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Self-harm

What is self-harm?

Self-harm is the intentional act of harming oneself in order to release inner turmoil and is a very secretive act.

It is a flawed coping mechanism in which teenagers engage to release inner anguish and distress as they are unable, or afraid, to express verbally how they are feeling.

Engaging in self-harm can cause more distress as the person embarks on a vicious cycle of trying to hide his/her wounds and scars coupled with feelings of guilt and shame, thus exacerbating the distress and turmoil that prompted the self-harming initially.

Acts of self-harm include: cutting, scratching, breaking bones, biting, pulling out hair, hitting self, burning self and poisoning.

The tell-tale signs a teenager may be self-harming

  • Self-harming can be difficult to detect because of its secretive nature. The following signs may indicate that a teenager is self- harming:
  • Looking for excuses not to engage in PE and sports activities like swimming
  • Noticeable change in character
  • Talking about him/herself in a negative way
  • Unexplained wounds, scars and bruises
  • Wearing long-sleeved tops and long trousers even in hot weather
  • Disappearing more than usual and spending longer periods of time in his/her room, and locking the door
  • More frequent and longer periods of time spent in the bathroom
  • Lack of engagement with friends
  • Noticeable collection of instruments that can cause injury and facilitate cutting
  • A collection of plasters, soothing creams and antiseptics hidden in his/her room
  • Blood spots on clothing and bed linen (turn clothes inside out to check)
  • Refusing to go clothes shopping
  • Finding laxatives in room, plus weight loss, and vomiting
  • Reacting passively and retreating to room when challenged on an issue
  • Looking for reasons to avoid family functions and seeking opportunities to be home alone more constantly and frequently.

What to do if you discover your child is self-harming

Discovering that a teenager is self-harming can be a daunting experience. You may feel afraid, angry and disgusted.

On discovering a teenager is self-harming, action needs to be taken in a proactive rather than a reactive manner:

  • Attend to your own feelings; do not approach a teenager about your suspicions or observations until you are more relaxed and grounded.
  • Approach with compassion and understanding.
  • Time your approach; wait until you have the teenager alone and are sure you won’t be interrupted.
  • Engage in a dialogue and outline your concerns in terms of what you have noticed. For example, ‘Sarah, I wanted to have a chat with you. I have noticed that you are not yourself and I am worried about you.’
  • Now be direct: ‘I have noticed that you have marks on your arm and I am wondering if you are self-harming.’
  • Do not get into a power struggle. The teenager will probably become defensive. Expect this reaction and remain composed and empathetic.
  • Remember, the teenager will be struggling with his/her own feelings, which may include shame, anger and anxiety.
  • Keep dialogue going. Let the teenager know you are there to help, not judge, and that you appreciate this is difficult for them.
  • Outline what will happen next. For example, ‘We will make an appointment with the doctor. We will find a therapist that will help you and I will support you all the way. We are in this together.’

If you are a parent who has discovered your child is self-harming, do not ignore what you have discovered. You may need to get emotional support yourself. It is advised that you engage with a service that can support you and your child.

Listen, listen and listen! Do not get angry and judge; this will cause the teenager to close off from you and intensify his/her inner turmoil.  Let him/her know you are aware of what is going on and appreciate he/she is in pain and you want to help.

Do not issue ultimatums in relation to stopping the self-harming behaviours. The act of self-harming is a coping mechanism and teenagers will not be able just simply to stop until the reasons for their actions have been uncovered and coping mechanisms that are more positive/nurturing have been developed through professional intervention.

Get professional help by engaging with a service that can support the teenager appropriately.

Websites with helpful guidance for parents:

Young Minds:

http://www.youngminds.org.uk/for_parents/whats_worrying_you_about_your_child/self-harm

This site also directs you to a number of common mental health and behaviour concerns in children and young people aged 1-25. http://www.youngminds.org.uk/for_parents/worried_about_your_child

The Royal College of Psychiatrists:

http://www.rcpsych.ac.uk/healthadvice/parentsandyouthinfo/parentscarers/self-harm.aspx