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Why Do Teens Self-Harm?

If you’ve recently discovered your teen is self-harming, you have to be wondering, “Why do teenagers cut themselves?” Cutting seems like a somewhat recent phenomenon.  It’s been around for a long time, but it has grown in notoriety and popularity.  The majority of teenagers I work with who have tried cutting mostly did so because a friend told them about it, or they hear about it on Tik Tok.  They wanted to try and see if it was a helpful way to cope with emotional pain.  Most find that it isn’t, and do not continue to cut.

By contrast, the teens who cut more seriously and regularly give us great concern.  For example, when I see a teenager in my office who cuts frequently and/or deeply, I worry.  Firstly, we immediately begin the discussion of the teenager completing an evaluation with a psychiatrist (We have several referrals we can offer, including Oak Health, Progeny Clinic, and Mind Health Institute, among others) having the teenager see a psychiatrist for an evaluation.  This is not cutting for attention as much as a deep emotional disturbance.  Oftentimes medications are needed in these situations.

A teenager telling mom she has been cutting.
A teen telling her mom about her self-injury. Credit: Castillo Dominici

Why Do Teenagers Cut Themselves: Where On the Body Tells a Story 

When considering why teenagers cut themselevs, it is also important to note is that teens cut in a variety of places.  The most common location is the inner forearm of their non-writing hand.  So, if they write with their right hand, the cuts are on the soft side of their left forearm.  Also, there are other common locations such as the inner thighs, and the stomach.  Usually, cutting on the thighs and stomach is done to avoid detection.  By contrast, teenagers who cut on their arm often want to be found out.  This is particularly true if they cut and then wear short sleeves.

Cutting as a Coping Skill

Importantly, why do teens self-harm?  There are of course a variety of reasons.  Cutting is not a one size fits all venture.  However, the best explanation I’ve ever heard was by Richard Bautzer, MFT.  He told me he believes teens cut as a coping skill to control their pain.  You would naturally ask, “Why would they inflict more pain on themselves as a way to control pain?”  This is because there is some emotional stressor that feels uncontrollable to the teenager.  This stressor really could be anything.  For example, the teen who is cutting might be managing the stress of parents going through a divorce.

Another Reason Why Teenagers Cut Themselves: Cutting to Control Emotional Pain

Cutting to control pain works like this: A teen can control when they cut, for how long, with what device, and how deeply.  This is untrue of emotional pain.  For an adolescent, emotional pain often seems random and unmanageable. Also, many teen clients have explained they can see the blood, which represents the inner pain. Somehow, it’s more tolerable to have tangible pain than invisible emotional pain.

Steps to Take if Your Teen is Cutting Themself

What do we hope you take away from this discussion as a parent?  The most important thing is that cutting is serious.  If your teen is self-injuring, then they might be suicidal.  Self-harm, whether done for attention or something deeper, is abnormal.  Your teenager needs an evaluation by a professional.  Call a therapist, school counselor, pediatrician or psychiatrist.  Whatever you do, call someone.  While it is tempting to hesitate if your teen tells you they can stop, my experience tells me you cannot assume this is something you should handle on your own.

Dialectical Behavioral Therapy is one type of counseling commonly used to help teens who are cutting. It teaches tolerance of uncomfortable emotions as your teen explores why they’ve been using self-injury as a coping skill. DBT helps a teenager recognize emotions, consider their cause, and then permit themselves to have those feelings instead of trying anything to neutralize them (i.e. cutting, lashing out, drugs, etc.). DBT also explores why teenagers cut themselves so that it is easier to find healthy alternatives. While most Teen Therapy OC therapists are comfortable with DBT, Jazmie Albarian has taken the extra step of becoming certified in DBT. It is worth calling her to find out how DBT can help your teen.

A Final Thought on Teen Cutting Behavior

A final thought for parents who have children that self-harm: It is terrifying.  I realize that finding out your child, whom you love more than words can ever express, wants to inflict pain on him or herself is one of the scariest things you’ve dealt with.  Don’t hide this from everyone because you feel ashamed.  Talk to one or two close, trusted people so you can have support.  You have to make sure you’re not spending a lot of energy and time blaming yourself.  Instead direct that energy toward finding a solution.

Also, don’t blame yourself. You need all your emotional resources available to confront and control the problems your teenager is facing. You will eventually have time to dig in to what you want to change, but that comes a little later.

All in all, finding out your teen is self-harming is beyond overwhelming. From one parent to another, my heart goes out to you. As a therapist, I want to walk alongside you through this incredibly difficult time.

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT