Parenting Quick Tips

Family doing stretching exercises at home

(Note: I personally hate it when people tell me how to parent my child! But, that doesn’t stop me from honestly consider suggestions that might fit my life, me and my child. So, feel free to take and implement what is helpful and leave the rest behind.)

Parents usually enter my office worried and full of questions. My feeling is that many parents today parent out of fear and uncertainty about what exactly is the “right” thing to do.

Newsflash: There is no one right thing to do.

There are definitely things you don’t want to do but, when it comes to helping a child grow into a productive, independent, caring, courageous, and respectful adult who gives generously back to the world, many roads lead to Rome. And the road is dependent on a child’s, as well as a parent’s, personality. Even though the road might be different, there are some basic guiding principles which you might want to take into consideration.

In any profession, there are issues that repeatedly come up which you tend to consistently answer in the same way. This is how it is with being a therapist as well.

Following is a list of the most common things I teach or point out to my clients when parenting questions are brought up. There are grouped under two categories – change your perspective and improve communication. Many (or all) of these may be familiar to you but, it’s nice to have a reminder once in a while.

Change your perspective

1. Consider the resources needed by your child to succeed.

Does your child have the skills and resources needed to comply with your requests and expectations?

2. Don’t get into a power struggle.

Ignore negative reflex comments (“I hate you!”) made my your child and stay focused on the goal.

3. Avoid judgments.

Focus on changing behavior, not negatively defining yourself, your child or their behavior.

4. Be a good example.

Demonstrate through your own behavior what you would like your child to learn.

5. See it through their eyes.

Consider your child’s experience and how you would like to be treated if it were you in that situation at that age.

Improve communication

 6. Teach your child how to express and manage his/her feelings; build their emotional quotient.

They will use these valuable skills for the rest of their lives in more ways than you can image.

7. Anticipate potential problems.

Put strategies in place beforehand instead of responding reactively in the moment.

8. Don’t lecture.

Speak briefly, clearly and with authority (which is not the same as yelling). You don’t need to yell to get respect. Stay in control of yourself.

9. “Catch” them doing the right things.

Children respond to verbal praise much better than they do to punishment and criticism.

10. Be consistent.

Rules, expectations and schedules are important and children find them comforting.

11. Follow through.

Mean what you say and say what you mean. Do I really need to say more?

12. Give them choices whenever possible.

Help children feel and learn that they can choose how they want respond. Life is almost never about only one choice but, one among many.

Ultimately, it boils down to one thing – does your child feel loved?

There are so many great parenting books out there. But, keep in mind that the way someone else parents may not work the same or as well for you and your child because you and your relationship with your child is unique. Take whatever is helpful and leave the rest – trust your instincts as a parent. However, try something consistently for long enough to build habits and don’t give up too soon.

Happy parenting!

 

Children and Sleep Problems

Bully pulling hairConnie is a young mom who is frustrated with her nine year old son, Matt. “I know he can pull it together because he can do it at school.” Her conclusion, “He’s just choosing to misbehave.” The pattern that Connie describes is one where Matt is well-behaved at school, but when he comes home, he is impossible to manage. He is picking fights with his siblings, wants to run around instead of sitting and doing his homework, “he is defiant and won’t listen to me”, and “his temper tantrums are explosive”.

The scenario described by Connie above is one I hear all the time from parents. Nine year old Matt is well behaved at school, but once he gets home he is his mother’s worst nightmare. (Really, when it happens most days out of the week, this is not an exaggeration.) Moms usually report that teachers don’t have any complaints – “He’s quiet, well-behaved, gets his work done.” So, what’s the deal?

When parents come in wanting to discuss their children’s behavior, one of the first things I ask about is how their child is sleeping. If it’s off, it’s one of the first things we work on. Because children and sleep problems do not mix well.

Think about your own life as an adult and what you are like when you haven’t gotten the sleep you need. Not only are you physically exhausted, but you are also an emotional wreck. It takes a lot of energy and resources to keep your emotionally wrecked and exhausted self contained. When sleep deprived, we adults are easily emotional, exhausted, unfocused, unproductive, and irritable. There are very few physical and emotional resources available to live life, let alone manage relationships well and give your best at your career. Now take all this exhaustion, apply it to your sleep-deprived child and then multiply it a hundred fold.

