This blog is designed to support those who care for teens struggling with self-harm, recognizing that it doesn’t address all situations where self-harm occurs. If you or someone you know is in immediate danger, please contact a crisis hotline like the Suicide & Crisis Lifeline at 988 for 24/7 confidential support.
Being a teenager in today’s world is hard. Increasingly rigorous standards for college acceptances has expanded the academic and extracurricular demands placed on students. Adolescence, which is historically already an emotionally volatile and confusing stage of life, is now made even more complicated due to social media. The pandemic limited both the opportunity for and practice of in-person communication and forced much of social interaction online. Sadly, one report by the CDC found that mental health-related emergency department visits among adolescents increased by 31% from 2019 to 2020 (CDC). Therefore, it is no surprise that teenagers have turned to unhealthy coping mechanisms to find relief from the stresses of living in a high-pressure world. Self-harm, the practice of intentionally hurting oneself to deal with difficult feelings and circumstances, is on the rise. In fact, recent studies have shown that approximately 17% of adolescents have engaged in some form of self-harm, with rates as high as 25% among teenage girls (Mental Health America). As parents, counselors, friends, and youth workers, how do we walk alongside a teenager who is self-harming?
Common Reasons Teens Turn to Self-Harm
While there is no limit to the reasons that might contribute to the struggle of self-harm, I have personally seen these common themes emerge amongst teenagers who self-harm.
1. “I feel out of control”
The world is overwhelming. Circumstances and people are often beyond our ability to control or even influence. Self-harm is a way to take back control, even for just this one particular area of life. The teenager gets to determine when they self-harm, what they do to injure themselves, and how long it lasts.
2. “I am guilty”
When a teenager has failed to meet the expectations of others or even themselves, there is a sense that they have done something wrong and there needs to be punishment. The feelings of guilt demand reparation, and self-harm is the fitting penalty for an area of failure, sin, or inadequacy. One teenager I counseled shared that cutting was a way to prove that she cared because at least she was doing something about her situation. Another teen shared that she felt like she deserved this treatment because of her unworthiness; that because she was lazy, irresponsible, and an overall bad person, it was fitting that she hurt herself.
3. “This is serious”
For many teens, it is hard to articulate the heaviness of the burdens they carry. Simply stating that school is stressful or that expectations from parents are suffocating doesn’t seem to adequately represent the overwhelming feelings of guilt, frustration, hopelessness, or anxiety that they are feeling. Self-harm is a tangible way of demonstrating the gravity of what they are experiencing to themselves and to others (though most do not wish for others to find out about this particular struggle).
4. “I need emotional relief”
When anxiety, frustration, or other negative emotions are mounting and nothing seems to help, self-harm is a way to release the pain. For just one moment, the physical pain takes the mind off of its worries and helps to distract from the negative emotions. Unfortunately, the emotional release is always temporary as the root causes for the negative emotions are never addressed. Often, the teenager spirals into an unhealthy cycle of harming and temporary relief until someone discovers the behavior and intervenes.
Help for the Self-Harming Teen
Every teenager is unique, and the specific truths of Scripture needed to counsel their hearts will take careful consideration to discern and minister. Here are some of the specific themes that I have turned to as I walked with teens who struggle with self-harm.
1. Everything we do matters to God
Surprisingly, the teens I have counseled have viewed their self-harm as an area outside of their relationship with God. Because the harm is done in secret and to themselves rather than towards others, nor is it explicitly spoken about in Scripture, it can feel outside of God’s jurisdiction. One starting point can simply be to help the teenager see that self-harm is not an isolated, private act, but that it is ultimately revealing what they believe about God and their relationship with Him. Being a Christian is much more than obeying the ten commandments, but rather, about making all of life a worship opportunity. In fact, even what we eat or drink, and everything else that we do, we are meant to do for the glory of God (1 Cor. 10:13). How we handle our emotions, what we do to our bodies, and what we think and believe can either move us towards God and others in love, or away from God and others in isolation and despair.
