(Content warning: this post talks about self-harm in general terms.)
I’ve talked before about the challenge of conceptualizing behavior as a symptom of mental illness. This is especially challenging for parents when it comes to discipline; on the one hand, you can’t make symptoms go away by punishing them, but on the other hand, if a dysregulated child punches me, I still want to correct that behavior (later, when we are both calm) and communicate that it is not okay to hurt people.
In this post, I am going to talk about self-harm behavior and why it is not helpful to punish someone for self-harm. I am specifically referring to non-suicidal self-injury behaviors. More information about what self-harm is can be found here.
When a child or teen is engaging in self-harm behavior, many parents’ impulse is to punish them. The logic is something like, “You are hurting yourself. It’s bad to hurt yourself. I punish you when you do bad things.” But this does more harm than good and can exacerbate mental health issues.
All behavior seeks to meet a need. If we find the need behind a problem behavior and meet that need in a healthy way, a lot of issues resolve themselves. Self-harm behaviors can occur for many reasons:
- Physical pain causes the brain to release endorphins, which cause a positive emotional response. People with mental illnesses caused by chemical imbalance might engage in this behavior to get the “good chemicals” going in their brains. Instead of punishing, get your child the support they need for their mental health, like enrolling them in therapy and talking to their physician about the option for medication.
- Mental illness is a liar, and sometimes people with mental illness feel that they deserve to feel pain. Self-harm can be a manifestation of this thought process, so punishing the behavior reinforces this idea. Instead of punishing, communicate to your child that they are loved and worthy of love. Seek mental health services to help them combat these thoughts.
- Some people who experience trauma or dissociative symptoms use self-harm behavior to regulate unpleasant feelings or intrusive memories. The physical pain is a way to “snap out of it.” Instead of punishing, encourage healthy grounding techniques to cope with these symptoms, and find mental health services to help your child with the underlying symptoms causing them to self-harm.
- Sometimes, behavior emerges out of a need for control. Many things in life are not in our control, and this is doubly true for children and teenagers – they don’t decide where they live, where they go to school, and have limited say in the food they eat or the clothes they wear. In this case, self-harm becomes the only thing they feel in control of, and punishing that behavior causes them to develop a stronger need for control. Instead of punishing, find healthier, more appropriate things your child can feel in control of, like letting them redecorate their bedroom or plan the dinner menu. Therapy services (both individual and family) can help your child work through this need and find appropriate ways to feel in control.
- It’s hard to think about behavior as involuntary, but for many, behaviors that can be labeled as self-harm occur due to an impulse control or tic-related disorder. Punishing the behavior is ineffective because the individual may or may not be consciously aware that they are doing it. Instead of punishing, use mindful awareness and gentle redirection to alert the child when they are engaging in the behavior. A therapist can help the child develop appropriate alternatives, and a physician may have recommendations for medication that can stop the behavior.
- “Stimming” refers to behavior that is self-stimulating or self-regulating. It is often referred to in the Autistic community, but individuals who are not Autistic might also stim. Stimming behavior is often harmless, but it can also manifest as head banging or other behavior that might be dangerous. As previously noted, because this behavior meets a need, you can’t simply punish it away. Instead of punishing, if a stim behavior is harmful, have a mental health professional help your child identify safe stim behavior as an alternative.
- For reasons I will go more into another day, I don’t love the terms “cry for help” or “attention-seeking” because they get used as a reason not to offer someone support. But sometimes, people engage in self-harm behavior as a way to communicate that they need help. They might not know a healthier way to ask for help, or they might have tried asking in other ways and been disregarded in the past. (It’s important also to remember that, if someone is hiding self-harm behavior, it’s not “attention-seeking,” since they are deliberately trying not to receive attention for the behavior!) Instead of punishing, get your child the help and support they are asking for!
The main takeaway here is that self-harm behavior needs to be met with support and mental health services rather than grounding, taking away privileges, or shaming.
“But won’t that reinforce the idea that self-harm gets needs met, and they will want to do it more?” The short answer is no. The long answer is, if you can meet the underlying needs in a healthy way, the need for self harm goes away. Hear. Listen. Meet the need.
In my book, I Don’t Want To Be Bad, I explore more ways to teach kids how to communicate their needs and emotions appropriately rather than simply punishing them for their mistakes.