Is your child exhibiting signs of self-harm?

Warning signs of self-harming behaviour include unexplained wounds or scars on the forearms or hands, and unnecessarily keeping sharp objects like razor blades. — Positive Parenting

Tina's mother was worried.

The teenager had not come out of her room for the last five hours and had missed her dinner.

At 9pm, Tina’s best friend rang the house to say that Tina had posted a picture of herself with cuts on her wrist on her social media profile.*

Cutting one’s self is a classic example of self-harming behaviour.

Other examples include intentionally overdosing on medication, taking poison and hitting one’s self.

Basically, self-harm refers to acts that individuals carry out with the intention of harming themselves.

It is more common in teenagers and young adults.

And girls are usually more prone to such behaviour than boys.

Why it happens

A number of teenagers who self-harm do so on impulse, i.e. they act on the spur of the moment, without any intention to commit suicide.

They may be seeking relief from the buildup of tension – as a way to distract themselves or escape from painful feelings.

Some may find themselves overwhelmed by strong emotions during a stressful situation and feel that they cannot find an alternative way to express these emotions.

We should be especially concerned and vigilant if we observe any of the following:

  • A person becomes withdrawn and repeatedly speaks about wanting to end life.
  • Dangerous methods of self-harm are chosen.
  • A person takes elaborate steps to avoid being discovered.
A small proportion of individuals who self-harm may have the intention to commit suicide.

For some teenagers, inflicting cuts that are visible may be an expression of deep emotional wounds and scars that they are feeling inside.

Others may be driven by strong feelings of rage towards others, or even towards themselves.

And some teens may be trying to influence or manipulate others through self-harming behaviour.

The factors that make some teenagers more prone to self-harming behaviour are:

> Personal and psychological issues
  • Experiences of physical, emotional or sexual abuse
  • Being a victim of bullying
  • Depression
  • Feeling hopeless or worthless
  • Having high levels of anxiety
  • Being prone to impulsive behaviour
  • Having poor problem-solving skills
  • Having difficulty making decisions
  • Consumes illegal drugs or alcohol
> Family and social issues
  • Parental divorce or separation
  • Conflict and violence within the family
  • Living in poverty
  • Difficulty adjusting to a new environment, e.g. after moving to a new city
  • Social isolation and lack of supportive friends
  • Quarrel with friends
> Situational factors
  • Break-up with boyfriend/girlfriend
  • Exposure to friends who have self-harmed
  • Exposure to self-harming on social media

Warning signs

Some actions may be visible to others.

For example, a teen may attempt self-harm during an argument or upload posts about their actions on social media.

Others may retreat behind locked doors and hurt themselves in secret.

Look out for signs of self-cutting, like:

  • Unexplained wounds on the forearms or wrists
  • Frequent or constant wearing of long sleeves to cover wounds
  • Bloodstains on clothes or bed linen, or blood-stained tissues in the trash, and
  • Keeping of sharp objects such as razors or knives.

What to do

So, what can parents do?

> Never dismiss or ignore the problem

Avoid scolding or making hurtful remarks.

Self-harming is a signal that a teenager is having difficulty coping and is in need of help.

> Try to understand

Are there any personal or family issues that could make your child prone to self-harming behaviour?

Has there been any recent incident, such as a disagreement with a family member?

Are there difficulties at school?

Remember that there sometimes, multiple factors can lead to self-harm, and the specific reasons may be different for each person.

> Listen to your child

Have you been too busy to have daily conversations with your child?

Teenagers may keep problems to themselves when they feel no one is listening.

Some problems can be difficult to reveal, such as bullying or sexual abuse.

Set aside time to explore what is troubling him or her.

Reassure your child that you are there to help.

> Seek professional help

Ensure that your child receives medical attention to check for any serious injury or harm.

It is equally important for doctors to identify any psychological problem that requires treatment, such as depression, and to assess the risk for repeat incidents.

A psychologist or counsellor could teach your child techniques to reduce anxiety, calm their emotions and relieve stress.

They could help your child build coping skills, such as how to tackle problems or communicate with others.

They could also advise parents on appropriate ways to communicate with and support their child.

*This scenario is an example and not meant to represent any real person.

Dr Mary Joseph Marret is a consultant paediatrician. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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