Why multiply it? Because kids don’t have the knowledge, experience and skills that adults have acquired over a lifetime to manage their lives. Children are still learning how to do this thing called life. They have many developmental tasks they are expected to accomplish and master each day – making and keeping friends, managing and organizing educational demands, extracurricular sports, responding to adult demands, and generally having very little control over how they live their lives and spend their time.

When exhausted, most children work very hard to get through their day at school, holding back the tidal wave of all the behaviors they would rather engage in to express their exhaustion. When they come home (from holding their breath all day at school), they finally take a breath and let loose. It’s a lot like you holding back anger towards your boss all day and then, when you get home, well…you know.

A good night’s sleep can have a huge impact on how your child functions, copes with every day demands and their resilience in the face of life’s surprises. It also makes your job as a parent a little easier. A good night’s sleep is vital to your child’s mood and brain function (not to mention your sanity). Difficulties with sleep can potentially point to bigger issues – ADHD, anxiety, depression, behavioral problems, academic difficulties, and worry. It is an early first sign your child’s body uses to communicate, “Something is wrong in my world. I need your help.”

Sleep difficulties fall into five categories

Falling Asleep

Kids who fall into this category often describe that their mind “clicks in” when their head hits the pillow. Anxieties, worries and events of the day can flood their consciousness, rev them up and make it difficult to sleep. They often complain, “I can’t shut it off.” Their brain becomes a place where thoughts, feelings, ideas, memories, and imagined futures bounce uncontrollably off one another. Their brain jumps at lightning speed from one item to the next.

Staying Asleep

This sleep difficulty is characterized by multiples awakenings during the night. The repeated interruption of the sleep cycle makes it very difficult for children to achieve Mother comforting her crying little girlREM (rapid eye movement) sleep which is the restorative stage of sleep.

Early Morning Waking

In this scenario, kids wake up super early and then cannot go back to sleep. This can make for very long days and less than stellar behavior at the end of the day.

Restless Sleep

In this case, sleep is…well…restless. Kids toss and turn. They awaken to any noise in the house. They are so fitful they often awake to find the bed torn apart and covers kicked onto the floor. Sleep is not refreshing and they awaken as tired as when they went to bed.

Difficulty Waking

Difficulty waking is usually preceded by an inability to stay asleep or multiple awakenings until about 4:00 a.m. Then, they fall into “a dead sleep”, from which they have extreme difficulty rousing themselves or being roused by someone else. These are the kids that sleep through two or three alarms and family members’ attempts to get them out of bed. They are commonly irritable, even combative, when roused before they are ready. Many of them also say they are not fully alert until noon.

Strategies For A Good Night’s Sleep

Maintain a regular sleep schedule

Recent research (see the journal Pediatrics; a study involving 10,000 children) has come out that actually shows a strong connection between an irregular sleep schedule and behavioral issues in children. Thankfully, it is possible to get them on the right track by the time they are 7 – 10 years old. Phew! Kids like routine. It helps them to know what can be expected and many of them find consistent schedules quite comforting. It can be tempting to flex on a sleep schedule during weekends and holidays, but I would recommend you not. Keep things as consistent as possible.

Get their bodies moving – exercise

Exercise helps with burning extra energy as well as helping to manage depression, anxiety and ADHD. I usually recommend something that involves staggered breathing, constant movement or movement that involves a left-right contralateral movement. For example, cycling, running, and swimming. But, exercise is exercise. Get them moving in the morning or at some point during the day, so they’re not moving so much at night. Exercise can also promote deeper sleep and more time in restorative sleep.

No eating and drinking two to three hours before bedtime

This is a difficult rule to follow because kids love their snacks before bedtime. If they must eat something, keep it small and focused on carbs – milk, toast, a small bowl of cereal – whatever your child’s diet can manage. You want to give them just enough to quiet their bellies; avoid overstuffing them or they will need bathroom breaks in the middle of the night. Overfeeding will defeat the purpose. If they are asking for water at bedtime, this is a possible sign they are dehydrated and not getting enough water during the day.

