If you have a teenage son or daughter, you might have heard the term “self-harm” whispered in hushed tones by another parent or a teacher.
Some people think it is just a trend which is not to be taken too seriously. But research suggests that self-harm is a a very real and ongoing phenomenon.
Recent estimates report the rates of hospitalisation for self-injury at over 7,000 people per year in Australia. In the decade from 1996 to 2006, the rate of hospitalisation for self-harm went up by 43 percent overall, and this was even higher for females.
And, considering that self-harm is one of the biggest predictors of youth suicide, it is certainly not a problem to sweep under the carpet.
For parents it can be very difficult to understand where this type of behaviour comes from. In fact, it is probably not something you would have even heard about when you were growing up.
Read on to find answers to common questions about self-harm and some practical advice about what to do if your child is self-harming.
What is self-harm?
“Self-harm” (otherwise known as “self-injury”) can describe a range of methods to harm oneself physically. It can include (but is not limited to):
- Cutting, scratching, picking or scraping the skin;
- Pulling out one’s own hair;
- Burning one’s own skin;
- Ingesting poisonous substances; and,
- Bone bruising or breaking.
Why would a teenager want to self-harm?
The reasons why any person may engage in self-harm can vary widely.
For some, it may be a compulsive or addictive ritual that they perform regardless of how their life is going. Others may only self-harm during periods of high stress or following a traumatic incident.
Here are some of the reasons why adolescents may self-harm:
- Some teenagers report that the physical pain they experience while harming themselves can serve to dull or distract from emotional pain.
- When a child self-harms in a ritualistic manner they may feel it helps to calm them down or to feel as though they have a sense of control over circumstances in their life.
- Self-hate and venting of anger towards oneself can also result in self-injurious behaviour.
- Other teenagers report that self-harming can make them feel a sense of heightened emotion or experience. Such people report that they can’t feel things, or that they feel flat. They might argue that self-harm intensifies their experiences and allows them to briefly escape from the banality of their life.
The most common misconception about self-harm is that it is merely an “attention-seeking” behaviour. This is typically not the case. (Nevertheless, it is true that some people self-harm in an attempt to exert some degree of control over others by causing shock or somehow ‘punishing’ them for perceived mistreatment.)
Self-harm may provide temporary relief for the person but it does not help them deal with underlying issues. In the long-term, many people who self-harm may end up with permanent scars and tend to escalate the self-harm over time.
Who is most at risk of self-harm?
Children with an existing anxiety disorder, eating disorder or depression are the most at risk of engaging in self-harm and they need to be taught practical strategies to replace the negative coping behaviour with more positive alternatives.
Self-harm is highly correlated with suicide but there is a clear distinction between those who aim to self-harm for the reasons discussed above and those who genuinely wish to end their own lives.
The issues that lead a person to self-harm and also lead a person to attempt suicide are often related but the reasoning (albeit irrational) behind self-harm and suicide attempts are often quite different.
How should you not respond to self-harm?
It’s important to remember that even if you don’t understand the reasons behind an act of self-harm, ignoring the behaviour or becoming angry or upset is not helpful. The child’s distress is real, although their strategies for coping are misguided.
Thinking to yourself something like, “That is completely irrational! I refuse to indulge this behaviour by feeling sorry for them or giving them undue attention.” is likely to be counter-productive.
What should you do if your child has self-harmed?
If you discover your child has self-harmed here are some key steps to follow:
1. If the injuries are serious, it is important to immediately consult a doctor, the emergency department of your local hospital or a mental health professional.
2. Don’t overreact to any evidence of self-harm, such as scars or burns. Be matter-of-fact.
3. Dress the wounds if they are still fresh or provide appropriate first-aid.
4. Ask some questions:
- How did it happen? Go through the events step-by-step.
- What did they use to inflict the self-harm?
- Where did they do it?
- How were they feeling at the time?
- What thoughts were going through their mind?
- Have they self-harmed before? If so, how often?
Remember to approach this as an opportunity for open discussion, to let your son or daughter tell you how they are feeling.
5. Consider: What do you think they need from you right now?
6. Determine the severity of the harm. (E.g. are the cuts superficial or deep?)
7. Seek professional help.
An experienced child psychologist can help identify the underlying issues that may be contributing to the self-harm and will assist your child to develop alternative coping strategies to replace the negative coping mechanism of self-harm.
8. Implement a safety plan at home:
- Remove dangerous objects.
- Ensure they are not left alone (especially in the bathroom or bedroom) with the door closed.
- Check in with them regularly to see how they are going.
9. Implement a safety plan at school:
- If possible, collect your child from school or arrange for a trusted person to collect them. Don’t let them go home alone.
- Talk to relevant staff (on a ‘need-to-know’ basis) and make sure everyone is on the same page.
- Ask the school to remove dangerous objects where possible.
- Ask that they are not left alone anywhere (such as the toilet or change rooms).
- Advise staff about signs to watch for.
What about after-hours help?
If you need after-hours advice you can contact a helpline:
- Lifeline – 13 11 14
- Kids Help Line – 1800 55 1800