What To Do If Your Teen’s Friend Is Self-Harming | A Parent’s Guide

A lot of parents believe that self injury is just cutting.

And it's actually a much more broad category. It is really any intentional kind of injury or harm to oneself. And that may or may not be associated with any sort of suicidal ideation or wish to die. But we do know that the longer that a young person is engaging in self injury, the risk of suicide or a suicide attempt increases significantly by about fifty percent. So this is a really important moment to intervene if you do get this information.

Welcome back to the Parenting Pair Podcast. I'm Dr. Suzanne Allen. And I'm Dr. Annalise Caron And this week, Annelise and I wanted to respond to a message that we got from a parent recently, which is a message that we've actually gotten frequently throughout our careers.

I would say it comes up at least once a year for, you know, over the core on average over the course of, you know, I've had my time practicing.

Professionally, and I would say personally too. Mhmm. So this parent reached out to us because her teenager came to her and shared that one of her friends was cutting herself Mhmm. And had disclosed that, that this other young person's parent was unaware, no one knew this was happening, and this teenager brought it to their parent because they were really worried about their friend and not sure what to do. And in turn, this parent reached out to us really worried as well and not sure that they were doing or saying kind of the right things.

And just a couple of things to highlight in this situation that comes up. First of all, it happens frequently because research really shows that teens are more likely to go to teens and express these things than necessarily to go to their own parent, whether that be for embarrassment or shame or not feeling secure telling their parent or So it's really common that, you know, and the dynamic that happens for the teen that receives the information is that that can feel but can bring out a lot of emotions. They can feel great burden, like they have to do something. But oftentimes, and this was not in the note we got, but I'll just highlight it, sometimes the teen who receives the information might even be told by the other teen who, you know, is self injuring, hey, don't tell anyone. And so what was so, I thought, positive about this reach out from this mom is that their teenager who received the information that the friend was self injuring went to their mom.

Because oftentimes teens feel like they can't, you know, because their friend has said, don't tell anyone, which is a real burden, you know? So just before we even jump into the whole, you know, topic today, I just want to say this might be something if you have teenagers at home that you just mentioned to them. Hey, if ever you hear I hear this happens sometimes. If ever you hear that one of your friends is cutting or self injuring or hurting themselves in any way, you know, just know that you can come to me with that information and I'll help you. Like, no judgment.

You know, I I just want to let you know we'll figure it out together because that's something that happens and I hear teens feel really stressed by it. Mhmm. You know, light and airy, not related to anything, just opening that door, I think can be important.

Absolutely. So this is a really big topic, I think. There's a lot of directions we could go. And so I've been thinking about this before today, and I believe it will be helpful if we kind of work in sections here almost. And so I would say let's group it into three different areas.

One, just a little bit of information psychoeducation about self injury so that parents want we don't have to be you don't have to be, you know, detectives or clinicians and and kind of manage all this yourself, but just so you're aware and understand a little bit more about this and and can speak with your teenager about this. So one, information. Two, how to care for your own child or teen if this is disclosed to them and support them through this. And number three, of course, how we can best support and help teenagers who are engaging in self injury.

Mhmm. Yeah. And and I think there's there's a lot of thoughtfulness, you know, at at each step in that, but really kind of protecting your own teen and also protecting the other teen that's involved. And there are real nuanced ways to do this, and you do not have to do it all alone yourself. So let's jump in to just what is self injury.

Right? Because that might I think a lot of parents believe that self injury is just cutting. Right? You might see it in a movie or be aware of someone who cuts with, know, a knife or something like that.

Or a razor blade is one that you see in movies quite frequently. And it's actually a much more broad category. It is really any intentional kind of injury or harm to oneself. And that may or may not be associated with any sort of suicidal ideation or wish to die, but it does not have to be. So it could also be things like burning, scratching.

Sometimes with adolescent boys, find more punching themselves. Right. Hitting, head banging. Yeah. So some really distressing and difficult things to hear about as well.

So that that is kind of the broader, you know, category of what it is. And I think a lot of times, we as adults and teenagers, when they hear about this, can wonder, like, why would someone do this? Why does this happen? And so just kind of understanding that there are some different ways in which self injury can kind of function or operate to to help someone or Right. Can be useful.