Reduce nighttime distractions

Some kids are very sensitive to light and sound. Kids with ADHD are wired so they can’t not pay attention. So, eliminate as much noise and light as possible. Some options: use a white noise maker, use a clock that lights up only when a button is pressed, put up blackout curtains, use a sleep mask, or use earplugs.

Have healthy bedtime rituals

Evening rituals signal to the brain and body that it is now time to slow down and move towards sleep. It also provides kids with the opportunity to connect with caregivers. Some rituals could include: cuddle time, reading a book, turning all technology off, dimming lights, brushing teeth, changing into pajamas, getting a favorite blanket or stuffed animal, and/or saying goodnight to family members and pets.

Dress for sleep comfort

Chilly feet keep some children awake; wearing socks may help to send them into dreamland. Remove any scratchy tags from pajamas. Keep kids cool.
One tip from a client: don’t combine flannel pajamas and flannel sheets. Apparently, this combination makes it difficult for kids to turn over in bed because the fabric has a tendency to stick to itself.

family momentsHave some pre-bedtime relaxation routines

Foot rubs, visualization (imagining they are descending slowly on an escalator as they breathe deeply), breathing exercises where you can help your child focus on their breathing, and prayer (if this is a part of your life) to encourage them to entrust loved ones and concerns to God.
Another way to manage anxieties is to give kids a “parking lot” for their worries. Give them a place to put their worries so they don’t have to take them to bed. A journal where kids can write or draw their concerns works really well. Do this before their bedtime routine and store the journal in a place designated as a “safe place”.

Teach them to use self-soothing skills

Pay attention to what might give comfort to your child. Does he like wrapping himself in a blanket with only his mouth and nose exposed? (Many find it comforting to sleep this way.) Does she like it when you gently rub her back? In this case, you may want to teach your child to lightly rub her own arm as a relaxation technique. Maybe playing soft instrumental music would be soothing?

A self-soothing skill to try – teach your child to tap. One simple way of doing this is to have your child lie on their back with their arms at their sides. All they have to do is slowly tap their hands, bending up and down at their wrists in an alternating left-right pattern. This may help with promoting an automatic relaxation response in the body.

Pay attention to what works for you and your child and leave the rest. Then, be consistent.

Sweet dreams!

To Post or Not to Post…Pics of Your Kids?

BW portrait of sad crying little boy covers his face with handsA couple of years ago, an absolutely creepy application was released on Facebook during the Halloween season. It’s an interactive short film that shows a grungy and crazed looking man rifling through your Facebook page, accessing all your information and finding out where you live. The application actually uses the contents of your Facebook page to up the creep factor to dizzying heights.

The application is called “Take This Lollipop” and to enter the site, you are dared to click on a lollipop with a razor blade in it. The app then asks for temporary access to the information on your Facebook page. The application uses your data in the short film and then promptly deletes all your data and access permission. To date, it has had almost 14 million views.

The application is a brilliant piece of work, but I warn you, it is scary in an “Oh my god! I need to pick up my child from school right now!” kind of way. It’s brilliant because it changed how I thought about something which I had, to this point, taken for granted. It made me think more deeply about the information that is available on the internet about me, my family and my friends.

The creator, Jason Zada, who happens to be a commercial and viral marketing director, came up with this piece of horrifying film as a way to draw attention to online privacy. Zada’s desire was to create “something that messed with people”, “to get under people’s skin without any gore or anything” and to promote discussion about online privacy.

The application did its job…a little too effectively, if you ask me. I was so creeped that I refused to watch it as part of the preparation of writing this post. Once was enough, thank you very much!

He goes on to say, “Our privacy was dead a while back and will never be the same,” he said. “Life as a whole has changed. If you look at the video, the scariest part is that your information is in the video. The piece is scary because a person is violating your privacy, not because it’s bloody or there’s anything jumping out.”

To post or not to post your child’s picture online? That is the question.

Online, there is a very active and ongoing discussion about whether or not you are a bad parent if you post pictures of your child on Facebook (or any other social media site).