2. Christ is a high priest who empathizes with us
The struggles of this world can feel removed from and insignificant to a great God. One counselee shared that it was hard to pray to God about her struggles because He doesn’t ever need anyone and doesn’t suffer like we do. A core belief among those who self-harm is that no one truly understands the suffering that they are going through. They must deal with it on their own, and they alone are responsible for helping themselves. We can help the teenager to see that Christ not only sympathizes but also empathizes with us in every way because He Himself was “a man of sorrows, acquainted with deepest grief.” (Isa 53:3) Christ faced oppression, rejection, humiliation, betrayal, and the most brutal of deaths on our behalf. Therefore, there is no one more trustworthy than He to be a close confidante and source of help. He is the high priest who not only understands our weaknesses because he faced the very trials that we did (Heb 4:15), but also has the power to aid us in our need.
3. Lament: A better way of dealing with negative emotions
If self-harm is a way to relieve oneself of painful and unwanted emotions, we must equip teenagers with the tools to address their negative emotions in a healthy way. The process of lament has been modeled to us throughout the Bible – praying honestly, protesting the hard, boldly requesting, and ultimately moving towards deeper trust in God by meditating on his character and promises. In fact, laments make up the largest category of psalms, a testament to the reality that life is hard and there is plenty to cry out to God about. Whereas self-harm moves us away from God and others, lament draws our eyes upward and outward to the one source of true hope and help. Biblical lament may feel like a foreign concept, so for those walking with teens who are self-harming, the main objective is that we encourage them to speak their pain to God rather than keeping Him out of their suffering. Journaling, praying out loud, and even corporately lamenting by sharing with trusted friends and family members, are all ways that we can guide the teenager to fight Satan’s lies that we are alone in our suffering and put them on the pathway of God’s grace (For further information on the the topic of biblical lament, I would recommend the book Dark Clouds, Deep Mercy by Mark Vroegop).
4. The Grace of Repentance
A common motivation for self-harm is to escape suffering and to find temporary relief. The self-harming teenager rarely thinks about how God views this behavior. But ultimately, self-harm is a sin that grieves God because it makes self and suffering big while minimizes God and his grace. Self-harm communicates the lies that God is not in control but I am. God is not present but rather, I am alone. God does not care for me, so I must take things into my own hands. God has no authority over my life, and I get to determine what to do with it. While self-harm superficially reduces feelings of guilt, the relief is always temporary and ultimately results in the need to self-administer punishment again and again. True gospel-centered repentance eradicates the stains of sin and restores a believer to the joy of their salvation and renews a steadfast and willing spirit within them (Ps 51).
Exhortation to Helpers
For individuals walking with a teen who is self-harming, it is important to know that self-harm can be an addictive struggle that will take time to address. Like other addictions such as drug use or pornography, periods of abstinence can be broken by a difficult circumstance that unexpectedly arises. While self-harm is displeasing to God and painful for loved ones, it is important to meet the teenager from a place of understanding. Proverbs 20:5 says “the purposes of a person’s heart is like deep water, but a man of understanding will draw it out.” The teenager’s heart may feel like dark waters – murky, hard to see through, and difficult to retrieve, but meeting them from a place of understanding will help bring them out of the isolation that so often accompanies the shame associated with self-harm. Meeting them with understanding does not mean that we agree with their assessment of and response to the difficulties of life, but it does mean that we value their hearts more than simply correcting their behavior. Understanding is the entrypoint to encouraging teens to vulnerably show us their hearts so that we can then gently bring their pain, desires, beliefs, and hopes to Christ.
For additional practical considerations for next steps, such as determining level of severity or establishing a safety plan please check out this resource for parents: Cornell Research Program on Self-Injury and Recovery
This article is part of our Teen Mental Health Series.
Photo Credit: Annie Spratt