When the whole world feels like it’s asleep, but your teen is awake and grappling with strong emotions and difficult thoughts, and they’re feeling particularly alone, they may feel nighttime self-harm urges. That urge is an attempt to cope with the extreme emotional pain they’re experiencing. It might feel like a way to express or display their pain. Your teen might feel like they deserve punishment through self-harm. Or it may be a way to return to their body, when their mental state has pulled them too far into difficult feelings and hurtful thoughts.
During the day, your teen may be able to ignore their self-harm urges, but at night, they may experience a spike in these urges that can become particularly difficult to deal with.
Dialectical behavior therapy (DBT) can give your teen a supportive, structured way to cope with emotional overload without resorting to self-harm. DBT-A therapy for teens at Suffolk DBT helps teens cope with self-harm urges not only during therapy, but between sessions, equipping them with skills they can use any time, day or night.
Why do self-harm urges intensify at night for teens?
Without distractions, self-harm urges can get louder at night
During the day, your teen is busy. They have school, friends, video games, homework, a job, extracurriculars, responsibilities at home, and time with family to distract them from self-harm urges.
At night, there’s less to distract your teen. They’re supposed to be asleep, but their brain now has their full attention. Ruminating over difficult thoughts and the emotions they bring up can quickly become overwhelming, leaving your teen face-to-face with self-harm urges.
There’s less social support available at night
During the day, your teen has you, friends, teachers, their therapist, and even strangers they come across to talk to. They aren’t as alone, and so self-harm urges can feel less urgent.
At night, when everyone is asleep (or is at least trying to sleep), it can become harder to reach out, and if they do, they may be left waiting for an answer, or worse, on the receiving end of annoyance from their support system. They might turn to forums or social media where they can find just as much content that feeds self-harm urges as content that offers them support. This can make self-harm urges feel particularly unbearable, since bearing them alone can feel impossible for your teen.
Teens need sufficient sleep to support their mental health
A teen’s mental health hinges on getting enough sleep. Late bedtimes, insomnia, too much screen time, and poor-quality sleep (from stress, excess caffeine, or a disruptive sleep environment) can escalate mental health issues like depression, anxiety, and BPD. Regularly disrupted nights can escalate a teen’s mental health issues, and the misery of another night of missed sleep can make self-harm urges particularly hard to handle.
How can DBT distress tolerance help teens make it through self-harm urges at night?
Self-harm urges are distressing no matter what, but at night, they can be especially difficult to bear. Dialectical behavior therapy (DBT) distress tolerance skills help your teen make it through these dark nights without resorting to self-harm.
Urge surfing can help your teen ride out a desire to self-harm at night
Urge surfing can sound counterintuitive. It encourages your teen to sit with their nighttime self-harm urges, which might sound like the worst idea possible, but urge surfing hinges on your teen understanding that the urge will pass.
Urges move through us like waves, and if your teen can surf with the urge, staying present instead of spiralling into strong emotional reactions, it will pass. Your teen will learn to name their self-harm urges, recognize how it feels in their body, and then ride it out, staying present in their body and mind, without judging themself for what they’re going through.
Self Soothe uses your teen’s senses to reduce their distress
When teens are struggling with self-harm urges at night, they may find relief through using their senses to reconnect themselves to the present moment. The Self Soothe DBT skill encourages your teen to use comforting imagery, soft and comfortable clothes and blankets to touch, enjoyable fragrances and tasty foods for smell and taste, and soothing, calming sounds like the ocean or binaural music for listening.
By seeking comfort in sensory experiences, your teen can return to their body even when their emotions feel overwhelming, giving them an alternative to self-harm.
IMPROVE helps your teen make self-harm urges at night more bearable
When things are really bad, the self-harm urges at night are strong, and your teen is feeling very alone, the IMPROVE skill can make these hard moments more bearable. Your teen can focus on finding things that improve the moment, like:
- Imagery: Imagine a safe, enjoyable place.
- Meaning: Find meaning in the moment.
- Prayer: Pray to a deity or simply to the universe for strength in the moment.
- Relaxation: Deep breaths, a warm shower, or some stretching can help your teen relax.
- One thing: Focus on one positive thing in the moment, with all your teen’s attention.
- Vacation: Give yourself a vacation, literally or by just going to a different room for a while.
- Encouragement: Your teen can encourage themselves. They can do hard things. They’ve got this.
Parents are crucial safety supports for teens’ self-harm urges at night
When your teen lets you know they’re experiencing urges to self-harm, it can feel terrifying for a parent. You may fear they’ll escalate to suicide, or that they’ll be stuck in these self-harm cycles forever. You might also jump to the conclusion that they just want attention and be tempted to brush them off, leaving them to handle these scary thoughts alone.
Your teen needs you to recognize that they’re experiencing real distress, and they’re grappling with underlying emotions that are overwhelming them. Instead of panicking or ignoring your teen, try to show up for them as a calm, supportive presence in moments where self-harm urges are particularly strong.
Your teen needs you to listen, they need you to recognize their distress, and they need your support through reminding them to use DBT skills in the moment, and working through those skills alongside them, so they aren’t facing these difficult thoughts and difficult nights alone.
Suffolk DBT can serve as a helpful source of teen safety support when it comes to nighttime self-harm urges
Suffolk DBT offers teens and their families full-model dialectical behavior therapy at their offices in Manhattan and Long Island and online throughout New York state. Their therapists specialize in serving teens, adults, and college students who are dealing with depression, borderline personality disorder, eating disorders, and self-harm, helping them learn DBT skills that empower them to manage strong emotions and work through life’s challenges.
Still have questions? We are here to help. Call our office to speak with our intake coordinator.