Self-Harm... Why Do Kids and Teens Self-harm and Could It Be Trauma?


By Brye Balkum, MSW, LCSW

The story may begin something of this sort…You arrive home from work, tired from an eight-hour day saturated by deadlines, projects, and the never-ending supply of emails.  Upon entering your home, bracing yourself for the household demands, now begins the evening shuffle of transporting your kids to their respective activities. Your fourteen year old’s door is closed again; you knock on her door, the expected question about her day fills the air just as the door fully opens. Quickly, she scrambles to conceal what she’s doing, her back to you as she tells you “fine” and to “get out”, clearly irritated by the invasion of your parental presence. She’s been more secretive of late; her self-subjected isolation is a contentious topic between you two. “Where has that attitude come from?” you wonder to yourself. Once again, frustration settles over you by the lack of respect and appreciation. It dawns on you that something seems off, although you can’t quite put your finger on it. You open her door again to set her straight. The razor blade she’s holding clangs to the hardwood floor as she scrambles to pull her long sleeved shirt over the line of fresh, fine incisions, tears streaming down her face. You’re shocked and horrified; how could this have happened under your watchful eye? 

Perhaps, you know this story all too well. Or maybe, a friend has come to you in confidence about a vignette plagued with similar elements. As a parent, watching your child struggle and not knowing how to help can induce a gut-wrenching sense of powerlessness. Whether it’s the first or tenth time a parent spies a fresh wound infliction, the sting of helplessness can bring any parent to the point of doing whatever it takes to help his or her child. Flooded by various questions, a parent is likely to wonder what has caused his or her child or teenager to resort to self-harming behaviors, such as cutting, burning, hitting one’s self, or other intentional self-inflicting, pain-inducing behaviors. Self-harm can be caused by a number of concerns. Often, it can be linked to feelings of depression or anxiety. For many teens, self-harm is a means of “gaining control” of something in an environment that feels seeming out of control—an often silent but visual cry for help. What many people may not realize is that self-harm can also result as a symptomatic response to trauma.

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So what is meant by this term “trauma”? Trauma can occur when a person experiences one or more life-threatening events causing the person to fear that his, her, or another’s life may be seriously injured or ended; trauma may be experienced personally, witnessed, or learned about. If something frightening has occurred—either recently or in the past—to your child or teen, you may have noticed a change in your child’s or teen’s behavior, attitude, relationships with others, and/or school performance. As a parent, maybe you’ve felt more stressed or on edge; you’ve noticed the family dynamic has been negatively impacted for some time. As a child or teenager processes trauma, you may notice other specific behaviors, such as sadness, anger outbursts, irritability, difficulty sleeping, poor appetite, reoccurring thoughts about the “scary thing that happened”, worry, difficulty concentrating, jumpiness, nightmares, feelings of hopelessness, fearfulness, being impulsive, doing risky things, self-harm, and a number of other changes. Any or all of these can be overwhelming, confusing, and scary for your child or teen and most likely, for you, the parent. 

Whether it’s self-harm or any other post-traumatic change in behavior or mood, the good news is that trauma can be treated through therapy! When children or teenagers receive proper treatment targeting their trauma, they have reduced chances of past traumatic experiences negatively affecting their future. One of the most scientifically supported models for trauma is called Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). TF-CBT is appropriate for ages 3-18 years old; it helps to reduce unwanted thoughts, emotions, and behaviors by teaching children and teens about trauma and coping skills, processing past traumatic events, and building safety techniques to create a positive, hopeful outlook about the future. We all want the best for children and teenagers, including a health well-being, without the fear of the past hindering their futures. So rest assured, even if that initial story resonated uncomfortably well, there’s hope of a positive, bright change for you, your child, and your family in this new year!

To set up an appointment to begin treatment for self-harm or trauma for your child ages 5-21, contact:

Brye Balkum, MSW, LCSW via email at

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Barbara Lowe