Self-harm in children is a distressing subject. Within yourself it brings a massive feeling of guilt and anger at your lovely child for doing this to themselves. Your first feeling might be to ‘have it all out.’ Do not. Hold out your arms for a hug and both cry. This is something you are going to work through together and it is an exceptionally long and difficult journey with no easy or quick answers I’m afraid. Self-harm is not a mental health disorder itself, but a symptom of an underlying condition that needs to be addressed. It is far more prevalent than you may realise, but rarely talked about.
Below we look briefly at some definitions and then where to go for help. This is not something you will be able to work through yourselves. It is not a marker of you as a parent, but if your child had cancer, you would not try and solve it yourself.
What Is Self-Harm?
Self-harm is when someone hurts themselves on purpose. This can include things like cutting, burning, picking at the skin, or, in the worst cases, or trying to kill oneself. Self-harm can be seen but is often kept secret due to shame. It has been linked to a range of risk factors:
- Having friends or family members who self-injure
- Experiencing stressful life situations like traumatic events, bullying, family instability and sexual orientation uncertainty
- Living in social isolation
- Mental health conditions, like depression, anxiety, and personality disorders
- Drug and alcohol use or addiction
- A negative body image
The above do not mean that your child will self-harm, however it is a mechanism with which to get rid of stress and feel in control. Your child does not have the emotional tools to express themselves verbally or to handle the overwhelming emotions caused by the above. They may not like themselves due to their sexuality, or feel they need show how they feel emotionally through their bodies. It can, in exceedingly rare incidents, be used to manipulate someone else.
Who Hurts Themselves?
Girls are more likely than boys to hurt themselves, however the rates of suicide are higher in boys. There is no one type of person who hurts themselves. No child is ‘immune’ from self-harm. Social background or family type has no relation. It is slightly more prevalent in some However, exposure to images of self-harm on social media can normalise it, as can its prevalence in a social group. This is not to downplay it as a ‘fashion;’ however, it can be found within friendship groups, again as it can be ‘normalised’. We have advice of when to intervene in destructive friendships here.
One medical review across 40 countries found:
- About 17% of all people self-harm in their lifetime.
- The average age of the first incident is 13.
- 45% of people who self-harm ‘cut’.
- Only 50% of people asked for help.
Signs of Self-harm.
As well as the most obvious, there are some more subtle ones listed. If you have a concern about self-harm, maybe someone in their friendship group is, and you do not want to accuse your child, hopefully the below will give you some additional things to look for.
- Marks from cuts or burns, such as scars, on the arms, legs, stomach, back, etc.
- Cutting instruments found in your teenager’s belongings
- Always putting on long pants and sleeves (even when not appropriate, such as in warm weather)
- Putting an end to sports that require them to show their bodies
- Clothes with blood on them
- Changes in mood
- Low mood all the time and pulling away
- Sometimes feeling numb
- Being very agitated or worried
- Changes in relationships – leaving friendship groups
- They are extremely hard on themselves
- Having a tough time dealing with failure
- Finding it hard to show how they feel
- Having rigid thoughts and answers
What to Do if You Know or Think Your Child Is Self-harming
The first thing to do is talk to your child about how you feel. Be open and honest as this is what you are asking in return. Keep calm and hold each other. Cry together. Tell them your fears but do not pressurise them to do what you want. Let the experts do this. Although all you will want to do is talk about the scars, they need to talk about why they did this.
Try to produce a plan for what will happen next. Keep in mind that this will not be an easy conversation. Teenagers who hurt themselves may feel very ashamed or afraid of being “told off.” They will hate themselves for what they have done. Be kind, patient but determined. Let them talk while you listen. Instead of asking them directly why they hurt themselves, the conversation should lead on how they have been feeling.
Do not take away things they could use to hurt themselves. They will just find others and it will not solve the problem. What is more important is to talk to them about what you could do together and get their permission to get rid of things that could be tempting. Control is often a key feature of why they have self-harmed to begin with. Let them know you are around, but do not be “on their case” and check on them all the time. Do not tell them to stop, because if they could, they would. You do not need to tell them repeatedly what they are doing is wrong. They know.
As soon as possible ring your child’s school and make an appointment to talk to the councillor or welfare officer. They will have the best local contacts in the area, as well as be able to give you an insight as to what might be going on in your child’s peer group. Organisations such as CAMHS in the UK are over stretched. What you are going through with your family is overwhelming and serious. However, the waiting list is long and unless there is imminent likelihood of hospitalization it is unlikely you will get an urgent appointment. This will be a case where school councillors and, if possible, some private care will be needed. Do not be ashamed to ask for help.
There are treatments for people on their own, in groups, and with their families. There are a lot of real-world ways to help deal with the behaviors. But it will also be important to find out what makes people act the way they do and help them change in a fundamental way. How the family reacts to and affects self-harm can be an especially important part of getting better, and as a parent, you can do a lot of good.