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:
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: