Cutting and Self-Harm: Warning Signs and Treatment
Parents should watch for symptoms and encourage kids to get help.
What Parents Should Do
When parents suspect a problem, "they are at a loss of how to approach their
child," Conterio says. "We tell parents it's better to err on the side of open
communication. The kids may talk when they're ready. It's better to open up the
door, let them know you're aware of this, and if they don't come to you, go to
someone else ... that you're not going to punish them, that you're just
Be direct with your child, adds Lader. "Don't act out of anger or let
yourself become hysterical -- 'I'm going to watch you every second, you can't
go anywhere.' Be direct, express concern. Say, 'We're going to get help for
Parents often mistake cutting for suicidal behavior. "That's usually when
they have finally seen the cuts, and they don't know how to interpret it,"
explains Rosen. "So the kid gets dragged into the ER. But ER doctors aren't
always used to seeing this, and find it difficult to understand whether it's
suicidal or self-injurious behavior. Many kids who are not suicidal at all are
being evaluated and even hospitalized as suicidal."
Unfortunately, "the attitude in hospital emergency rooms can be very
cavalier and harsh about self-injurers," adds Lader. "There's a lot of dislike,
because it's a self-made injury, so ER personnel can be very hostile. There are
all kinds of stories of girls getting stitched without anesthetic. The thing
is, after they've self-injured, the girls are calmer -- so when they're getting
stitches, they feel the pain. Yet the doctor is angry, wants to get this over
Psychotherapy should be the first step in treatment, Lader adds. The SAFE
web site has a list of doctors who have been to her lectures, who want to work
with self-injurers. With other therapists, ask if they have any expertise in
working with self-injurers. "Some therapists have a fear reaction to it. The
therapist needs to be comfortable with it," she advises.
However, the girl or boy must be ready for treatment, says Rosen.
"The ultimate lynch pin is -- the child has to decide they're not going to
do this anymore," he tells WebMD. "Any ultimatum, bribery, or putting them in a
hospital is not going to do it. They need a good support system. They need
treatment for underlying disorders like depression. They need to learn better