Adolescents, Teenagers, and Non-Suicidal Self-Injury

In recent years the mental health community has become more aware of self-harm practices in the adolescent and young adult populations. Non-suicidal self-injury (NSSI) has been difficult for therapists and parents to fully understand due to its sensitive nature and the fear of suicidal ideation. Teenagers and young adults turn to this behavior to release emotional pain that they aren’t sure how to process and manage.

Although unhealthy and at times extremely dangerous, adolescents that practice NSSI are generally not suicidal and are using this practice to cope with painful experiences. As a result, therapist and parents are unsure how to act. Do we create a safety plan? Make sure the teenager is never left alone? Take them to the hospital?

In this article we’ll discuss the ins and outs of NSSI and how you can help your teenager navigate these rocky waters.

What is Non-Suicidal Self-Injury (NSSI)?

Non-suicidal self-injury, aka self-harm, is performed through avenues such as cutting, burning, hitting hard objects or self, pinching, scratching, and even interfering with healing wounds (Peterson et al., 2008). It is commonly assumed that NSSI is an attention seeking behavior and it certainly can be, but typically not as a means of hurting others or gaining sympathy. Rather, it tends to be used as a cry for help because of depression and/or anxiety.

Some people choose to engage in NSSI as a means of self-punishment, but most often the action is carried out simple to create a physical outlet to emotional pain. Oftentimes, parents of teens that engage in self-harm behavior don’t understand this explanation and tend to respond with statements of confusion trying to figure out why someone would cause intentional pain when they are already hurting.

Why Do People Engage in Non-Suicidal Self-Injury?

Studies have shown several possible reasons for this phenomenon, the most promising of which is the observation that the removal of physical pain brings emotional release. Therefore, it isn’t the pain that causes the relief but the way the person feels once the pain has stopped (Association for Psychological Science, 2017).

Other theories include the idea that the pain provides a distraction for the emotional pain and the release of hormones provides a sense of relief from negative thoughts causing the emotional distress. Whatever the reason someone chooses to engage in NSSI the fact remains that it is a potentially dangerous practice that can lead to long-term, negative effects on health.

Many treatment options are available to help individuals cope with painful emotional distress. If you or someone you know is engaging in self-harm behaviors seek support from a local therapist or contact your local crisis line.

How to Help Your Teenager Overcome NSSI

While discovering that your teenager is engaging in self-harm practices is disturbing for you as parents, it’s important to remain calm. Whether your child has disclosed this information to you of their own accord, you were told by their therapist or friend, or you discover it on your own, it’s important to remember that regardless of the reasons behind the behavior your child is in severe emotional pain and they need your support more than ever.

Show Your Teenager Support

Be sure to let your child know that you aren’t angry with them but you are concerned about the self-harm behaviors. While you understand that this how they have been able to cope it’s important that they remain safe. Be sure to let them know that if they are having the urge to self-harm or have engaged in the behavior, they can come to you for help without fear of punishment.

Create a Safety Plan

Engage your child in the discussion and be sure to take their input as to what coping skills to use at each stage of distress.

My favorite safety plan is a simple 1-10 list describing thoughts, feelings and behaviors at each level (1 is the lowest distress and 10 is the highest) and what they can do to cope. For example, at a level 1 I feel relaxed and content with life and I may be looking forward to something. I would also be engaging with people around me and laughing and smiling. At this level I would cope by continuing my self-care routine and spending time with friends and family. At a level 5, I might feel irritated, stressed or overwhelmed. I might have racing thoughts that some effort to control and I may want to isolate and stay away from others. At this level I would probably cope by journaling to get my thoughts out, talking to a close friend or family member and maybe a warm bath.

Once this safety plan is completed you have easy way to communicate with your teenager about their level of distress and a clear plan of action.

Regulate Their Access to Self-Harm Tools

Talk to your teens about the objects used for self-harm and ask them to give you the items for safe keeping. Oftentimes it’s a razor or lighter that is used and while you don’t want to restrict their use of these items you do want them to let you know when they are using them so you can help keep them safe.

Your teens may not be ready to hand over their tools or may give them to you but keep some hidden or obtain more of them after giving them to you. Therefore, keeping the lines of communication open and not punishing your kids is so important.