You’re bad if you do.

People in this camp adamantly say you should never post anything about your children. Two of the best reasoned arguments are: (1) to protect your child’s identity and safety and (2) to provide your grown child with a clean slate with regards to their personal image and branding.

You’re bad if you don’t.

The world has gotten very small and part of how this has happened is the level and extensiveness of connectivity provided by the internet. The argument on this side of the fence is that technology and the internet are a part of our culture. Social media has changed how the world functions and to keep your child disconnected technologically is to isolate them socially.

Frankly, I have never been one to sit on one side of a fence or another. I find that issues like this are more nuanced than the two opposing and extreme positions presented.

My personal response to the “to post or not to post” question is be wise about what you post.

A few rules you may want to consider when posting pictures of kids:

1. Do not out your child regarding their less than stellar behavior. No-one wants to be reminded of the times they behaved badly – not even you. It’s best to move on from bad days.

2. Do not post pictures of their embarrassing moments – tripping, falling, etc. Wasn’t being humiliated once enough?

3. No bathtub shots or anything provocative.

4. Kids sleeping. I know, they’re really cute and angelic when they’re sleeping, right? However, this feels to me like invading their privacy without their knowledge, so I personally don’t do it.

6. Public displays of affection. I get that the first kiss is special, but really?

7. No posts of those pictures they told you not to take in the first place. “No” means “no”.

8. Anything that can be used to identify your child’s location (team logos, school banners, mapped locations).

9. Use strict privacy settings. However, be aware that it doesn’t matter if you have the highest of privacy settings as a picture can quickly get beyond your personal list of friends.

10. Monitor your child’s Facebook page.

12. Do not use your child’s picture as your Facebook cover or profile picture. These are automatically made public and can easily be found on Google images.

11. Let your children view your Facebook page, using it as a tool to teach about what is appropriate and safe to post. Show them what good online habits look like by practicing them yourself.

12. Do not tag your friends’ children’s pictures without getting their permission first. This is just plain rude.

By now, all parents should be aware that anything that goes online is permanent. What you ultimately decide to do with your children’s privacy online is your decision. When I’m not sure what to do, I think about how I would feel if someone did to me whatever I am considering doing. In really ambiguous situations, I err on the side of caution and don’t do it.

Question: Are there pictures of you on a social network that you wish weren’t there? What did you do about it?

If Our Words Were Hands….

Hands holding a saplingI am someone who often engages in the “people watching” thing. Human behavior fascinates me. When I people watch, I observe how people carry themselves and move through the world, how they hold themselves when they speak or are thinking, and I take note of the difference between body language when people are by themselves as opposed to with others.

In one particular instance, I was waiting for a friend to arrive for a lunch date. I had not seen her in about a year and she was running a little late. As I was waiting, I found myself staring intently at a conversation that was happening at a table across the room between two women. It did not take me very long to realize that at least one of them was deaf as they were clearly using sign language to communicate. (Note: I am using “deaf” in the acknowledgement that there are individual preferences as to how those that are deaf like to self-refer.)

I find sign language mesmerizing – words  become hand movements and look, to me, like birds in flight. Therapists often talk about the “dance” of a relationship and conversation. Sign language is the epitome and visible embodiment of this relational and conversational dance.

As I watched (okay, I admit, it was super rude to stare), I noticed how hands are used in sign language to convey emotion, intensity, respect for the person in conversation with, and passion. Sometimes, it was graceful, gentle and gracious with intermittent gentle touches to drive a point home. Other times, there was what seemed like wild gesticulation; quick and cutting through the air to convey, to the best of my knowledge, something the speaker was passionate about, may have been emotionally triggered by and found important to convey or emphasize.

Grabbing womans arm

I was taken aback by the clarity of seeing and understanding that our hands can convey so much depending on how we use them. Hands can caress, cradle, support, warm, protect, soothe, stroke, draw close, clap, high-five – possibly conveying joy, pride, love, passion, desire, and support. But, they can also hit, throw, break, scratch, push away, punch, withhold, grab, tear apart – potentially communicating disgust, fear, anger, disrespect, hatred, disapproval, judgment, and jealousy.

