Self-harm is an act of emotional desperation. It's an action of last resort that happens when a teenager feels so intensely disturbed that they're willing to substitute emotional pain for physical pain. It's a relatively new phenomenon and tends to affect girls more than boys. It offers a kind of pseudo-relief from emotional disturbance, a sense of being in control of the pain, and can be oddly satisfying. Many teenagers with a history of cutting have told me that they eventually develop a taste for it and become very reluctant to give it up. In more severe cases it becomes the go-to coping mechanism to address emotional disturbance. 

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Self-harm, or "cutting", is usually done with a small sharp blade that can be easily concealed. The cuts are typically small and may happen in little groups of two or three. Teenagers who cut will can also pick at the forming scab, getting the cut to bleed again, which also makes the formation of scars more likely. However, the cuts rarely become a serious medical problem. The serious problem comes from its connection to suicidal behavior. Self-harm is not necessarily related to suicidality but teenagers who self-harm are at a very increased risk for suicidal behavior. There is also a fair amount of shame about self-harm and teenagers will almost always take measures to hide the cuts or scars by either wearing concealing clothes or cutting in places that are easily covered. Most of their concerns about cutting tend to focus on how other people will react when the self-harm is discovered. 

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In my experience self-harm doesn't last long once a good therapeutic relationship has been established and proper treatment to address the intensity of the emotional disturbance begins. Teenagers usually find that talking about their intensely disturbing emotions, with the emotion present, works as a way to relieve themselves of this intensity and makes self-harm no longer necessary. It's something that is not too hard to lose your taste for once a real alternative is available. 

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For parents, discovering that their teenager is self-harming can be very shocking and heartbreaking. Nobody imagines their child treating themselves like this. But most parents are good about recognizing that the cutting is a superficial manifestation of a deep emotional problem and reach out for help quickly when they find out. One thing to keep in mind is that teenagers can feel even more intensely disturbed if they think that their parents are shattered by learning about the self-harm. If you suspect your teenager may be self-harming ask them gently but directly and show them that although the behavior is disturbing and unacceptable you can still keep your composure and be a source of support. 

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Below is a list of typical signs that your teenager may be using self-harm to cope with disturbing emotions.