When your teen is engaging in self-destructive behaviors, what you usually see is the tip of the iceberg. You see the cutting, the substance use, the school refusal, the shutdowns or blowups, and it’s scary, confusing, and exhausting.
But what’s happening underneath those behaviors is often invisible. Big emotions. Overwhelm. Shame. Anxiety. A nervous system that’s trying to survive. And when all you can see is the behavior, misunderstanding and frustration are almost inevitable.
In this episode, I’m joined by therapist, author, and DBT clinician Katie May to help parents slow down and start understanding self-destructive behaviors in their teen or young adult kid through a very different lens. One rooted in the idea that all behavior makes sense, especially when you understand what it’s doing for them.
We talk about the iceberg analogy and why focusing only on the “tip” keeps parents stuck in fear, power struggles, and reactivity. Katie helps decode behaviors like self-harm, suicidal ideation, substance use, and school avoidance as attempts to regulate overwhelming emotions, not attention-seeking or manipulation.
Let’s have a look at how to respond to destructive behaviors in ways that reduce shame, build trust, and create the conditions for real change.
In this episode on understanding self-destructive behaviors, we discuss:
- The iceberg analogy: why behavior is only the tip of what’s really happening;
- What “all behavior makes sense” actually means for parents;
- How emotional dysregulation fuels self-harm, substance use, and school refusal in teens and young adults;
- Why parents often get stuck reacting to behavior instead of responding to their child’s needs;
- How your own regulation as a parent can de-escalate intense situations;
- Validating your teen’s emotions without excusing harmful behavior;
- How boundaries, connection, and repair work together;
- And more!
More about Katie May
Katie K. May is a licensed therapist, author, speaker, and group practice owner. She founded Creative Healing, a multi-location teen support center in the Philadelphia area, and wrote the #1 Amazon best-seller You’re On Fire, It’s Fine. With lived experience as a teen who turned to self-harm, Katie is one of only 11 Linehan Board Certified DBT Clinicians in Pennsylvania, the gold standard treatment for self-harm and suicidal behaviors. She equips parents and clinicians with practical, trauma-informed tools to decode behavior as survival and create lasting change.
Learn more about Katie on her website: https://youreonfireitsfine.com/ or connect with her on Facebook or Instagram.
Looking for support?
🗺️Need help setting healthy boundaries with your teen AND following through? My free guide will help you do so by creating your own Parent Home Plan!
🤍Influence lasting change in yourself and your struggling teen with my private coaching or parent group program specifically created for parents of struggling teens.
Have a question or need support? You can email me at beth@bethhillmancoaching.com
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And remember parents, the change begins with us.