What would my words be doing to the person I am speaking to if my words were hands? Then, I had an insight. (I hate it when that happens, by the way, because insight demands change and you can never go back to not knowing.)

What I see commonly in relationships is that we tend to treat the worst those who are the closest to us. We remain silent all day in the presence of tyrannical bosses and managers only to go home and unleash our frustration on to unsuspecting family members and loved ones. Hands may not be physically raised, but if our words were hands…. Or, if our not speaking or ignoring, when words are necessary, were hands….

A small shift in perspective has the power to change who we are and how we choose to be with others.

I invite you to a shift in your perspective.

Think of your words as hands and see what happens.

Humbling Ourselves to Our Children

Child smelling flowerIt’s tiring being a parent. Don’t get me wrong, it’s very happy-making and satisfying – but tiring. As a parent you are on duty 24/7 and it so happens that a beeper came with the baby. The light of my life is six years old (and going on 15). She is an angel – except when she’s just being five…and when I am being an irritated…ahem…adult.

Not only is it tiring, but parenting can also be anxiety provoking. Every decision and everything that comes out of your mouth having to do with the little one(s) is up for second-guessing and wondering whether it will create permanent damage. There have been times when I have wondered if, in addition to an “educational fund”, I should also be starting a “therapy fund”. You know, a savings plan that accumulates interest and which she can access when she turns 18 for the purpose of seeking out a professional that will fix the issues she has because of my less than perfect parenting skills.

I can see it now. She’s all grown up and on her 18th birthday there’s a lovely card with a statement outlining her fund as I smile lovingly and say, “Happy Birthday, dear. Here’s something for all the ways I have scarred you.” (There’s a business idea in there somewhere.)

There are so many times when I am with my daughter that I mess up because I didn’t get a good night’s sleep, I’m frustrated, I’m angry, and yes, even when I’m hungry. Then, later, I beat myself up. And the internal chatter goes something like this….

“You should know better.”

“What would clients think if they saw how you really are at home?”

“How can I make her feel better…fast!”

And, the inevitable, “I’m an awful mom.”

Yup, mother guilt is huge. And, from what I hear, father guilt isn’t far behind.

I am stronger, bigger, faster, and smarter than her. I am literally a superhero in her eyes. But, sometimes, I abuse my powers and use them for evil in little ways: pushing her out the door when we’re running late, raising my voice, demanding, sometimes cajoling, not listening, threatening…. Did I forget anything?

I’ve learned, however, that even these moments can be used to give my daughter a gift.

The gift begins with me, an adult, humbling myself in front of a six year old child.

As an adult, I don’t have to do anything in the presence of someone as powerless as her because she is young, small, innocent, weaker, easily manipulated, and has no other way, but through me, to meet her material, emotional and physical needs. I have a lot of power.

Instead, I often choose to give up power to my daughter after acknowledging that I am not only speaking to a child but, I am in relationship with another human being.

When I mess up, I have decided that I will choose to ask my daughter for forgiveness and let her direct me as to what will restore our relationship to one of trust and care. Some of her responses to my contrition have included:

  • “Mommy, you need to sit on the steps – one number…I mean minute… for each…how tall you are.” (Graciously, I’m just a little over five feet.)
  • “It’s okay mama, everyone makes mistakes. You have to promise to try hard not to do it again.”
  • “I need a hug.”
  • “Can we cuddle and watch a movie?”
  • “You have to sit on the steps. But, I will sit with you and we have to talk about it.”
  • “I don’t know. I’m still mad at you…you hurt my feelings.”

I used to struggle with humbling myself in front of my daughter. I wanted her to believe that mommy was a superhero, someone who could do no wrong, would save her from trouble and that I might somehow live up to her love for me (which is “bigger than anything in the whole world…and even bigger than that”). I have seen that apologizing to her has helped her to learn how to receive an apology and to forgive while also helping me to learn how to ask for an apology and receive the forgiveness and grace that comes so readily from a child that knows nothing of how to hold a grudge.

Sometimes, I wonder who is parenting whom….

