More children are self-harming since the start of the pandemic. Would you know the signs? An expert explains why we should be talking about self-harm, what signs to look out for, and what parents can do to help
The pandemic has had a huge impact on young people’s mental health. Troublingly, the incidence of self-harm (and other risky behaviour) in children and adolescents is on the rise. Discovering that a child is self-harming is devastating and extremely challenging for parents deal with. Most parents will feel a myriad of emotions, shock, confusion, anger, sadness, and guilt to name a few. They will most likely feel ill-equipped to support their child through this. The first step is to increase understanding of self-harm, read on to start that journey.
What is self-harm?
Self-harm can be defined as causing injury to oneself to cope with emotional overwhelm. To those who self-harm, it is neither irrational nor nonsensical; in the absence of positive coping strategies, when emotional overwhelm occurs, it may feel like there is no other choice. Self-harm is often not done with the intent of ending life, but more about managing emotional pain.
Types of self-harm
It can take many different forms, for example, cutting, burning, or embedding. Cutting is the most prevalent form of self-harm seen in teens. Non-lethal overdosing or taking of poisons is also a type of self-harm seen in this adolescent age group. Self-inflicted scratching, banging, hairpulling and picking of skin can also be forms of self-harm, these may be more prevalent in younger children. In its broadest sense, self-harm may be aggressive behaviours like hitting, biting, or punching others, causing harm to self, indirectly. Eating disorders and the misuse of alcohol or drugs may also be considered self-harm along with risk-taking behaviours.
The cycle of self-harm
Once a young person starts self-harming it is often hard for them to stop. A young person may experience emotional overload and if they don’t yet have any positive ways of coping, they may find themselves turning to self-harm. When they self-harm, they experience a temporary relief, a physiological high where everything feels okay for a short while. What follows is a low and feelings of shame, grief and guilt often surface. As they haven’t done anything to deal with the emotional suffering the cycle continues. One of the keys to recovery is finding a way to break the cycle by exploring alternative, more positive coping strategies when emotional overload occurs.
Reasons people self-harm
People who self-harm say it can offer a way to decrease the intensity of emotions, the physical pain being easier to deal with than the emotional pain. Some young people who feel numb or disassociated say that it makes them feel ‘real.’ For some, self-harming is a way of gaining control, perhaps of a chaotic/unpredictable lifestyle or one that is overscheduled and rigid. For others, it takes the form of self-punishment, perfectionists are at risk of self-harming as are young people who have been abused. Self-harm may meet an unmet need to be cared for or be a method to fit in with others. It may be a way of validating difficult emotions or experiences such as confusion around sexuality in the absence of other forms of validation. Self-harm can offer a means of communicating emotional pain such as rage or anger too difficult to talk about or can divert attention away from emotional issues too hard to acknowledge.
A young person may use self-harm to cope in response to a specific incident or ongoing stressors in their environment. Relationship difficulties between family or friends, bullying, trauma, exposure via media, difficult times of year e.g., anniversaries, increased academic pressure, times of change/transition may also be triggers for a young person to self-harm.
Often, as a parent you’ll have a gut feeling that things are not quite right for your child. Changes in behaviour, physical appearance or mood would be a concern. A young person who is low in mood or anxious is more susceptible to using self-harm as a coping mechanism. Young people at risk of self-harming may say that they feel hopeless, have low self-esteem and be hard on themselves. If someone is using self-harm to cope, they may become secretive or snappier than usual. Injuries that appear repeated/regimented in appearance, or those that don’t match their story would be cause for concern as would changes in clothing or weight. Young people who are self-harming may become more withdrawn or isolated, avoid changing rooms at school or going out with friends at the weekend where they may need to change clothes. Also look out for changes in eating/sleeping behaviours.
How to deal with self-harm in kids
Every situation is different and how you deal with it will depend on the relationship that you have with your child, how old they are, the reasons behind their self-harm and whether they came to you or you discovered that they were self-harming by accident. Know that your initial reaction and first conversation will have a big impact. It may affect how much they connect, trust, and confide in you moving forward. Before you have that first conversation do something to help yourself be as calm as possible. Self-harm is an often secretive behavior and the knowledge that you know about it may be overwhelming at first, they may need some time to settle before talking properly.
What to do
- Remain calm (even though you might feel panicky inside).
- Listen more than you talk.
- Let your child know that you are there for them and you want to help.
- Ask them how you can help and what they need.
- Acknowledge any strengths that you hear.
- Ask them what they have tried instead? When they could have self-harmed, but they didn’t.
- Listen out for any indications that they may have been influenced by social media and brainstorm with them how to reduce exposure moving forward.
- If they are open to it, offer them practical ideas to break the cycle by finding alternatives. See this link for more information: Understanding self-harm & finding safer alternatives
- Ask them who their other supporters are, do any friends know?
- Talk about professional support and what the options are. Offer to go with them to a professional but respect their need for privacy.
- Let them know that you’ll check in again and they can talk to you whenever they need to.
- Thank them for telling you, acknowledging that it must have been hard.
- Do treat your child as usual – especially if there are other children in the house who need support in coping with their sibling’s self-harming behaviours.
What not to do
See this link for more information: What not to do
- Don’t tell them to stop, offer your help in finding the support and strategies they need to develop healthier means of coping.
- Avoid being judgemental or critical.
- Don’t overreact or assume that your child is suicidal.
- Resist showing any disgust or anger.
- Don’t ignore or dismiss the self-harm.
- Avoid labelling it as attention-seeking.
- To begin with don’t ask why, the reasons may emerge in future conversations with you or a therapist.
- Unless you are concerned that an injury may need medical assistance don’t force a child to show you their wounds, this may make them more secretive.
When to seek medical attention
Many scratches and cuts can be dealt with at home. Burns may need to be checked by a medical practitioner. If an injury is serious or an overdose has been taken medical attention should be sought. Be aware that although self-harm is non-suicidal behaviour, the emotional overwhelm that leads to self-harm can also lead to thoughts of suicide. If you feel your child is at risk, seek urgent medical assistance by calling an ambulance (995) or taking your child to A&E.
What if your child doesn’t want to talk?
Talking about self-harm can be very difficult for young people. Sometimes talking whilst you are doing an activity together helps, car journeys can be a comfortable setting for some. Start with the small stuff to get the conversation going.
What can you control?
As parents, we often feel out of our depth with big issues like self-harm. Be aware that you are not to blame for your child’s self-harming behaviours, but do be aware of your relationship with them, could this be improved in your child’s eyes? Could the home environment be more harmonious? Is there anything that you could do more or less of that might help to relieve some of the stressors for your child.
It’s also important to take care of yourself so that you can be the best support for your child. Keep doing whatever helps you to stay grounded and calm in times of challenge.
Do bear in mind…
Self-harm is a young person’s way of coping at a particular moment in their lives and doesn’t mean that they’ll do it forever. Your child is still the same person you know and love. Young people who recover from using self-harm to cope often end up with increased resilience and strength. Self-harm may take a while for a young person to move away from and recovery may not happen immediately, however, with you walking by their side your child may end up being able to cope better with life ups and downs than they ever did before.