Understanding and Managing Self-Harm
What is self-harm?
The term self-harm is used to describe any action taken that results in physical harm to ourselves. Self-harm may include: scratching, cutting, burning or hitting. Behaviours such as restricting our food intake, binging or purging are often also considered a form of self-harm.
We don’t have reliable data for rates of self-harm in Dubai. We know that in the UK, around 1 in 6 young people will have self-harmed by the time they are 18. We also know that rates of self-harm have increased, and continue to increase, over the last few years.
Why do people self-harm?
Often the reasons why people self-harm are complex, with many different factors at play. Sometimes people that self-harm have suicidal ideations, and they harm themselves as a way of trying to end their life. However, often children and young people self-harm in response to feeling distressed and as a way of trying to cope with the feelings they are experiencing. Some children report feeling emotionally numb, and unable to feel anything, and so they self-harm as a way of trying to ‘feel something’. Often there is an underlying mental health issue that needs addressing and so support with this can help the individual manage their distress with healthier coping strategies.
How do I tell if my child is self-harming?
Self-harm is more common in children and young people that are experiencing a mental health problem such as depression or anxiety or are going through a period of stress such as exams, peer issues or bullying.
Some things to consider include:
- Have you noticed any changes in your child’s mood? Do they seem to be quieter or more withdrawn than usual?
- Do they seem to be more emotional, upset or stressed?
Not everyone that experiences stress or a mental health problem will self-harm. Some additional signs to look out for include:
- Unexplained cuts, bruises or burns
- Covering themselves up more than usual or avoiding things such as swimming or getting changed in front of others
How to support my child if I think they might be self-harming or know that they are self-harming?
- Talk to your child –Think carefully about when to talk to them. Try to do this at a time when you are both calm and there is adequate time to have a conversation. Perhaps you could do an activity you enjoy together and talk to them during the activity? We often find that children and young people open up more when we are side by side and do not have direct eye contact, such as when walking or in the car, or engaged in an activity together. Ask your child how they are, share with them that you have noticed that they have been acting a bit differently lately and you were wondering what is going on. Ensure that they know that you are there if they want to talk. They may not open up the first time that you try to talk to them, this is normal and ok, try again in a few days. Try to stay calm when you talk to them, they need to know that you are ok and that you can manage any emotions or difficulties they might want to share with you.
- Offer your child the opportunity to talk to someone else – this might include a family member or a teacher. Sometimes children and young people worry about upsetting their parents and find it easier to talk to someone else.
- Share your concerns with their school – speak to their teachers and anyone else they have regular contact with at school. Ask them what they have noticed and if they have any concerns.
- Develop a support plan together – ask them what help and support they think they need? What do they think would help them to stop self-harming? Who could they talk to or what could they do when they get the thoughts to self-harm?
- Help them find alternatives to self-harming – This is something that psychological therapy can help with. Here are a list of some of the things children and young people can find helpful when they have thoughts about or an urge to self-harm:
- Distraction: anything that takes their mind off the thoughts or the urge
- Physical exercise such as going for a walk or engaging in sports
- Writing down thoughts in a journal can help them to process how they’re feeling and feel a sense of relief
- Talking about how they feel to someone they trust
- Finding healthy and positive ways to express their feelings and soothing activities such as listening to music or drawing
- Seek professional support – what extra support is available within school? Consider an assessment with a psychiatrist and/or psychological therapy.
- Take any talk about suicide seriously – We know that this can be incredibly upsetting to even think about, let alone talk about with your child or young person. Of course, keeping your child or young person safe is your top priority as a parent. Don’t be afraid to talk to them about suicidal thoughts as mentioning it won’t put the idea in their head, and talking can often help them to feel understood and not alone. Ask them if they have had any thoughts about suicide, if they have thought seriously about doing it and if so have they thought about how they would do it, when and where. These conversations can be difficult and so if there are any suicidal thoughts present, please seek support early as mental health professionals are trained in being able to assess levels of risk. If your child is experiencing thoughts of suicide and has taken any steps towards acting on these thoughts get urgent professional support. Al Jalila Children’s Hospital can provide support in an emergency, they can be contacted on 800 2524.
Written by: Dr Charlotte Cousins
Clinical Psychologist, Children, Adolescent & Adults Specialist