…and the realization hits. The gift I think I am giving her is, in actuality, a gift to me.

For further thought:

What has your child forgiven you for?

How easy or difficult was it for you to get down eye to eye with your child and admit that you made a bad choice?

How did asking forgiveness shape or contribute to the kind of parent you are today?

Self-harm: Parents, there are answers…

Sad Teen on BenchMe – “What does depression get you doing that is against your better judgment?”

Teenage client – “Cut.”

Self-harm is a phenomenon that is becoming more and more prevalent among adolescents and teens. It has many ways of presenting itself – cutting, burning, bruising, branding, scraping, piercing (not the tattoo/piercing parlor type), head banging, scratching, unsafe sex, risky drinking and even breaking bones to name a few.

Parents often call me desperately looking for information and answers to “I’m really scared and worried. What can I do?” The terror is palpable over the phone and evokes in me a desire to somehow wrap comfort around these parents. However, I am often placed in the position of telling these parents I do not have the freedom to share information with them about their teens’ sessions with me and end the conversation by making some generic suggestions. Then I put down the phone; put my head in my hands, pause, and take a couple of deep breaths.

Those of you who are parents – take a breath and then keep reading. This post is for you. It is especially for those parents who are banned from therapy sessions with their teenager because your child has requested complete confidentiality – including confidentiality from you.

I want you to have some answers. I want you to have access to accurate information and some clear direction. I want you to know how I am working to help your child – what’s happening behind the closed door.

The following is some information I would tell you if I had the time and permission – because it’s generic, I can and in greater depth. To simplify it, I’ve organized it all in question/answer format.

Can my child really request their sessions remain confidential – even from me?

Yes. If your child has reached the age of 14 in the State of Pennsylvania, their confidentiality is protected by law – which means that therapists are also bound by law. (This age may be different in your state – please check.)

Confidentiality is an important aspect of therapy, especially for children who don’t feel they have any place to put those things which are most important to them. Assuring their confidentiality (even from their caregivers) can be encouraging to them in sharing their deepest hurts and feelings about what is going on in their lives. Therapy becomes a safe and trustworthy place with the opportunity to be heard without judgment. Safety is lost the more you express your worry and anxiety through prying.

However, the laws of disclosure still apply in this situation. A therapist has an obligation to report to you, and other authorities if necessary, if they suspect your child is a danger to themself or to someone else. If the therapist has a serious concern, they will let you know.

Why on earth would a child do such a thing?

“…the boy [who was self-harming by chewing on the buds of cacti, causing profuse bleeding]…pointed to his mouth, and said flatly, ‘The pain here is nothing compared to the pain here,’ this time pointing to his heart.” (Selekman, 2007, p. vii)

By being able to feel physical pain, the internal emotional pain is muted. Kids tend to use self-harm as a tool to help them feel better on the inside, gain some control over a life that feels out of control or is a desperate attempt to feel something (as opposed to a “black hole”). In a way, this is hopeful. It is a clear statement of their desire to be free of emotional pain by feeling physical pain, but not free of all feeling. I would rather your child want to feel something over not wanting to feel anything at all.

Isn’t this something you only see in girls?

Self-harm is an equal opportunity behavior – it is equally practiced by both males and females. It also is present across age groups and socio-economic status. The only stark difference is the rates of self-harm seem to be slightly lower in Asian and Asian-American populations. Why? There’s no clear answer for this.

Is self-harm really as prevalent as you’re suggesting?

Yes, it is. But, it has been difficult to get accurate numbers given the secrecy associated with self-harm. The conservative estimates are that self-injury is at about 15% among the adolescent population. The number is probably higher because in an anonymous survey, 17% of college students reported they self-harm. Unfortunately, it looks like the numbers are rising.

Why my child?

