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Talking about self harm

Talking about self harm: Self harm encompasses a wide range of things people deliberately do to themselves to cause physical pain or damage.

It is most common for people to cut the arms or the back of the legs. However it could involve burning, biting, hitting oneself, banging their head, pulling out their hair (trichotilliomania), inserting objects into the body or taking overdoses.

Reasons for self-harm

Sometimes there is no specific reason for someone to self-harm, it appears to generate a release from overwhelming negative or disturbing feelings. Sometimes they may self-harm to help cope with negative feelings and difficult experiences, to feel more in control, or to punish themselves.

When speaking with someone who is self-harming they may explain they do it to:

  • reduce tension
  • induce physical pain to distract from emotional pain
  • help express emotions such as hurt, anger or frustration
  • regain control over feelings or problems
  • punish themselves or others

It may start due to anxiety, depression, low self-esteem, poor body image, gender identity, sexuality, abuse, school problems, bullying, social media pressure, family or friendship troubles and bereavement or a myriad of other issues.

Self-harming can become a habit that is hard to stop.

How to help if you suspect someone is self-harming:

Keep an eye open for the following signs:

  • unexplained cuts, burns, bite-marks, bruises or bald patches
  • they are fastidious about covering up; avoiding swimming, short sleeved tops of shorts or changing in the presence of others. (although
  • this can be a normal part of growing up too)
  • finding bloody tissues in waste bins
  • becoming withdrawn or isolated from friends and family
  • low mood, lack of interest in life, depression or outbursts of anger
  • blaming themselves for problems or expressing feelings of failure, uselessness, hopelessness or worthlessness.

How to open the conversation:

If you are helping someone who is self-harming, the same CARES method will help.

Check for any immediate life-threatening injuries and if so, ask their permission to treat: e.g. Treat bleeding by applying firm pressure. Ensure you are safe and remove the danger that has caused their injuries.

Approach non-judgementally, allow them to talk and actively listen with compassion. Offer immediate support and encourage them to seek further help.

Remain calm, do not ignore their injuries, or overly focus on them. Speak to them as a whole person without focussing on their injuries or actions.

Ensure they know you care about them and are doing your best to help.

Listen to what they say and help them to be in control of their decisions.

Who should they speak to?

See if there is a close friend or family member that they are happy to talk to and help them contact them if they would like to.

Their GP should be the best professional person for them to see. They should then work with them to establish if there is an underlying reason for their self-harm.

It can be an incredibly difficult conversation for parents, teachers, friends, family and trusted adults to broach:

It is more important than ever not to appear judgemental.

Avoid interrogating and asking lots of questions all at once.

Keep an eye on them but avoid ‘policing’ them because this can increase their risk of self-harming. It is something they are likely to do in private.

Remember the self-harm is a coping mechanism. It is a symptom of an underlying problem.

Keep all lines of communication open, it may not be the right time or place. You might not be the right person for them so speak to. Tell them it is okay for them to speak to someone else and encourage them to get help. They may feel ashamed of their self-harm and find it very difficult to talk about.

Try not to be angry or disappointed with what they are doing.

Keep firm boundaries and a sense of normality, this will help the child feel secure and emotionally stable.

If you feel confident, you can ask them whether removing whatever they are using to self-harm is likely to cause them to use something less sanitary to self-harm with, or whether it reduces temptation. This can be a difficult question to ask and if you are not confident to ask this seek professional advice.

Seek professional help. They are likely to need a risk assessment from a qualified mental health professional. Their GP may be able to refer them to the local Child and Adolescent Mental Health Services (CAMHS).

Discovering and responding to self-harm can be a traumatic experience for someone who cares about the child who is self-harming. Many people feel guilt, shame, anger, sadness, frustration and despair – but it’s not your fault.

Organisations that can help with Self-harm

Mind – call 0300 123 3393 or text 86463 (9am to 6pm on weekdays) and a great resource website

Harmless – email [email protected] harmless.org.uk Provides a range of services for people who self-harm along with support for their friends and families.

Self-injury Support (for women and girls)

CALM (for men)

Young Minds Parents Helpline – call 0808 802 5544 (9.30am to 4pm on weekdays)

National Self Harm Network forums nshn.co.uk Well monitored self-harm support forum

If you struggle with suicidal thoughts or are supporting someone else, the Staying Safe website provides information on how to make a safety plan. It includes video tutorials and online templates to guide you through the process.
You could also download the free distrACT app. This gives you easy, quick and discreet access to information and advice about self-harm and suicidal thoughts.

Alumina – free online help for people self-harming

https://www.selfharm.co.uk/ – free online self-harm support for 14-19s

Lifesigns – Guidance and support network from people who understand

Young Minds Parents helpline – Advice and support for anyone worried about someone under 25.

NHS Choices – wealth of information on many topics

Emma Hammett
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