Breaking the silence: Understanding self-harm

4 min read   •   October 19, 2023
Elmien Ackerman

Gorgeous and creative teenager Ginny Miller burns herself when her emotions get out of control. One of the main characters in the American TV series Ginny and Georgia, Ginny struggles with various emotional and mental health challenges. In the show, Ginny turns to harming herself as a way to cope with intense emotional turmoil. But self-harm isn’t fiction.

Research indicates that 17% of teenagers will engage in self-harming behaviour at least once. We spoke to psychiatrist, Dr Beatrice Steenkamp, to shed light on the reasons behind this behaviour, its warning signs, and most importantly, how to help learners struggling with this behaviour.


What is self-harm?

Self-harm is when someone intentionally hurts themselves by cutting, burning, carving, or hitting themselves. Self-harm is also known as non-suicidal self-injury (NSSI). Adolescence can be a tumultuous time in your child’s life, and Dr Beatrice says that self-harm is used as a way to cope: “Self-harm is an unhealthy coping mechanism used to regulate negative emotions”.

According to Dr Beatrice, teenagers who engage in this behaviour report feeling relief after the act, and some report getting addicted to that feeling of relief.

Also read: Breaking the ice on social anxiety

How do you know if your child is self-harming?

“Most of the time, you won’t know if someone is self-harming unless they tell you,” Dr Beatrice says. There are, however, a few signs that you can look out for. These warning signs include:

  • new or recurrent injuries,
  • wearing long-sleeve garments even when it is hot,
  • talking about self-harm or engaging with social media posts that appear to promote self-harm.

Self-harming teens often struggle with low self-esteem, extreme sensitivity to real or perceived rejection and isolation, or the perception of invalidation or lack of support.

What causes teenagers to self-harm?

According to Dr Beatrice, the causes of self-harm or NSSI are complex and multiple factors could influence a teenager to self-harm. Predictors of NSSI behaviour may include:

  • a genetic predisposition,
  • severe early childhood trauma,
  • co-morbid psychiatric illnesses (including eating disorders, mood disorders, adjustment disorders and substance abuse disorders), and
  • exposure to NSSI through interpersonal relationships or social media.

Studies show that teenagers will self-harm (up to 59%) within a year when a friend also engages in NSSI. Teens with an underlying psychological vulnerability can easily be triggered when exposed to NSSI. Dr Beatrice explains that 64% of young adults know someone who self-harms. She adds: “The increase in social media posts that appear to promote self-harm worsens the behaviour”.

Also read: Practical tips on how to keep your kids safe online

Understanding the brain’s role

“Neuro-imaging studies show that teenagers who engage in self-harm have increased activity in the parts of the brain (the amygdala) associated with emotions, which intensifies distress,” explains Dr Beatrice. Additionally, these studies also indicate overactivity in the parts of the brain that regulate memory and emotional processing (the hippocampus), which suggests that these teens struggle to process emotions or memories related to negative events (real or perceived). During emotional turmoil, these teenagers struggle to regulate their feelings, often perceiving situations as unbearable and finding it hard to think rationally.

Dr Beatrice points out that when a teenager is stuck in this painful emotional state, they may resort to self-injury as a coping mechanism. For them, seeing blood might offer a visible sign that they are managing their emotions. People who self-harm often do it to “feel something” when they are emotionally numb during stressful situations.

Read more: How to help a child manage depression

How to help someone who self-harms

If you suspect that your child may be intentionally hurting themselves, Dr Beatrice recommends the following ways to help:

  • Talk to them about it, but do not judge or scold them.
  • Encourage them to seek help from a professional.
  • Help them to explore healthy coping mechanisms and motivate them to follow through.

“It is important that individuals seek help,” Dr Beatrice advises. Treatment usually consists of evaluation for co-morbid psychiatric illnesses and treatment thereof (with appropriate medication), as well as psychotherapy. Therapy sessions typically focus on understanding the behaviour, identifying triggers, assisting with emotional regulation, exploring healthy coping mechanisms, and mobilising a support network. “There is hope for NSSI. Self-harm can be treated,” Dr Beatrice concludes.

If you feel that online schooling might be an option for your child and would like to discuss possible concessions that could assist them, please reach out to us at or call us on 087 405 2233.