Don’t always keep your eyes on them, don’t take their door off their wall, and don’t search their room. This will only enforce their fears of talking to you in the future and coming to you when they need support. With that said, be sure to let them know that your primary goal is keeping them safe because you love them so you’re going to be checking in on them often.

Seek Professional Help Immediately

Be sure to seek professional help immediately. Right now, therapists have a huge waiting list all over the country, but there are many support groups and resources available to help you get started in the meantime. Call as many clinics as possible and get on their waiting list being sure to mention that your child is engaging in self-harm. This can sometimes get you bumped to the top of the waiting list and many clinics can offer other resources while you wait for a therapist to become available. If your child is already seeing a therapist check in with them often to see how therapy is going and if there is anything else, you can do to support your teens.

Take Care of Yourself

As a bonus tip, I want to remind you as the parent to take care of yourself. Your child will need a lot of support during this time, but you can’t pour from an empty cup. Be sure that you are getting enough sleep, eating well, and taking time to laugh and enjoy your hobbies. Model appropriate self-care for your children so they can learn how to take care of themselves.


  •  Peterson, J., Freedenthal, S., Sheldon, C., Andersen, R. (2008). Nonsuicidal Self Injury in Adolescents. Psychiatry (Edgmont), 5(11) 20-26.
  • Association For Psychological Science. (March 10,2017) Why Does Nonsuicidal Self-Injury Improve Mood?
Forming Lasting Relationships with Love Maps

Forming Lasting Relationships with Love Maps

February is often the month we celebrate relationships. The focus is typically on romantic and intimate relationships, but in this article, we’re going to discuss a simple concept that can help you build and maintain lasting relationships of any kind. It’s one of the seven principles that relationship researcher, John Gottman, details in his book “The Seven Principles for Making Marriage Work” entitled “Love Maps”.

What is a Love Map and why are they important?

Dr. Gottman defines a love map as “that part of your brain where you store all the relevant information about your partner’s life.”

During the dating period, we are so enthralled with our new partners that we are naturally curious about them. We ask questions, check-in multiple times per day, and plan elaborate experiences that we just know our partner will love. As we do this, we’re forming a map of our partner’s inner world: what they like and don’t like, how they experience stress, how they enjoy spending their free time, all the way down to where they were born and how they got along with their parents growing up. 

While many aspects of your partner’s love map will remain the same, certain aspects of it will need some updating from time to time. We do this by forming rituals of connection that allow your partner to express what’s going on in their world and how they are navigating through it. In other relationships, this concept is applied differently. The following are a few examples of ways to incorporate love maps into not only romantic relationships but also in your family relationships and friendships.

How to Use a Love Map in Your Romantic Relationship

In some ways, romantic relationships are easier to build than others due to the amount of time spent together. However, maintaining vulnerability needs to be intentional. Start by setting aside regular time to check in with one another.

You can set aside a regular time to check in with one another during the evening hours or right after coming home from work. If finding things to discuss is difficult, you can ask the same questions to start your conversation:

  • What was the best part of your day? 
  • What was the worst part of your day? 
  • What made you proud today? 
  • What are you looking forward to?

These questions give you an idea of what is stressing out your partner and what is making them happy. They can even provide you with ways to support your partner during difficult times and may even bring about additional topics of conversation.

How to Use a Love Map in Your Family Relationships

Creating a love map of family relationships can be fun, but it can also bring up some painful memories as well. In a romantic relationship, we ask questions about their family traditions and dynamics. When creating love maps with family members you may find that you have very different memories of the same experience. 

To better create a love map with your family members, work on creating new memories instead of focusing on past memories. Try hosting a game night and play games like “Hot Seat” or “The Confessions Game”. Both have great questions for expanding your love maps and the competitive nature of the game will help keep things light.

How to Use a Love Map in Your Friendships

Your friends are in your life to support you when you need it, but friendships need to be maintained as well. After all, how can you know when your friends most need your support if you don’t know what’s currently going on in their lives? 

