As a way to cope and process these rapid changes and needs in their lives, the young person may occasionally engage in self-talk. Self-talk is a way in which an individual helps to clarify their thinking and make decisions.
Self-talk is not a problem in itself, but it becomes an issue if the young person is responding to voices speaking to them. Usually if the adolescent is mumbling to himself as a result of externalised voices (called hallucinations), there are also other signs of problems. These can include deterioration in daily functioning such as school and self-care, increasing sleep problems, as well as other unusual behaviours which parents and peers may find odd and bizarre.
While this does not apply to every teenager, when young people feel overwhelmed by the changes in their lives, they may engage in self-harm as an escape or unhealthy way of coping.
Self-harm refers to a range of behaviour that people intentionally engage in to cause direct and immediate damage to their own body, where the desire to die is usually not the primary motivation.
Some self-harm behaviour includes:
- Scratching, puncturing or cutting one’s own skin
- Taking toxic or corrosive substances (e.g. bleach, detergents), overdosing on medications or vitamin pills, or swallowing sharp objects
- Hitting oneself against hard surfaces or using hard objects
- Scalding oneself with hot fluids
- Hair-pulling
The reasons for self-harm vary amongst individuals. Some reasons are to:
- Relieve painful emotions, psychological distress or tension
- Self-punishment from the sense of guilt or shame resulting from past traumatic/abusive experiences
- Express emotional conflict or turmoil which the teenager has difficulty putting into words
- Communicate a need for support – a desperate cry for help
- Regain a sense of control – especially for a teenager who perceives that everything is out of control in his or her life except for “when, how, and how much I cut myself”
- Distract oneself from difficult life circumstances and situations – e.g. parental divorce, relationship problems and academic setbacks
Be vigilant to the tell-tale signs – such as insisting on wearing long sleeves or pants even in hot weather, having unexplained wounds or scars on the body and discovering sharp objects in the child’s bag.
Facilitate open communication, not secrecy – if you suspect self-harm, let the teenager know what you have noticed and express your concern in a caring, non-confrontational way.
Try to see things from the teenager’s perspectives – it helps you understand why the self-harm is happening in the first place.
Do not judge or criticise – Remember that the teenager may already be feeling ashamed and guilty. Avoid passing judgemental or critical comments, which may exacerbate bad feelings, possibly triggering another round of self-harm.
Encourage the teenager to undergo treatment and be an active player in your child’s treatment plans – Know the roles of the various mental health professionals caring for your child, understand the therapy goals and support your child in being compliant with treatment plans.
Work with the school – Your child spends a lot of time at school and it is only practical to share information about his condition with selected school personnel (e.g. form teacher or school counsellor). They can help look out for your child and keep you informed of any rising concerns.
