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Self-Harm Among Teens

Q: What is self-harm?

Self-harm refers to a spectrum of behaviour that people intentionally engage in to cause direct and immediate damage to their own bodily tissue, 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


Q: Why do teens resort to self-harm?

The reasons for self-harm vary amongst individuals. Our experience working with these teenagers suggests that self-harm may be used to fulfill a number of functions:

• 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

Q: What are the usual parts of the body that they self-harm?

Based on clinical experience, one of the most common means of self-harm seen in our local teenagers is self-cutting.

Self-cutting usually occurs on the wrists and forearms, often with multiple superficial cuts made each time. Self-cutting may also occur on other “unusual” parts of the body concealed by clothing, such as the inner thighs, hips and even on the soles of the feet, to avoid detection.


    Supporting a Child or Friend Who Self-Harms

  • Supporting a Child or Friend Who Self-HarmsBe 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 teenager’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.  


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