Your child or adolescent harming themselves can be a terrifying prospect. It may leave you, as their parent(s) or carer(s), feeling powerless, scared and unsure about the best way to support them.
Sadly, self-harm is common in children and adolescents and is most common in females between the ages of 15-24 years. Research cited by National Institute of Clinical Excellence (NICE, 2011) found that of a sample of 15-16 years surveyed, 10% of girls and 3% of boys had self-harmed in the previous year.
Despite these figures, the true scale of the problem is difficult to quantify as most people will try and conceal their self-harm due to high levels of shame. Children and young people who are looked after have been identified as especially at risk of self-harm (e.g. Harkess-Murphy, MacDonald & Ramsay, 2013).
What is self-harm?
The National Institute of Clinical Excellence (NICE) describe self-harm as
‘self-poisoning or self-injury carried out by an individual irrespective of motivation’ (2011)
Self- harm can encompass a wide range of behaviours. These can include:
- Cutting
- Burning
- Pinching
- Punching (walls etc. to harm self)
- Overdose of tablets
- Excessive alcohol use
- Strangulation (use of ligatures)
- Restricted eating
Some myths
There are some huge myths around self-harm and what it can mean about children and young people. These can often make fear and stigma worse, meaning that people do not seek the help and support that they need. Some main myths include:
- Only girls self-harm
- It’s always to get attention
- They must enjoy it
- It’s a ‘fad’, all the kids are doing it at school
- They want to end their life
- Talking about self-harm increases the chances of your child engaging in that behaviour
Why do young people self-harm?
So having outlined the myths, then what are the truths about why young people self-harm? Fundamentally, however scary and hard to understand it is, self-harm is a communication of your child’s emotional distress. This difficulty in communication feelings and distress can happen for many reasons.
Young people who have experienced developmental trauma (from early abuse and/or neglect), have usually missed out on crucial experiences where they would have been supported by their caregivers to make sense of their emotions and then learn to manage them effectively (see emotional regulation). They may have also grown up in environments where expression of their emotions was punished. Due to their difficulty in regulating and making sense of their strong emotions, they may find that harming themselves eases the chaotic feelings they have in the very short term by the tension being temporarily relieved. In short, the physical pain that they experience may feel more manageable than the emotional pain.
It may also feel safer to direct their anger inwardly than towards others. Young people who are looked after or adopted can often feel that they have little control over their emotions. Self-harm may help them to feel that they have some control over something in their life as well as communicating their feelings and needs to others.
Typical Strategies
Often people try to tackle the very scary issue of self-harm by ignoring, punishing or minimising the issue. For example, ignoring cuts or not providing the relevant care needed or grounding the young person. This can often be done with the best of intentions but ignoring or applying consequences can escalate the problem further as this does not address the child/young person’s emotional needs and can cause even greater emotional dysregulation.
How as parents and carers can you respond differently?
It is understandable that you may experience a range of emotions including fear, worry and anger. However, as with other difficult behaviours, it will really help if you can try and be aware of your own feelings about your child hurting themselves. If you are able to do this, then you will be in a better position to respond with empathy. Seeking your own support can also help with this.
Giving the young person space to talk when they are ready is crucial. This works best if you can be non-judgemental, accepting of their distress and actions and empathic about how they are feeling. Curiosity can really help you to understand why your child is hurting themselves and prevent you from trying to guess or answer for them. What function does it serve for them? They may also require more time with you or that you keep more of an eye on them (which can be tricky with an adolescent who is craving independence!) to ensure that you can keep them safe and they have opportunities to talk. However, this needs to be balanced with giving them space too.
It may feel helpful to speak with your child about additional support that they may need. Your GP should be able to help think about a referral for therapeutic work if you and your child think this would be helpful.
Practical Considerations
- If your child is finding it difficult to share their feelings and worries with you, is there someone else in the family or another safe adult they can talk to? (Aunt, older sibling, professional etc.). It will help to share some of the difficult feelings that are causing the self-harm.
- Be mindful that medication or other implements that could be used to cause harm are kept away safely. However, when children and young people are distressed they can be hugely creative and may find everyday items to use. It can be impossible to secure everything, hence providing them a space to talk is likely to be most effective.
- When trying to help your child reduce their self-harm you may see an increase in other tricky behaviours.
- If you feel it is an emergency call 999 or attend Accident & Emergency (A&E)
Additional Reading
http://www.youngminds.org.uk/for_children_young_people/whats_worrying_you/self-harm