So often, as clinicians, we think a lot about emotion regulation.

Right. Right. And we can think of two sides of that. Right? We can think of emotion regulation in terms of like decreasing, you know, intense emotions or kind of helping or perceiving that they're helping sort of feel maybe if they feel emotionally numb.

Yep. Because you hear that from teens sometimes that they're in so much pain, they're in so much distress, they do not know what to do, they are suffering so badly, and that if they do cut themselves or scratch themselves, that often they describe feeling some sort of a release Release. Or release. On the other hand, we have heard a lot of teenagers talk about not feeling anything, feeling numb to whatever situation it is. And they want to feel something because they they are deeply upset, kind of logically about Yes.

Whatever the situation is. And so that they might engage in self injury to create pain, that physical pain that matches what they are experiencing as their emotional pain.

Right. So there's the emotion regulation piece. And there's really sort of a just communicating distress. Yeah. Sometimes teens don't know how or or maybe can't articulate what's going on for them, and it's a way to call attention and communicate to people in their lives, I'm really struggling.

Mhmm. Right? And I think it's distressing for people and, you know, to learn that someone's cutting or to see someone's cutting. So it can be, you know, quite effective at helping people notice or offer support when kids don't know how to ask or, you know, don't feel safe to ask. And that's not necessarily even a fully conscious process sometimes, you know, that they We're

not saying they're trying to get attention.

No. Absolutely not. But it can help to communicate the level of distress they feel. Mhmm. And that's actually really useful and helpful in ways.

Mhmm.

And by communicating that at times, sometimes that can also serve the function of things being pulled back and retreated. Right? If there's kind of punishment or consequences happening from a parent that possibly they may pull back on that. You know, maybe a way to communicate distrust appears if there's been bullying, you know, and and a hope that maybe that might help stop that if people are aware. Right.

So it we are not saying at all that it is attention seeking and and purposely sent, but it it can be a way that teens are communicating the level of distress of their own emotions or the environment around them.

So now we understand that really as scary as this may feel and as hard as it may be to understand if you've never had the urge to self injure, that actually this behavior is understandable. And we wanna be really, you know, open to any sort of difficulty and not immediately judgmental of that.

Of the teen or of the family. Right? Like, what's going on in that household that this kiddo is doing that? Right? There's a very wide range of reasons why this could happen, and going right to judgment about the teen or the family environment or whatever it may be is likely unhelpful.

And if that's communicated to your teenager, going to really put them on the defensive and shut them down when they're coming to you for help. Right. And they need help because while we are saying that self injury is not always associated with suicidal ideation or suicide, what we do know is that the longer that a young person is engaging in self injury, the risk of suicide or a suicide attempt increases significantly by about fifty percent. So Yeah. This is a really important moment to intervene if you do get this information.

Right. So let's talk about if your child, like this mom who reached out to us, is the one who's received this information from their friend. Mhmm. What do you say as a parent? What do you do?

Mhmm. Right? I think the number one first thing to do is just acknowledge that your child brought this to you. You know, thank you so much for telling me. You know, I'm really glad that you told me because you need support.

You don't need to carry this alone. Mhmm. You know? And I think one of the reasons that teens don't tell their parents, important things like this or things that they worry about, they worry about their parents' judgment. And so whether it be another friend is self injuring, maybe another friend is feeling suicidal, They may keep it to themselves either because that friend has asked them to, you know, to keep it private or because they just fear that maybe their parent's going to overreact.

Mhmm. And we really want to try to just say, hey, and sort of take this tone of, I'm gonna help you figure this out, and we're gonna figure it out together.

Yeah. And, you know, acknowledging the telling, right, is such an important component of it. I think also acknowledging without making assumptions that this may be difficult for them. It might have been upsetting to hear that, you know, so checking in with them, how are you doing? What did you think or how was this for you when you found that out?

