Dr Sara Delia Menon is a clinical psychologist at Alliance Counselling in Singapore. She specialises in self-harm in adolescents and adults.

She advises parents to pay attention to a child’s behaviour and moods. “Notice changes in mood and social activity, where your child is more withdrawn, down, or emotionally volatile”, says Dr Menon. “Listen carefully if a child often says everything is hopeless. For example a child is saying ‘What’s the point?’ Or ‘There no point, and nobody understands me’.”

A child who is self-harming may also try to hide scars or wounds. So pay attention if your child or their friend are always trying to avoid activities that require them to show their bare arms or legs, or they refuse to wear short-sleeve shirts or shorts. “Note if they have unusual wrist coverings or bandages, and unexplained scars or wounds,” Dr Menon shares.

Another red flag is if a child has items like blades, knives, or other sharp objects lying around. Some kids may even tell you or a family member if they are self-harming – but if they tell anyone, it’s usually a friend.

Every child and teenager has intense mood swings. But what’s different now is that the internet and social media give us all more information to process, at much faster speeds. “This increases the demand on adolescents to process and manage information – which even adults find difficult to do” explains Dr Menon.

“Think back to when you were between 13 to 15 years old. Try to recall the questions you had about yourself. Now multiply that by the amount and speed of information available now. Adolescents now have a much larger magnifying glass zooming in on their thoughts, feelings, and behaviours.

A youth is also also more vulnerable to self-harm if they are:

• Often impulsive
• Not able to express their emotions easily
• Lonely or isolated 
• Facing conflicts at home, or conflicts with their friends
• Facing mental health difficulties like depression, eating disorders, or anxiety

“Self-harm is a means of regulating emotion,” says Dr Menon. “It distracts from negative emotions. It provides relief from interpersonal or emotional difficulties. It can be a welcome change from feeling numb or overwhelmed,” she explains. “Self-harm can also be self-punishment, to relieve feelings of shame or guilt.” 

Many adults see self-harm as ‘attention seeking’ behaviour. But Dr Menon points out that most children or teens who self-harm do it in secret. “Many individuals go to great lengths to hide their behaviour.”

Self-harm is very hard for parents to understand. It is also hard for young people to talk about. So any discussions about it are going to be tough. Your instinct may be to scream or yell at your child, but try to stay calm and collected. 

Shock, guilt, worry, anger, fear, denial, blame, and helplessness are all common reactions for parents, says Dr Menon. And it’s okay for you to show your emotions – you are not a robot. Your feelings show you care. But this is not the time to scold your child – they already feel bad enough.

“Self-harm is often a sign of overwhelmed or unregulated emotion. So if adults exhibit dramatic displays of emotion such as angry outbursts, accusations, or interrogations, it will overwhelm the child even more, and shut the doors of communication,” she explains.

Her advice is to do your best to remain calm. “Make it clear that you are worried, but your main interest is helping them.”

“Ask questions calmly. When did it begin, when does it usually happen? How does it make your child feel? What’s happening in your child’s life that feels overwhelming? And so on,” says Dr Menon.

If your child is not ready to open up, do not force a confession. Dr Menon explains, “Self-harm behaviours already stir up feelings of shame and guilt, so try to balance inviting your child to share versus demanding they do.

 “Let them know you are glad they opened up to you, and that you will help them find a safer way to manage their big feelings.”

And if you lose your cool, take a break. You can always go back another day. Dr Menon assures, “Go back to your child and let them know, ‘I didn’t handle that in the best way, can we try again?’”

If you feel overwhelmed by this situation, or the behaviour is not getting better, it’s time to seek professional help from a therapist who can help your child learn to cope with emotions in a more positive way.

Your own emotions will be hard to handle at this time, but instead of blowing your top, try talking to a psychologist, counsellor or family friend. This shows your child that even the most negative emotions can be handled in a constructive way.

And of course, show your child love and encouragement. Says Dr Menon. “Prioritise family time and relationships.”

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