Self-harm

What is Self Harm?

Self Harm, as defined in the National Institute of Clinical Excellence guidelines (2004), is an:

“expression of personal distress, usually made in private, by an individual who hurts him or herself”.

Self Harm behaviours can include:

  • Scratching or picking skin
  • Cutting body
  • Tying something around body
  • Inserting things into body
  • Scouring/scrubbing body excessively
  • Hitting, punching self (punching walls etc.)
  • Pulling out hair
  • Over/under eating

Why do some young people self-harm?

During adolescents young people may encounter particularly painful emotional events. They may not know where to go for help or they may not trust, or feel able to talk, to the adults around them. They may not have a healthy support network or have the problem-solving skills to tackle these difficulties on there own. This can result in feelings of helplessness and hopelessness, which can lead to self-harm.

How can you help?

  • LISTEN!! Most young people who have spoken about what helped them reduce or stop self-harming say that having someone who really listened to them was really was the one thing that really made a diference.  If they will not talk to you (many young people find it difficult to  talk to their parents about difficult issues) then find someone they can talk to.  Many schools have counsellors or other pastoral support or get advice from your GP who can refer to TAMHs (targeted adolescent mental health service) or visit the BACP website to find a therapist.
  • Be non-judgemental and genuine and try to put yourself in their shoes
  • Encourage alternative behaviours to self harm (see list of distractions below)
  • Teach coping and problem solving strategies
  • Help them to develop awareness and recognise feelings that may trigger self harm
  • Help them to identify a support network and encourage them to access this support

Some young people may only self harm once or twice in response to a particular difficulty, however, this can also become a regular coping mechanism which becomes hard to stop. It is important to remember this and sometimes it is useful to  think of it like smoking.  Some people use cigarettes to deal with stress, they know this is not a healthy way of coping but they still do it and self-harm is similar and can easily become a vicious cycle.

selfh

What keeps it going?

  • Release of endorphins
  • A way of letting people know how difficult and distressing things are.
  • A form of relief and release, or distraction
  • A form of self-punishment
  • Rarely it can be a way of becoming part of a group
  • Unchanging difficult situations
  • A way of coping with unattended trauma

Different people find that different things help them reduce or stop self-harming, talking to someone, keeping a feelings journal , listening to music or physical exercise are often popular distractions a more comprehensive list is below.

Distractions that may help:

  • Draw on yourself in a red marker
  • Snap an elastic band on your wrist
  • Put plasters or bandages on where you want to self-harm
  • Make ice cubes and rub them on where you want to self harm or squeeze them
  • Take a photo of yourself when you are upset, write all over it how you are feeling or write a journal
  • Take a hot shower, use an exfoliating body wash and sponge
  • Draw over old scars, (which will provide a repetitive action and hopefully relieve urges)
  • Bite into a chilli
  • Read a book
  • Watch TV
  • Bake a cake
  • Listen to music
  • Go for a run or walk
  • Go on the internet
  • Allow yourself to cry
  • Go outside or to a public place
  • Run your wrist under cold really cold water
  • Ice dive (dunk your face in really cold water)
  • Phone or text a friend

Remember that self-harm is usually a coping mechanism and not an indicator of suicidal intention.  Most self-harmers do not go on to complete suicide but the question needs to be asked, if they are having suicidal thoughts contact your GP immediately to enable them to access professional support.