self harming in teens
What is self harm?
Self-harm is the intentional act of harming oneself in order to release inner turmoil and is a very secretive act. It is a flawed coping mechanism in which teenagers engage to release inner anguish and distress as they are unable, or afraid, to express verbally how they are feeling. Engaging in self-harm can cause more distress as the person embarks on a vicious cycle of trying to hide his/her wounds and scars coupled with feelings of guilt and shame, thus exacerbating the distress and turmoil that prompted the self-harming initially.
Acts of self-harm can include cutting, scratching, breaking bones, biting, pulling out hair, hitting self, burning self and poisoning.
Why do teenagers self harm?
It can be extremely challenging for some of us to understand why a teenager would deliberately harm him/herself. You may wonder how physically hurting yourself could make you feel better; if anything, would it not make you feel worse? In my work supporting teenagers who self-harm, the following reasons for this behaviour have emerged:
- Inducing a sense of release
- Validating inner pain
- Giving a sense of control over a situation they feel they have no control over
- Helping them to stay alive by giving a momentary release from the distress that might otherwise lead them to consider or complete suicide
Self-harm is a means of communicating and releasing distress and inner turmoil. Teenagers engage in this act as a way of coping, not necessarily as a means or desire to end their lives. Many teenagers in this level of distress do not want to die but simply want the emotional pain to end and the act of self harming gives them a momentary release.
What are the signs of self harm in teenagers?
Self harming can be difficult to detect because of its secretive nature. The following signs may indicate that a teenager is self-harming:
- Looking for excuses not to engage in PE and sports activities like swimming
- Noticeable change in character
- Talking about him/herself in a negative way
- Unexplained wounds, scars and bruises
- Wearing long-sleeved tops and long trousers even in hot weather
- Disappearing more than usual and spending longer periods of time in his/her room, and locking the door
- More frequent and longer periods of time spent in the bathroom
- Lack of engagement with friends
- Noticeable collection of instruments that can cause injury and facilitate cutting
- A collection of plasters, soothing creams and antiseptics hidden in his/her room
- Blood spots on clothing and bed linen (turn clothes inside out to check)
- Refusing to go clothes shopping
- Finding laxatives in room, plus weight loss and vomiting
- Reacting passively and retreating to room when challenged on an issue
- Looking for reasons to avoid family functions and seeking opportunities to be home alone more constantly and frequently
What to do if you discover a teenager is self harming
Discovering that a teenager is self harming can be a daunting experience. You may feel afraid, angry and disgusted. On discovering a teenager is self harming, action needs to be taken in a proactive rather than a reactive manner:
- Attend to your own feelings; do not approach a teenager about your suspicions or observations until you are more relaxed and grounded.
- Approach with compassion and understanding.
- Time your approach; wait until you have the teenager alone and are sure you won’t be interrupted.
- Engage in a dialogue and outline your concerns in terms of what you have noticed. For example, ‘Sarah, I wanted to have a chat with you. I have noticed that you are not yourself and I am worried about you.’
- Now be direct: ‘I have noticed that you have marks on your arm and I am wondering if you are self harming.’
- Do not get into a power struggle. The teenager will probably become defensive. Expect this reaction and remain composed and empathic.
- Remember, the teenager will be struggling with his/her own feelings, which may include shame, anger and anxiety.
- Keep dialogue going. Let the teenager know you are there to help, not judge, and that you appreciate this is difficult for them.
- Outline what will happen next. For example, ‘We will make an appointment with the doctor. We will find a therapist that will help you and I will support you all the way. We are in this together.’
- If you are a professional who works with teenagers, you need to point out to the teenager that you have to take action and inform the teenager’s parents. This will no doubt be met with resistance. Remain composed and empathic and try your best to get the teenager to agree to such action. You have a duty of care and action needs to be taken to protect the welfare of the teenager. Refer to your agency’s policies and procedures in relation to child protection and act accordingly.
- If you are a parent who has discovered your child is self harming, do not ignore what you have discovered. You may need to get emotional support yourself and I would advise that you engage with a service that can support you and your child. Services available....
- Listen, listen and listen! Do not get angry and judge; this will cause the teenager to close off from you and intensify his/her inner turmoil. Let him/her know you are aware of what is going on and appreciate he/she is in pain and you want to help.
- Do not issue ultimatums in relation to stopping the self-harming behaviours. The act of self harming is a coping mechanism and teenagers will not be able just simply to stop until the reasons for their actions have been uncovered and coping mechanisms that are more positive/nurturing have been developed through professional intervention.
- Get professional help by engaging with a service that can support the teenager appropriately.
A very useful guide for parents and others is to ‘AID’ and ‘ARM’. Keep them in mind when taking any action.
A Attend to your own feeling and compose yourself.
I Inform the teenager you are aware of his/her self-harming with compassion and understanding.
D Discuss the need for professional help and decide on appropriate actions together.
A Activate a support system for yourself.
R Refer the teenager for professional help and guidance.
M Maintain a positive relationship with the teenager.
Where to get help
Here are just some of the organisations that can support you:
- MIND - Mind provides advice and support to empower anyone experiencing a mental health problem. Find out more at www.mind.org.uk
- National Self-Harm Network - This charity offers individuals who self-harm support and also provides support and to family and carers of individuals who self-harm. Find out more at www.nshn.co.uk
- Self Harm UK - This charity delivers caring, child-centred work which focuses on the emotional and social needs of all young people. Find out more at www.selfharm.co.uk
Overcoming Self-Harm & Suicidal Thoughts - buy the book
Published by Hammersmith Health Books, this practical guide is written for parents and others who are caring for young people who engage in self-harming and suicidal thinking.
Written by Liz Quish, a qualified counsellor, psychotherapist and parent coach with over 20 years’ experience, the book is filled with insights and advice based on her extensive experience of working with vulnerable teenagers.
Buy the book online today