Because they potentially could be operating in the mode of either fearful about breaking their friend's trust or feeling like, I'm I've got to do something. We've got to figure this out. And that is important. And also at the same time, we want to acknowledge that there may be some impact here of them either seeing evidence of this, seeing it, or just being aware of that and checking in on them is just a way to to show some love and care and allow them to have some emotions as well as you.

And I think just really acknowledging that situations like this are always so very complicated. There are so many different nuances to it. There's so many people's feelings. There's worry on your part as the parent and worry, you know, that your teen may be experiencing. And just sort of acknowledging this and not immediately jumping to, we're gonna do this, we're gonna do that.

You know, Just having that presence of mind and really validating the, you know, maybe confusion or difficulty of it goes a long way to help your teen feel better, even if you're feeling quite nervous inside. Because I think that's another thing. Parents get this information and it feels very overwhelming.

It feels very overwhelming.

Yeah.

I think, you know, if there's space for it, if they're asking questions about it or if you think it would be helpful, you know, helping them make some sense of it. And again, that doesn't mean that you have to explain exactly why this is happening. You likely don't know. But a simple statement like, it sounds like your friend is really hurting, or there's something really going on for them right now. And I wanna help you, and I wanna help them get more help.

Mhmm.

Yeah. Because I think they need it.

Right.

And you can explain a little bit more, you know, about what self injure is about as we discussed earlier, But I don't even know if that's necessary. I think just acknowledging this is a sign that your friend is really suffering and you want to help them and I want to help them too. And we're going to need more than just the two of us here.

Which may cause distress in your teen. Yes. And it may cause some distress in you to see your teen distressed. And all of that is normal. Mhmm.

Right? But being willing to step in sort of as the you know, with the confidence even if you don't feel it, we probably are going to need to bring someone in to help your friend because this is too much of a burden for you to figure out alone. And so I'm gonna help you do that.

And I think being transparent about that, and that doesn't mean you have to have the exact plan outlined because your teen might provide additional information that maybe there is something happening at home and they're not sure you can talk to the parents. Or there might be a lot more that comes out, but I think being transparent about your friend needs help, and I'm going to help you figure out the best way for us to handle this. And maybe that's going to involve the school, or maybe that's going to involve the other parents. But I'm gonna tell you what I'm going to do. Because I think that if you know, unless there's another reason not to do that, think that builds trust in your teen that you're not just gonna go start making phone calls and doing all kinds of things that they're not aware of when they've shared really private information with And

I think you also can validate your teen and say, I know this is really hard, but you did the right thing by telling me about your friend's self injury. And it may feel really hard right now, and you may be worried about your friend right now, but you did the right thing, and we're going to figure it out. I do wanna highlight what Suzanne just said there about one option of, you know, there is what to do is to call the parent. Right? Call the parent of this teen if you have a

way to access them. So let's shift, right,

to what what can we do?

Because I think you're naturally shifting. So let's shift to that of what do we do We to help the other

tell the team what we're going do, but what are our options of what to do? One is to call the parent if you have an easy way to do that and there's no knowledge that you have, like Suzanne mentioned, of a barrier to doing that, like that that the parent, you know, isn't a safe person for this teen. Right? Another thing that I have, you know, encouraged teenagers to do and talked to parents of teenagers to do is include the school. You can go to a counselor at the school and talk to them and get guidance from them.

Because if you don't have access to the family or if that's not the right choice, I think that is a natural way for a professional to get involved and help guide the teen in the family.

Mhmm. And I would say for calling the parent, you know, and I feel a lot of empathy for this because I think both you and I have been involved in this in many ways clinically and also as just humans and and as parents ourselves. Even when you know the other parent, it can still be tricky. Yes. And if you don't know the parent, it can be tricky.

So you can, if you believe that to be the right next step, call a parent you know or call a parent you don't know if you can Mhmm. Get their information. And recognizing that, you know, this other parent might be aware or they might not be aware, and you might be sharing something quite shocking, quite unsettling, quite devastating with them. And so we can't always predict kind of what their response might be in the moment. And so I think sometimes just going in I think a lot of parents I know have felt very nervous, and I have too about these calls.

