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Elaine Hutchinson

Creative Art and Play Therapy

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Beaten up teddy bear

Some children and young people deliberately hurt themselves as a way of coping with negative events or difficult feelings they have experienced.

Often self-harm or self-injury is not about a failed suicide attempt, but it still needs to be taken very seriously as there is a link between self-harm and suicide or suicidal thoughts.  Not everyone who self-harms wants to end their life, but it is important that self-harm is not dismissed as just ‘a phase’ or ‘copying others’.  Help is needed to manage the underlying problems in a less harmful way.

In this article I will look at:

  • Different kinds of self-harm
  • Possible triggers for self-harm
  • Some reasons behind self-harm
  • How therapy can help
  • Some alternatives to self-harm behaviours

According to beheadstrong.uk, at least 1 in 4 young people aged 14 have self-harmed, with the average age of 12 being around the time self-harm often starts, however, I have seen younger children who self-harm as a therapist.  It is thought from current research that the transition from primary school to secondary school and the start of puberty may be linked to this.  Girls are thought to self-harm more than boys, but this may be because boys may self-harm through risky behaviours, such as getting into fights.

Some self-harm is less obvious than others

Often self-harm is thought to be cutting to the arms or legs and although this is a very common way of self-harming, there are many other ways in which a child or young person can self-harm, some of which are much less obvious to spot. 

These include:

  • Picking scabs repeatedly or re-opening cuts/other wounds
  • Pulling off fingernails or toenails
  • Biting or hitting own body
  • Pulling out hair
  • Burns
  • Headbanging
  • Inserting objects into the body or under the skin
  • Issues around eating, including eating toxic substances
  • Overdose

Sometimes children and young people choose to self-harm through risky behaviours including smoking, drinking, taking drugs, having unprotected sex and other high-risk activities.

Some triggers for self-harm

Self-harm can be used as a way of maintaining control or self-punishment as well as about coping with difficult things that have caused emotional distress or relieving over-whelming feelings.  Often it can be a build-up of lots of issues, rather than one ‘big’ event that triggers a self-harming episode.

Church yard

Triggers for self-harm include:

  • Stress
  • Grief due to bereavement or loss
  • Anxiety
  • Depression
  • Low self-esteem
  • Bullying
  • Pressure at school
  • Family or relationship problems
  • Confusion over gender or sexuality
  • Physical or sexual abuse
  • Complex mental health issues

Reasons behind self-harm

The reasons for self-harm can be incredibly complex but the common reasons include:

  • A physical demonstration that help is needed
  • A response to intrusive thoughts
  • Maintaining or regaining control over difficult feelings, experiences or events
  • Physically expressing feelings that are hard to name
  • Using physical pain to distract from emotional pain
  • Managing emotional upsets
  • Reducing tension
  • Identifying with peer group

How can therapy help?

Therapy can help by building resilience and coping strategies so the triggers and the urge to self-harm can be better managed and distraction or substitution behaviours can be investigated in a safe and productive way.  The emotions around the urge to self-harm can be safely explored and relevant safe alternative behaviours that give the same emotional release can be suggested.

As a therapist I can also support the family around the child or young person who is struggling with self-harm.

Possible alternatives to self-harm behaviour that some of my clients have found helpful


  • Make clay models and smash them
  • Throw ice cubes hard against a brick wall to smash them
  • Flatten cans for recycling or shred egg boxes or cardboard

Sad or depressed:

  • Make a tray of special treats and share it with someone special
  • Take a bath with scented oil or bubbles
  • Do something nice for someone else

Craving sensations or feeling empty:

  • Squeeze ice
  • Bite into a hot pepper or chew ginger
  • Rub some Vicks or liniment under your nose

Wanting focus:

  • Practise/learn a physical skill like balancing a peacock feather vertically in your hand, keepie-uppies or juggling
  • Use Google translate, find ten different words in a new language that you like and work on learning them
  • Do a word search or sudoku, learn positive meaningful poetry or song lyrics by heart

Girls with a book

Feeling guilty or like a bad person:

  • Talk to someone that cares about you and ask them to name three things they like about you
  • Practise random acts of kindness like leaving positive notes in library books for others to find
  • Do something nice for someone you know

Where else to go for help?

If you have any questions, please feel free to drop me an email: This email address is being protected from spambots. You need JavaScript enabled to view it.

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