Marco Polo is a great way to stay connected and know what is going on in your friends’ lives. Be sure to ask questions involving their current stressors and successes, but also take a look down memory lane and ask about their lives before you became friends. Be sure to plan regular “friend dates” because the only way to build on your love maps is to communicate.

Love maps are essential to helping you navigate through your relationships. They can guide you in the direction of creating lasting and meaningful relationships with others. We are social beings and we actually need human connection and understanding to survive in this world. Even in this busy world, we need to take the time to form these connections with our loved ones, no matter what those relationships look like.

Want to Form a Love Map, but Struggle with Mental Health?

Forming love maps with your loved ones truly enhances your life. If your mental health is preventing you from forming meaningful relationships, but you’re unable to find the help you need due to finances, find out how we can help you now. The Overt Foundation exists to subsidize mental health treatment so that you can live your best life, free of the mental health challenges you face now.

For more information about love maps and examples of questions and ways to incorporate this principle into your relationships visit the blog on the Gottman Institute Website.

Increase Motivation with Goal Setting

This time of year, everyone is getting excited to start a new year fresh with new ideas and inspirations. There is research stating we are more motivated to start working on goals at a clear milestone, such as Monday, the first day of the month, our birthday and especially the new year. Many people suffering from depression or anxiety notices a lack of motivation or excitement regarding previously enjoyed activities, what therapists call anhedonia. Goal setting is one of the ways we can treat a lack of motivation. ls give us something to work towards and when done properly they give us hope and pride that has been lacking in us for so long. Here are a few easy steps you can take to help create easy to follow goals and increase your motivation.

Start small
When depression and anxiety are at its worst looking at big daunting goals might just push us further into the dark hole. Although creating small goals can seem insignificant, James Clear, author of Atomic Habits reminds us that a 1% increase is still an increase and builds a lot of momentum over time. On the other hand, trying to increase by 15%, failing and moving back to 0% can do more damage to our sense of confidence than it does good. Instead, think of a very small action item, one that doesn’t require much thought or effect, so small that it would feel really silly if you didn’t do it.

Let’s say I have a goal to make sure my living room is picked up before I went to bed at night. A small action item could be to make a habit of picking up all the trash that I can easily see in my room before getting into bed that night. If that seems like too much for, go even smaller by committing to putting one thing away each night. Is your room going to be clean every night before you go to bed? No! But are you forming habits that you’ll be able to sustain in the long term? Yes! And your room looks slightly better than it did when you started.

Recognize the motivation
Let’s say after a week of taking care of all the trash you can visibly see in your room you feel more energized and want to do a little more. Great! Do it! Be sure to really take a second to appreciate the motivation while it’s here. Stop when you’ve felt you have had enough and allow yourself to go back to the simple goal the next day. Don’t feel any pressure to do more every day just because you felt
motivated to do more yesterday.

Get yourself some accountability
Find yourself a friend or family member that is willing to check in with you and see how your goals are moving along. If you’re seeing a therapist regularly, checking in with them is a great way to then process what might be keeping you from achieving your goal. If you don’t have an actual person or would prefer to keep all of this to yourself, be your own accountability buddy by writing a journal entry once per week stating what went right, what went wrong, and brainstorm possible solutions.

This is a marathon, not a sprint.
Accept that it is going to take some time before you feel more energized and willing to jump up and get things done. One way to keep the momentum going to measure your goals in some way. Create a scale of 1-10 that ranks your level of motivation for the day and keep track of those numbers. After a while you will start to see a small increase, and another small increase, and another until eventually you’ve reached your goal and can continue adding more if you choose to.

Don’t give up
Failure is often looked at as a negative in our country and it can be so easy to say, “Well, I didn’t follow through with that task the last two days in a row, so I’m going to give up this week and start again on Monday.” Shift your thinking to recognize that every time you practice it helps change neuro pathways in your brain helping you create long standing habits that increase motivation. Don’t wait for Monday to start again. Start right now, today.

These five steps will help you manage your goals to increase motivation and help you on your mental health journey. If you’re struggling with motivation to the point that it interferes with your daily life, don’t hesitate to reach out to a therapist. If you aren’t sure what goals would help you the most look for our next post on using your values to set meaningful goals.