So I sometimes kind of think like through a little bit of a script to help with that and just I lean in sometimes a little bit on kind of the DEAR man scale from DBT, the the DEAR part, which stands for describe, express, assert, reinforce. I don't go necessarily through all that, but just the describe, just kind of the basics of like, here are the facts. Like, because I just wanna share something that I have heard. And if I think as another parent, I would wanna know, I'd become aware that you're a teen. Maybe self intrigue.

Yep. And I was just very worried when I heard that, so I wanted to call and share that information with you so that you might be able to help or support them. Right. You don't have to add in other details of No. Why teens self injure or here's 15 referrals for people.

That's not your responsibility. Unless they and if they ask you, do you know it? Sure. But sometimes just the, like, I wanted to share this with you. We care very much about your child, and so we wanted you to be aware of this.

And and kind of that's enough sometimes. Because that can be quite shocking for parents to get that phone call.

Right. And and I I would say more often than not, parents are very appreciative to receive that information. Mhmm. They may, you know, be overwhelmed or surprised or But typically, that's enough to then send them, you know, in a direction. Yeah.

I guess I think that there.

And if not, you've tried to take that next step

Mhmm.

To help them. And maybe have some empathy that, you know, maybe they were so shocked or taken back that they may not have had a a grateful response or a regulated response. Now, if anything comes of that conversation that makes you more deeply concerned that you don't believe that this parent is going to be able to help this young person, I think going to the school is a great option. Right. If you are concerned about kind of imminent risk for this other child, you can call 211.

You can call 911.

Explain what 211 is? Yes. Suzanne? Because that may be state specific.

Yes. Yes. Yes. So please check that within your state. That is Connecticut specific.

It's an emergency kind of mental health support hotline that you can reach out to if you have concerns about someone's safety.

And most states have a mental health support hotline. In some states, there's mobile crisis. There are different resources that are easily accessible. You know, you also can just call 911, you know, if there's significant imminent risk and they can figure that out. I've also when guiding people in other states where I wasn't practicing, you know, friends, family members, you know, you can call the non emergency police number and ask them.

And they'll give you, you know, what's the proper resource if there's a more imminent concern. Mhmm.

So there are those resources out there.

After you've done that, after you have shared the information either with the parent or the school, I think it's really important to check-in with your teen. Because these situations are always complicated. They often feel like they might have betrayed the person or the friend who said, please don't tell any adult about this, but I'm self injuring. Please don't tell any adult about this, you know, but I'm considering killing myself. You know, whatever this sort of secret is, they feel that they've, you know, betrayed the And and their friend may

be angry or upset with them.

And so they're they they may have to cope with that and and face that. And I think if you can be that sort of steady I know this is really difficult, but in the big picture, this is the right thing to do to help someone who's struggling because it's too much for you to bear alone. And it's, you know, very frequent that teenagers are walking around with this information and feeling that heavy burden and not feeling as though they can share it with an adult. So I think having portraying that confidence and, you know, that you did the right thing and we've done the right thing, even if it's hard right now, is important. Mhmm.

Mhmm. Yeah. Yeah. So I think that kind of brings us to the what now, Suzanne. And I have one, if Yeah.

We can Go for it. I think it's just the idea that we don't have to know everything.

Oh, yeah.

I I appreciate that. Thank you. Yeah. Because, you know, that's why we have, you know, doctors and professionals and mental health providers and schools and, you know, we don't have to know everything. We just have to take a step towards getting support, which is the right thing to do for our own teens if they're in this situation and the right thing to do for the teen, you know, who's who's struggling.

That's great. Thank you for that. I needed to hear that today.

If this episode was helpful to you or you think it might be helpful to someone you know, please go ahead and share it. You know, self injury happens very frequently. And so I think the more that we can get this information out there, the better. Additionally, if this has resonated with you and you feel inclined, please rate and review the podcast. It just helps lift us up sort of in the podcast world, and that helps get the information to more parents.

So with that, have a great week. And now a quick word from our lawyers. The Parenting Pair Podcast is designed for informational and educational purposes only. Do not rely on the information presented in this podcast as a substitute or replacement for professional psychological or medical advice, diagnosis, or treatment. If you have concerns about you or a family member's well-being, please contact a licensed mental health professional or physician.