Is This Self-Harm? A Parent Asks

A parent writes in about her 14-year-old daughter who has started drawing on herself and picking the skin off the bottom of her feet. She’s heard this might be a form of self-harm and wants to know whether to be worried, and how to get her to stop.

It’s a question that brings up a lot of anxiety for parents, and understandably so. The word “self-harm” can feel alarming. So let’s start by being clear about what self-harm actually is, and what it isn’t.

What Self-Harm Actually Is

Self-harm, also referred to clinically as non-suicidal self-injury or NSSI, is the intentional injuring of one’s own body without the intent to die. It is important to understand that distinction: self-harm and suicidal behavior are generally two separate things. A teenager who is engaging in self-harm is not necessarily suicidal. They are typically trying to cope with emotional pain that feels overwhelming and unmanageable, and they have not yet found healthier ways to do that.

Self-harm can take a number of forms, including cutting, burning, scratching, or hitting oneself. These are serious behaviors that require professional attention. They do not resolve on their own, and they are not just a phase that a teenager will grow out of without support.

That said, not every concerning behavior is clinical self-harm. A teenager who is drawing on herself, biting her nails, twirling her hair, or picking at her skin may be expressing anxiety or boredom rather than engaging in self-injury. The two can look similar on the surface but they are meaningfully different underneath.

The Question Worth Asking: What Is She Drawing?

In the case of the parent who wrote in, Kent’s first question is a good one: what is your daughter actually drawing? If she’s drawing anime characters, words, or decorative designs, that’s a very different picture from a teenager who is drawing lines on her skin that look like cuts.

That distinction matters clinically. One of the early interventions sometimes used in self-harm treatment involves having a teenager draw the marks rather than cut them. It’s not a long-term solution, but it can be a step on the path toward stopping. So if your daughter’s drawings look like they’re imitating self-injury, that’s worth taking more seriously and exploring with a professional.

If the drawings look like art, self-expression, or absent-minded doodling, that’s a much less concerning picture. The same logic applies to picking at her feet. If it’s not causing wounds or significant distress, it may fall into the category of a habitual anxiety outlet rather than self-harm, similar to nail biting or hair twirling. You can address it practically, setting a reasonable expectation that it doesn’t happen at the dinner table, for example, without treating it as a clinical crisis.

Signs That Something More Serious Is Going On

Parents are often the first to notice when something shifts. If you’re concerned about your teenager, here are the signs worth taking seriously:

Unexplained wounds, cuts, burns, or bruises that your teenager can’t account for or dismisses vaguely. Wearing long sleeves or covering skin in warm weather in ways that feel out of character. Frequently wearing wristbands or bandages without a clear reason. Withdrawing from activities that involve showing skin, like swimming or gym class. Keeping sharp objects or lighters in their room without explanation. Significant changes in mood, withdrawal from friends and family, or expressions of feeling numb, hopeless, or like a burden.

Self-harm most often happens in private and is actively hidden. Teenagers who are self-harming are usually not doing it for attention. They are doing it because it provides temporary relief from emotional pain, and they are often deeply ashamed of it. That shame is part of why they hide it, and it’s one of the most important things to hold in mind when you’re figuring out how to respond.

How to Respond If You Discover Your Teenager Is Self-Harming

Your initial reaction matters more than you might realize. The way you respond in that first moment will determine whether your teenager feels safe coming to you or whether she shuts down entirely.

Stay calm. This is genuinely hard when you’re frightened and heartbroken. But a panicked or angry reaction confirms your teenager’s fear that this is too much for you to handle, and makes her less likely to be open with you going forward. Take a breath. You don’t have to have all the answers in that moment.

Lead with love, not alarm. Tell her you love her. Tell her you’re not angry. Tell her you want to understand what she’s going through. The goal in that first conversation is not to extract information or immediately fix the problem. It’s to make her feel less alone and less ashamed.

Don’t demand that she stop immediately. This may seem counterintuitive, but demanding that a teenager stop self-harming without addressing what’s driving it is not effective and can be counterproductive. The behavior is serving a function for her. Until she has other ways to cope with the emotional pain underneath it, taking away the coping mechanism without replacing it doesn’t help her. It just leaves her with nowhere to go.

Get professional support right away. This is not something to wait out or manage on your own. A therapist who specializes in adolescent self-harm can work with your daughter to understand what’s driving the behavior, help her develop healthier emotional regulation skills, and provide the kind of consistent, professional support that this situation requires. Please don’t try to be her therapist. Be her parent. Let us do the clinical work.

