It’s always concerning to hear that self-harm is on the up. With the amount of stress young people are under, it’s no surprise some are struggling. In this post, I will share the reasons why people self harm; an understanding formed through years of working with young people. My experience includes working with those who’ve cut different parts of their body, burnt themselves, consumed toxic substances (I don’t mean drugs or alcohol), and in rarer instances, swallowed objects. These are the types of self-harm I am referencing for this post. If you are reading this as a parent or carer, I’ll suggest some dos and don’t to help you get through what is a worrying and distressing time.
Adolescence is a funny time. Brain development means connections are firing on all cylinders, giving reason for why adolescents are more likely to engage in risky behaviour. They are more likely to act impulsively without truly thinking about the consequences of their actions. Adolescence can bring up previous, unresolved emotions and experiences that may have been distressing, upsetting and difficult to cope with at the time. It can also be a time where present traumas and personal challenges are difficult to contain and work through. These could be family or relationship problems, bullying or peer pressure, or academic stress. Of course something traumatic may have happened to the young person in recent months. This could be ongoing or a one-off abusive or neglectful experience.
Just because a young person is self-harming, it doesn’t mean they have been abused or neglected. I used to consider it when assessing a young person (in fact, you have to ask those awkward questions as part of safeguarding), but it wasn’t always something I was left wondering about. I have found that the type of self harm can be indicative of the type of distress someone is experiencing. There is a difference between someone scratching their wrists to someone who feels the need to drink a toxic substance like bleach. Each comes with its own story.
When I’ve talked to young people about their self-harm, they’ve offered the following reasons:
- It’s a release. The young person describes a build up of tension or emotion and self-harm has become a way of coping with this rather than expressing it in a different way. I suspect sharing emotions feels unsafe in some way, whether it’s a fear of being judged, misunderstood, or dismissed. In my experience, this release of tension is particularly characteristic of those who cut.
- It’s seen as a punishment for something, or a reflection of what is deserved. This connects to someone’s self-worth and sense of shame.
- It can be something friends do together. (There can be a competitive element but it also brings a sense of belonging.)
- For those who feel empty or disconnected from their emotions, the sight of blood is a sign of life. It serves as a reminder that they are alive.
- Consuming toxic fluids can be an indicator of wanting to cleanse. It can be associated with feeling dirty, damaged, or contaminated in some way.
- It may be a safer way of eliciting care, especially when emotions are cut-off.
These aren’t exclusive reasons but in my clinical experience, these are the most common explanations. If you know a young person’s self-harming, and are aware of some of their past and present experiences, you may be able to make some sense of how they got to this point. However, this is easier said than done when it’s your child, or a child in your care. It can be hard to see the woods for the trees and it might be more appropriate to seek help from an outside source (actually I would advise this anyway, see below).
Does Self-Harm Lead to Suicide Attempts?
The short and unhelpful answer is “sometimes.” Just because someone is self-harming, it doesn’t mean suicide is being contemplated too. There are many young people who have never self-harmed but have attempted suicide. It works both ways. Self-harm is a coping strategy, it doesn’t always mean that person is an increased risk to themselves. Some have thoughts about hurting themselves in a more serous manner but are clear they do not wish to act on them, others think they might. It’s important to have someone, a professional, explore the young person’s level of risk as well as formulate a helpful way forward.
There will always be some young people who are a worry, who are riskier when distressed. Keeping them safe is very important, which brings me onto the Dos and Don’ts.
I Know It’s Hard but Please Don’t
Fly off the handle. I put this bluntly but please try not to lose your mind and express anger towards the young person. This will make them feel judged, and if they feel judged they are less likely to come to you for support. Being angry will make them feel like they’ve done something wrong. It could make them feel shamed which won’t help in the short or long term. If someone is self-harming, it’s not because they feel good about themselves. They don’t need to feel worse than they already do. As a parent you are likely to feel a myriad of emotions and that’s completely normal. It’s time of huge anxiety and worry.
Blame the young person. A bit like the above advice. You can ask, but demanding to know what is going on is unlikely to help. The young person may have come to you (great) but if you’ve discovered the self-harm by chance, it can be hard to tackle and talk about. I am not saying you shouldn’t let them know you are worried about them, or that you are aware of their self-harm but this needs to be done in a measured way. Overwhelming them will not lead to an improvement. It’s not about whether it should be talked about, more the tone associated with how it’s done.
Tell them to stop. It sounds counterintuitive I know, but I don’t think I’ve ever met anyone who enjoys self-harming. Most people would like to stop but don’t feel they can. It’s a way of coping, take that away and the risk may increase. I always ask about a person’s self-harm – when they were most likely to do it, where they’ve harmed themselves, what they use, and how it helps them. I would ask them to make sure any cuts were kept clean. Together we would work out if there was anything they feel they could do instead should they feel the urge to hurt themselves. Usually once people access help and start to make sense of their emotions, the frequency of self-harm naturally declines.
Ask them to show you marks on their body. Some people feel comfortable with their scars and marks on show and others don’t. You may wish to see the marks to check the severity but this may be best left to the GP or another health professional.
Instead, Try These (The Dos)
Seek help. The first and obvious place is your GP. Sometimes young people are reluctant to go. If they really won’t, there’s no reason why you can’t go as their parent or carer. It means your concern and the self-harm will be noted. It’s better than nothing. The best case scenario would be for further help to be accessed and the appropriate support implemented.
Be sympathetic and empathic. All the worry and anxiety can be draining but when children are distressed and are struggling to express their emotions, they need the adults around them to attune to them. If you were in emotional pain, how would you like someone to respond to you? It’s an important question and a good one to hold in mind, if you can. It can be challenging as some young people can be quite remote and distant. They can be hard to reach despite your extensive efforts. Don’t give up.
If the young person is wanting to talk about it, go with it. It may help you understand what is going on for them and they may have some thoughts on how you can help. Also, talking helps. The more they talk and turn to others to cope, and the more they feel understood, the less self-harm may be needed.
Keep safety in mind. If you are concerned about any risk your child may present to themselves, you need to take measures to ensure their safety. Obviously, go to your GP and share your concerns. Do sensible things too, like making sure medication is not accessible at home. Lock them away if you have to. If your child is wanting to go out with their friends, have an agreement about checking in with them during their time away and them contacting you if they need to. Ask them to be home by a particular time (I know – easier said than done).
I think some parents find it hard to trust their child once they learn they are self-harming. It’s hard to know they will be okay when away from home and with their friends. Admittedly, it’s a fine line. You don’t want to stifle them; that won’t help. However, avoiding the problem and showing little concern is not the answer either. Letting them know you are there and you can be relied upon is a good place to start.
If We Take Care of Ourselves
Parents or carers can really struggle to understand and come to terms with the knowledge that their child is self-harming. This is normal, as is the anger, frustration, upset, and anxiety it comes with. It’s not unusual, or negative, for parents or carers to need a space to explore their feelings connected with this. It’s a lot to cope with and it’s hard to know what to do for the best sometimes. If you feel supported as a parent or carer at such a trying time, you will in turn, be able to support your child.