of self-harm your child is inflicting. It may include therapy, mindfulness exercises, medication, support groups, family counseling, or a number of other approaches. Your mental health provider will work with you to build a plan that suits your child and family’s unique needs.
Little Otter is available in select states for evaluation. We also offer parent coaching, and child therapeutic services as needed. You could also consider speaking to your pediatrician, who may have additional recommendations for child specialists in your area.
Remember, as difficult as this situation may be, you’re not alone - and there are methods that can help. We’ve heard from parents of a 4-year-old who has big feelings, a 5-year-old struggling with school, a 9-year-old who is really tough on themselves, and others struggling with self-harm. If your family is navigating this challenge, support exists to help your little one develop more effective, healthy ways to deal with their feelings.
Do you have a question you’d like to ask a child psychologist?
Submit your questions here. Remember, you can choose to remain anonymous if you’d prefer.