What Actually Helps: Channeling the Energy

For teenagers who are engaging in more mild anxiety-driven behaviors like drawing on themselves, picking at skin, or similar habits, the most useful thing parents can do is help them find healthy outlets for whatever is driving those behaviors.

Creative outlets are particularly effective. Drawing, painting, journaling, music, and other forms of artistic expression give anxious or emotionally overwhelmed teenagers somewhere to put what they’re feeling. In our practice we’ve seen knitting work remarkably well for some teenagers, including those who were pulling their hair. The repetitive, tactile nature of it provides a regulated sensory experience that can address some of the same needs the problematic behavior was meeting.

Physical activity, social connection, and time outside are also genuinely useful, not as distractions but as real contributors to emotional regulation. A teenager who is physically active, socially connected, and sleeping adequately is in a meaningfully better position to manage difficult emotions than one who is sedentary, isolated, and exhausted.

And talk to her. Find out what’s going on for her. She may not even be fully aware that she’s doing the behavior. But the conversation opens a door and signals that you’re paying attention and that she can come to you.

When to Be More Concerned

If your teenager is engaging in any form of clear self-injury such as cutting, burning, or scratching that leaves marks, please reach out to a mental health professional right away. This is not something to take a wait-and-see approach with. It is not just a phase. It will not resolve on its own.

Self-harm is serious and it is treatable, but it requires professional support. The sooner your daughter has access to a therapist who specializes in this area, the better her outcomes are likely to be.

If your teenager has expressed any thoughts of suicide or you believe she may be in immediate danger, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988, or take her to your nearest emergency room.

Get In Touch

If you’re worried your teenager may be engaging in self-harm, or you’re not sure whether what you’re seeing is serious, please reach out. At Teen Therapy Center in Woodland Hills, we work with teenagers who are struggling with self-harm, emotional dysregulation, and the underlying anxiety, depression, or trauma that often drives these behaviors. We also work with the parents who love them and are trying to figure out what to do. We serve families throughout the West San Fernando Valley, including Woodland Hills, West Hills, Calabasas, Tarzana, and Encino. Reach out today for a free phone consultation.

If you or your teenager are in crisis right now, please call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day, seven days a week.

FAQ

Is drawing on yourself a form of self-harm?

It depends on what’s being drawn and why. A teenager who is drawing decorative designs, words, or pictures on her skin is most likely expressing boredom or mild anxiety rather than engaging in clinical self-harm. However, if the drawings appear to imitate cuts or self-inflicted marks, that’s worth taking more seriously and discussing with a professional. When in doubt, a conversation with your daughter and a consultation with a therapist can help clarify what’s actually going on.

What is the difference between self-harm and a suicide attempt?

Self-harm, clinically known as non-suicidal self-injury, is the intentional injuring of one’s own body without the intent to die. It is generally a coping mechanism for overwhelming emotional pain rather than a desire to end one’s life. That said, research does show that self-harm over time is associated with an increased risk of suicidal thinking and behavior, which is one of the most important reasons to take it seriously and get professional support early rather than waiting.

My teenager is cutting herself. What do I do right now?

Stay calm and lead with love rather than alarm or anger. Tell her you love her and that you’re not angry. Then contact a mental health professional who specializes in adolescent self-harm as soon as possible. This is not something to manage on your own or to take a wait-and-see approach with. If you believe she is in immediate danger, call or text 988 or take her to your nearest emergency room.

How do I talk to my teenager about self-harm without making things worse?

Lead with empathy and curiosity rather than fear and demands. Tell her you’ve noticed something and that you’re concerned because you love her, not because she’s in trouble. Avoid ultimatums about stopping immediately, since the behavior is serving a function for her and she needs support in developing other coping tools before she can let go of it. The goal of the first conversation is to make her feel seen, less alone, and safe enough to eventually open up. A therapist can help facilitate this process if the conversation feels too difficult to have on your own.

Can self-harm be treated?

Yes, absolutely. Self-harm is a serious behavior but it is very treatable with the right professional support. Therapeutic approaches that focus on emotional regulation and building healthy coping skills have strong evidence behind them for adolescent self-harm. The earlier a teenager gets connected with a therapist who specializes in this area, the better. Recovery takes time and there may be setbacks, but with consistent support most teenagers do find their way to healthier ways of managing difficult emotions.