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.
- Picking scabs repeatedly or re-opening cuts/other wounds
- Pulling off fingernails or toenails
- Biting or hitting own body
- Pulling out hair
- Inserting objects into the body or under the skin
- Issues around eating, including eating toxic substances
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.
Triggers for self-harm include:
- Grief due to bereavement or loss
- Low self-esteem
- 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
- 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
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?
- Childline (for under 19s) 24/7 helpline 0800 1111
- CALM (Campaign Against Living Miserably) helpline 5pm-midnight 0800 58 58 58
- Samaritans 24/7 helpline 116 123
- www.calmharm.co.uk – free app with support and strategies