This is a hard one. There can be all kinds of reasons leading to what many kids who self-harm report as feeling they really don’t have anyone they can talk to who accepts them for who they are. Here are some possible risk factors:

  • A history of sexual and/or emotional abuse
  • Low self-esteem
  • Childhood neglect
  • Social isolation
  • Unstable living conditions
  • Families that suppress and cannot tolerate unpleasant emotions
  • A history of or current struggle with mental health issues (eating disorders, depression, anxiety, obsessive compulsive disorder, post-traumatic-stress disorder)
  • Family history of suicide
  • Families where feelings are disregarded or diminished; there’s no-one who understands the feelings and inner life of the child

What do you mean by “families that suppress and cannot tolerate unpleasant emotions”?

The ability to tolerate unpleasant emotions and the related skills of problems solving, active listening, communicating, identifying emotions and their potential source are all necessary for healthy relationships. When these skills are missing, there is no place to put all the “bad stuff” in our lives and no way to resolve them.

Part of our jobs as parents is to be able to pass along the skills of living and relating to our children. But, the only way we can do this is to have these skills ourselves. We cannot pass along what we don’t know. Families of self-harming kids may not have these necessary skills not because they don’t love their children but, because they never learned how.

Is my child suicidal?

Not all self-harming adolescents and teens are suicidal. In fact, as many as 60% of them have never had suicidal thoughts. But, self-harm can be a harbinger of suicidal ideation (the state of having suicidal thoughts and plans). The danger in self-cutting is that it can lead to accidental suicide.

Why don’t these kids just stop self-harming?

It’s not as easy as that. The ease of giving up self-harming behavior is dependent on how long it has been going on. It’s easier to think of self-harm along the same lines of drug abuse and addiction.

Initially, cutting can be experimental – something that kids have heard will ease the pain. When self-harm occurs, experts theorize opioid-like endorphins are released in the brain which creates a natural high and emotional relief. The more often kids engage in self-harm, the greater the chance there is of an “addiction” to the behavior. The greater the addiction, the more difficult it is to treat because self-harm has its own form of cravings and withdrawal.

Some kids don’t stop because they can’t.

The sooner self-harm is identified and treated, the faster it will end, hopefully without leaving lasting scars – both emotionally and physically.

What does treatment look like?

Self-harm is a behavior that is very difficult to treat. Therefore, it is important to get your child into therapy with someone who has experience working with self-harming behaviors. ASAP.

The first step is to get some safety and containment around the behavior. This is the most difficult part for parents. Because “stop” is a process, therapists will normally start with educating your child on how to stay safe if they self-harm with the goal to decreasing the behavior.

For example, in the case of cutting, they may encourage your child to make sure they take care of their wounds to avoid infections as well as alert teens to signs they may have gone too far and need medical attention. As a parent, restrict access to sharp implements, but kids have been known to find creative ways of being able to continue in this behavior. Therefore, make sure your child knows where all the medical supplies are in your home while also expressing your hope they will find other ways to address their pain and your love for them. Also let them know that you are there to talk to them. When they do come to you, listen non-judgmentally and with the aim of understanding them to the point where they feel understood. There is a stark difference between thinking you understand your child and your child feeling that you have understood them. You are aiming for the latter.

Treatment can take the form of individual sessions and family sessions. I personally encourage parents to get their own therapist to learn how to cope with their own fear and anxiety, get information about what self-harming is all about, learn solid communications skills and begin the discipline of being non–judgmental. During intake, the therapist will ascertain what other issues may be important to discuss with you based on your personal history individually and, if applicable, as a couple and family.

Individual treatment with your child generally focuses on managing any urges that may arise during the course of treatment, helping them better tolerate stress, regulate their emotions, improve their relationships, and providing self-care and self-soothing skills they can use to cope with their emotions. Throughout this process, there is a gentle nudging in the hope of encouraging communication with parents and movement towards engaging in family therapy.

Are there any medications that treat self-injury?

No.

But, it may be helpful to medicate possible underlying emotional issues such as depression and anxiety. However, this is a conversation to have with a psychiatrist or your child’s doctor. Specifically ask about the “black box” warning on antidepressants – it contains important information on how these drugs may affect your child. Make sure to ask about long term studies on children, the pros and cons of medication and adverse reactions so you and your child can make an informed decision.

This is a lot to digest and I probably haven’t covered everything.

Feel free to send me a message – personally or through this blog – if you have any other questions.

…and don’t forget to breathe.