How much supervision is appropriate for son who is self-harming?

Parent Cafe
1

Last night, my 16 year old son showed me that he has been cutting. He had 30+ very fresh cuts on his arm. He also had a single deep cut last week that required stitches, although at that time I accepted his story about a freak accident. He says he has been cutting for about a month, but in hindsight, I suspect it has been going on much longer.

We had a good calm discussion last night. He told me that he doesn’t know why he cuts. He says that his life is actually pretty good. He says he is not having social difficulties. He says he is not stressed about his grades, and it looks like he will be finishing up the year with straight A’s. He says he does have some anxiety about the future, but that he knows that he is usually able to handle challenges as they come up, so he realizes his anxiety is somewhat unfounded. He knows that I am calm, reliable, and willing to help him work through whatever is going on. He is a very introverted, private person, and I assured him that I would not be telling family and friends.

I got him into a therapist this morning. He opted to speak with the therapist privately, so I don’t know what was discussed. He does like the therapist and will be returning next week.

I’ve been reading about self-harm online. One issue that I don’t see is addressed is, how much supervision should I be providing? He has always been a super responsible kid, so he’s had a good amount of trust and freedom. Now things are different, because I need to keep him safe. But I also don’t want to make his issues (whatever they are) more difficult by hovering and not trusting. I am a single parent and work full time. He will be home alone for many hours during the summer weekdays. I also have two overnight trips planned in the next few months, when I’d intended to leave him home. Now it feels like I shouldn’t go; I would be worried the entire time. I can’t ask family or friends to check in on him, without invading his privacy. I also can’t easily cancel without at least hinting that there are issues, which would also be an invasion of privacy. His father is in the area, but is not very emotionally connected and would probably do more harm than good, if we asked for his help.

2

OP here, with additional info. It would not make sense for him to come along on the overnight trips. They are wilderness horse riding trips with a group of middle aged women; he is an indoorsy teen guy. He would hate it.

3

No advice here to offer but I’m glad he felt comfortable confiding in you and open to seeing a therapist.

4

He needs activities scheduled to give him a routine and keep him in the eye of a responsible person during the week. Volunteer work? Paid job? Summer classes? Summer camp? Any of these or a combo of some would make sense.

You can ditch the overnights with your pals without any explanation other than “Decided to spend some quality time with kiddo.”

5

I don’t think it would be violating any privacy laws to ask his therapist for advice on what is the most healthy way you should be reacting in this situation.

6

I have a little experience with this subject. I would say to err on the side of caution. What your child says doesn’t really matter - it’s what he does that should inform your decisions. I would skip the trip if I were you. I can say that one time in the past, that’s what I should have done but didn’t. I’m still paying off the ER visit. :frowning:

7

I know that my parents would not have left me alone overnight at 16 (though they were more likely concerned with teen pregnancy).

Is there an aunt or grandparent around he could stay with while you are on your trips? The adult doesn’t need to know much. He is a minor child still in need of adult supervision to some degree.

8

I second the advice to contact his therapist and ask. I’m sorry you guys are dealing with this. It must be very scary.

9

I have no words of advice, but congratulations on having a relationship that makes your son comfortable in confiding in you, and also congratulations on getting him into treatment so quickly.

10

I would second speaking to therapist. Not only will you get professional advice, but if you have to tell you son that he has to stay with someone/have someone stay with him and he doesn’t like it, you can tell him to discuss it with the therapist knowing that they will say (even if you don’t tell him you’ve spoken).

11

I agree that you should make your own appointment and talk with therapist about your supervision concerns and ask for guidance. Best of luck in navigating these challenges.

12

I agree with the give him structure and keep him busy. When I was going through some emotional issues as a teen, I found that being a jr. counselor helped me, but if that’s not his thing anything from volunteering to a job with consistent hours may help. Summers can be hard.

13

My daughter is a recovering cutter; my son still struggles. And yes, both have anxiety and depression. I know this is scary stuff. You probably already know that cutters aren’t usually suicidal, although they can accidentally cut themselves severely (as you have discovered.)

Physiologically, it releases endorphins, which can anesthetize emotional pain or stress. It’s often the type A, straight A kids who do this. Over time, this endorphin rush becomes addictive. It’s hard to break the cycle of stressful situation–cutting–guilt and shame–cutting. And you really can’t stop a kid who cuts by taking away the sharp things or watching them like a hawk. If they want to do it, they will find a way.

So you’ve started with therapy and some honest talk. That’s great. But you should be in therapy, too, ideally with your entire family. Our therapist required us all to go, with both group and individual sessions. Like eating disorders, self-harm is a family disease, even if only one member suffers from it.

My daughter also came to me. For months prior, I kept finding weird sharp implements in the dishwasher. She was sanitizing them so that she didn’t get an infection. So yeah, type A. I would actually encourage your son to do this, as weird as it sounds. Tell him that you know he’s struggling not to cut, but if he does, he should run the scissors, razor, knife or whatever through the dishwasher or clean them with rubbing alcohol.

Telling him this won’t normalize what is obviously an abnormal coping behavior, but it will make it clear that you can be trusted to talk openly without judgment, and with practical advice. Encourage him to tell you when he feels like harming himself and listen without freaking out. Ask him if there’s anything else he can think of that might bring the same relief.

Don’t cancel your trips, but do share with him that you are considering it and discuss ways to keep him safe while you’re gone. If you do think he’s spiraling down, then yes, stay home, but recognize that healing is a process. There will be relapses during stressful times, but they should grow further apart as your son learns to manage his emotions in more productive ways.

I would normally send this stuff via PM, but this is such an important topic (and a common problem) that I’m leaving it here in case it helps anyone else.

14

I’m going to agree with everyone else. I would speak to the therapist and your son together so that everyone is clear you aren’t trying to violate his privacy with his therapist. Just say what you said here.

That said, if it were me, I wouldn’t leave overnight and would be sure at the least to be available for anytime he does need to open up and have a parent there. Especially until whatever the underlying issue is discovered.

15

Stay home. Ask the therapist for a residential treatment program, perhaps for 3weeks. In the right place, this could be an amazing experience for him. But don’t rush, lots of not so good places.

I can only imagine your anxiety. Self-harm is serious.

16

With my daughter it was important that we trust her. Hovering increased her stress and thus her cutting. We had an arrangement that I would examine her body weekly but that I would not actively prevent her from cutting. Meanwhile she and her therapist worked out other stress management techniques until the need to cut subsided.

17

OP here. Thank you all so much for your comments and sharing your experiences. I am letting all of your advice sink in. I am thankful for this caring community.

18

Work with your son and his therapist to develop a safety plan together.

19

Instead of asking here, I would make an appointment with the same therapist. Not to find out what your son divulged, but to find out what his/her advice would be.

Then I would make an appointment with the guidance counselor at school… I know the first time I saw evidence that one of my students had been cutting, I ran right to her guidance counselor. I was relieved to learn that she was under professional care, and that the school was aware of the issue.

This is your first trip down this road, but the guidance people at school have traveled it too many times before.

20

I don’t have any advice but I just wanted to say that you must be an amazing mom for your son to have such trust and faith in you. I hope the therapy and whatever other strategies you both employ help and that your son finds peace quickly.