Insight into self-harm
"Having found out my child was self-harming, I was so devastated and confused as to why. My emotions were all over the place, not knowing how to help her, where to go for professional help – it was so stressful. As a father I just wanted to wrap her up in cotton wool.”
Being told or finding out that your child is self-harming triggers a strong reaction in most parents. Many feel hurt, confused, anxious; scared it might indicate suicidal intent. Some believe it to be attention seeking or that it reflects badly on them as a parent.
Self-harming can begin at any age; however, in recent surveys, (Self-harm statistics | Head Strong (beheadstrong.uk)) the average age was found to be 12-13, which is likely attributed to secondary school transition and the onset of puberty. By the age of 14 the same survey found that around 25% of children had self-harmed, but due to the hidden nature of self-harm it’s impossible to be accurate. Whilst girls are thought to be more likely to self-harm than boys, it’s worth remembering that boys choose less obvious ways to hurt themselves (see below). There is no typical profile of someone who self-harms; it can affect anyone of any age, gender, or ethnicity. However, children who are neuro-divergent or struggling with their sexual identity are thought to be more likely to be at risk.
“I wanted them to see the pain I was feeling on the inside, to understand I was silently hurting.”
Children self-harm as a coping mechanism for overwhelming feelings including intrusive thoughts, memories, depression, anxiety, hurt, fear, stress, and feeling bad about themselves. They want to feel good, better or different, to gain a sense of control and use physical pain to distract themselves from the emotional pain.
“I felt a warm sense of relief, as though all the bad things about me were flowing out of me and it made me feel alive, real.”
In the book Healing the Hurt Within, Jan Sutton talks about the 8 C’s of self-harm and the function it serves:
1. coping and crisis intervention
2. calming and comforting
5. confirmation of existence
6. creating comfortable numbness
Note, there is no mention of attention seeking and as self-harm is often kept hidden, how can it be so?
“Instead of dismissing someone who harms themselves as an attention seeker, it is more helpful to stop and ask yourself, “Why might they need support or attention? or, “How can I help?”
The relief brought on by self-harming is often temporary and afterwards the person may feel ashamed, confused, and frightened. The feelings build up again and so does the urge to self-harm which is why a cycle is often established. Self-harm is like an addiction, with the act providing the person with an escape from their overwhelming feelings and they then crave that escape again. Just like an addiction, the self-harm can build as they need to hurt themselves more to gain the relief.
“I didn’t want to hurt myself, but I couldn't escape my feelings any other way.”
There are many behaviours that can be classified as self-harm, obvious ones such as cutting, burning, scratching, hair pulling from their head, eyebrows or eyelashes, scalding, inserting things into the body, swallowing toxic substances, tying something tight around the body. Less obvious behaviours can include over-exercise, excessive shopping, smoking, drinking, dangerous driving, reckless sexual behaviour, drug use, risk taking, disordered eating. Males are more likely to punch walls, hit themselves, break their own bones or get into fights.
People that self-harm can be good at keeping it a secret, but there are things you can look out for:
Unexplained cuts, burns, bite marks, bruises, bald patches.
Keeping themselves covered, avoiding changing clothes in front of people, avoiding activities like swimming or sunbathing.
Bloody tissues in the waste bin.
Outbursts of anger.
Low or depressed mood, withdrawing from day-to-day activities.
Blaming themselves for problems.
It’s frightening to find out your child is self-harming but try to stay calm and not to panic. This is about them, not you and what they need is someone who really hears what they have to say.
“Mum started crying and shouting. It became all about her feelings and I felt I was to blame and wanted to hide.”
Try to be understanding, don’t ask too many questions. You can start the conversation with “Do you want to talk about it?”, or “How can I support you?”.
Validate their feelings and let them know their feelings are allowed. It doesn’t matter if you think it’s a minor problem, to your child it’s become overwhelming, and they are looking to you for understanding and acceptance.
Thank them for sharing, remember this can be very difficult for them.
Let them know you love them; they are feeling afraid, they need reassurance.
Try and spend some time together. They may push you away so you will need to persevere. Use messaging apps to let them know you are there for them if you can’t tell them face to face.
Remind them it’s temporary and you are there to support them.
If they don’t want to open up to you don’t put them under pressure, instead ask them who they feel they can talk to and encourage them to talk to that person.
Ask to check their wounds are clean and they don’t require medical attention or give them the right equipment to clean the wounds themselves. Try not to be shocked, it’s important to make sure they take care of their wounds.
“My mum and dad came into my room and did something brilliant for me. They accepted it. They didn’t shout at me or tell me off.”
If your child tells you that they have the urge to self-harm, then help them ride the wave. Some want to do physical things such as hitting a pillow, exercising, or playing loud music. Some want to be soothed, perhaps by taking a shower or wrapping themselves in a blanket.
In 2019-2020 there were 538,564 referrals to CAMHS (Children and Young People’s Mental Health Services).
There is support out there for children that self-harm, but the reality is CAHMS is overwhelmed and, unless there is suicidal intent, your child will be placed on a waiting list which can be very long. However, you can:
Talk to the pastoral team at school, they may be able to put support in place at school.
Contact the Charlie Waller Trust Charlie Waller Trust, mental health charity. They can help find local support groups in your area.
Young Minds have good information on-line for parents and children, Self-Harm & Mental Health | Guide For Parents | YoungMinds
Read the book ‘Can I Tell You About Self-Harm,’ by Pooky Knightsmith, There are some very useful insights in there by children who have self-harmed.
Look for a counsellor who works with children. There are private options and some low-cost options available.
If you have concerns about your child, or need support yourself, please contact Counselling For You at firstname.lastname@example.org.
“Self-Injury is a behaviour that develops to cope with life’s pressures and ills. Acceptance, awareness, education, and empathy are crucial to enable those suffering in silence to step out of the closet of secrecy and shame, and to receive the help they need and deserve.” Kate Rufus
Sutton, J; Healing the Hurt Within; Oxford: How To Books Ltd; 2007.
Robson M, Pattison S; The Handbook of Counselling Children and Young People; Sage, London; 2nd Edition.
Knightsmith, P; Can I tell You About Self-Harm; Jessica Kingsley Publishers; 2018
Rufus, K; Attention Please; BACP Children, Young People and Families; March 2022
Self-Harm & Mental Health | Guide For Parents | YoungMinds (accessed 18/11/22)
Charlie Waller Trust, mental health charity (accessed 16/11/22)