Self Harm

What is self-harm?

Deliberate self-harm is when somebody intentionally injures or harms themselves. Some examples are overdosing (self-poisoning); cutting or burning themselves, bruising themselves, pulling hair and picking skin. It can also include taking illegal drugs and drinking excessive amounts of alcohol. Self-harm can affect anyone and is more common than people think. Some reports say that as many as one teenager in ten could be affected, but it’s hard to say exactly because most people keep their self-harm secret.

Why do people do it?

Self-harm is not attention seeking, in fact many people keep their behaviour hidden. Because of the stigma and low self-esteem they are unlikely to seek help. Self-injury is a way of dealing with very difficult feelings which build up inside. Some people say they have feelings of anger or tension that get bottled up inside until they feel like exploding. Self-injury releases this tension. Others say they are feeling desperate about a problem but don’t know where to turn for help. Self-injury helps them feel more in control. It may be a way of punishing themselves if feelings of guilt or shame become unbearable. People who have suffered very upsetting experiences such as trauma or abuse try to cope by pretending that these events never happened and as a result they say that they feel detached from the world and feel numb. They see self-injury as a way of feeling more alive.

Whatever the reason is, self-injury is always a sign of great distress. Sometimes people can end up killing themselves accidentally. ‘Copy cat’ self-harm can happen in groups. Anyone who self-harms is struggling to cope and needs help.

Getting help.

If you do injure yourself you may want to stop doing it even though you don’t know what else to do to help you cope. Stopping self-harming is easier to do if you can find other ways of coping. You need to think about talking to someone you trust, someone who will listen to you and give you practical help. A person you could trust to listen to you could be a member of your family, your carer, a doctor, a teacher, a school nurse, a social worker or a youth worker. These people may not be able to give you the help you might need and may not understand why you harm yourself, but they can offer you support and help you find out more about what help is available. Many people find it useful to talk to someone who is trained to help. Going to your family doctor is a good place to start, as they will know where you can get more specialist help. If there is no one you trust to talk to you could try a telephone helpline (for telephone numbers see resource list at end.) People who self-harm often find a variety of personal strategies which they find useful to minimise or manage their harming, including:

Having a better understanding of why and when you self-harm, and identifying people who are supportive and make you feel good about yourself.

Minimisation – making a small cut rather than a big one; using clean instrument to cut yourself with. This may mean cutting yourself earlier, rather than letting distress build up.

Distraction – try to do something else rather than cut yourself. For example squeezing ice, biting into something strongly flavoured i.e. lemon, hot pepper, ginger root. Or hit a punch bag, tear up an old newspaper or go for a run.

Avoidance – not keeping razor blades or other sharp objects in the house.

Talking – talk to somebody you see as “safe”.

What can you do to help if you think you know someone who is self-harming?

If a person is thinking of killing themselves, they often try to let people know they are upset. But self-injury is often kept hidden from everybody – even family and friends. The person may feel so ashamed, guilty or bad that they don’t feel like talking about it. There may be clues such as refusing to wear short sleeves or take jumpers off for games. If someone tells you that they self-injure, or you suspect they may do, here are some ways in which you may help:

	Recognise signs of distress and find some way of talking to the young person about how they are feeling
	Listen to their worries and problems, and take them seriously.
	Be understanding. Don’t patronise them, judge them or jump to conclusions.
	Help them to find ways to solve their problems, but be aware you cannot necessarily change a person’s life or coping mechanisms.
	Stay calm and constructive, however upset you feel. Don’t panic.
	Help them work out who else can help, and offer to go with them to tell someone or offer to tell someone for them.
	Make sure they get the right kind of help as soon as possible.
	Don’t be offended if they don’t want to do things your way.

Someone may tell you that they are hurting themselves and ask you to keep it a secret. This can put you in a very difficult situation- of course it is important to respect there privacy, but you must recognise that self-harm can be very dangerous. Therefore it is important to try to get help as soon as possible. Try to work out with the person who would be the best person to tell. If they refuse to do this try to let them know that you’ve had to tell someone, and explain why.

What specialist help is available?

If you feel that professional help is needed, your family doctor should be able to advise you about local services available and they can make a referral to a child and adolescent mental health team, which usually includes psychiatrists, clinical psychologists, nurses and social workers who can offer specialist help. There are different approaches, depending on what is causing the problem. It often involves both individual and family work. Individuals need help with how to cope with the difficult feelings which cause self-harm. Families often need help in working out how to make sure that dangerous behaviour doesn’t occur again, and in how to give the necessary support. Sometimes specialist help is needed over a long period of time.

Resource List – for further information and advice.

The YoungMinds Parent information service- for information and advice on child mental health issues. 102 – 108 Clerkenwell Road, London, EC1M 5SA. Tel: 0800 018 2138. www.youngminds.org.uk

Childline – a 24-hour helpline for young people providing confidential counselling, support and advice. Freepost 1111, London, N1 OBR Tel: 0800 1111. http://www.ChildLine.org.uk

Careline – provides a confidential counselling service for young people and adults. Mon – Fri 10am – 4pm; 7pm – 10pm. 020 85141177

National Self- Harm network- provides information and support to people who self-harm.

PO Box 16190, London NW1 3WW

The Young People and Self-Harm Information Resource website- an international listing of projects that relate to young people who self-harm. www.ncb.org.uk/self-harm

MIND infoline- provides information on all aspect of mental health. Granta House, 15 – 19 Broadway, Stratford, London, E15 4BQ 0345 660163 or 020 8522 1728

Mental Health Foundation- for information and advice. Tel 0207 535 7400 http://www.mentalhealth.org.uk

Self Harm

[information for professionals] [information for young people]