I ran my first training course for parents on understanding self-harm eleven years ago. It was a cold November evening, we sat in a town hall clutching cups of tea and I talked about self-harm to parents of local secondary schools. Many found it hard to talk about and most of the session was spent dispelling myths and the stigma around the subject.

Thankfully there is now more and willingness to talk about self-harm, but many of those stigmatising myths, such as ‘they’re doing it for attention’ still pervade.

Many parents are often left confused and unsure about what to do or say. This post hopes to dispel some of those myths and offer some simple advice to parents.

What is self-harm?

Self-harm can cover a range of things that people do to themselves in a deliberate and harmful way.

Although cutting is the most common form of self- harm, other methods include head banging, hair pulling, burning and scalding, biting, scratching, stabbing, breaking bones, swallowing objects, self-poisoning and overdosing. By injuring themselves, a person is able to manage painful and distressing thoughts and feelings. There are many reasons why a person might decide to self-harm, and sometimes they won’t be aware of what need the self-harm is filling in their life. Often a person starts self-harming as a child, but many adults also self-harm.

Why do people do it?

Self-harming is not a mental illness – rather, it’s a means of coping with difficult emotions and feelings. All behaviours, self-harm included, fill a need for us. Some of the needs self-harm fill include:

• Coping with overwhelming emotions

• Expressing emotions

• Communicating distress

When we get stressed or upset we have a coping mechanism to deal with the feelings. It might be going for a run, having a glass of wine after a long day at work, chatting with a friend, journalling, or indulging in comfort food. Each person has their own ways of coping. Some ways are healthier than others. Self harm works the same as all the ways mentioned above. 

For a person to move on from self-harm it is important for them to find new coping mechanisms, as simply removing self-harm can create significant issues. Counselling helps someone learn what function self-harm is serving in their life as well as helping them to learn new ways to deal with their problems. 

Sometimes self-harm can be due to being emotionally dysregulated- when a child gets so upset or angry, it is a way of letting out those feelings. This is often seen with younger children who may hit or scratch themselves, pull hair or bang their head against the wall.

If a child or young person doesn't have a language for what’s going on, they struggle to communicate and may use self-harm as a desperate as a way of expression. Part of the recovery is learning to express themselves in constructive ways. By doing that they gradually reduce the need to self harm.

‘Attention seeking’ is a phrase that comes up a lot around self-harm. It has so many negative connotations that cause a great deal of stigma and shame. Sometimes a person might self-harm to communicate their distress because they need help and don’t know how to ask for it. They are in need of attention. If your child was ever in pain and distress in other situations, being bullied at school or having a chest infection, they need attention, care and support. It is the same with self-harm, they need that attention, they just don’t know how to, or feel they can’t, ask for it.

How can I stop my child hurting themselves?

Simply put, you can’t. They have to want to stop themselves. Begging your child to stop, removing objects they may use to harm themselves or even physically restraining them is profoundly unhelpful. It can drive the behaviour “underground” and they will be less likely to communicate with you or ask for help. Children whose parents try to control their self-harm often feel more out of control as well as judged and misunderstood.

The key is to offer empathy to your child. Accepting where they are at and how they are feeling and communicating this to them. This doesn’t mean accepting or approving of their self-harm, but it is about validating their feelings and helping them find new ways of coping. If a child feels ashamed about their self-harm they are more likely to hide it. 

Injuries 

The very nature of self-harm means there is the risk of the child hurting themselves badly. All serious injuries should receive medical attention straight away. 

Trying to confiscate every item a child could hurt themselves with is impossible, and can resort to them using something that is even more dangerous. Allowing for open communication for your child to come to you for help if they have hurt themselves is the safest thing you can do. 

Suicide 

There is a big difference between self-harm and suicide. Self harm is more often a coping mechanism- not a way to end their life. 

If you are concerned that your child is suicidal it is important to stay calm and not overreact. Do not be afraid to ask the question- it won’t be putting ideas in their head (contrary to the popular belief). If they do talk about suicidal ideation it is important to establish if they have created a plan on how they would kill themselves. It is important to seek help from your GP or, if needed, A&E if your child is expressing suicidal thoughts.

ommunicating with your child 

As hard as it is, staying calm when talking about self-harm or suicide is really important. Some children may avoid talking to their parents or carers about self-harm if they fear they will upset them, or that they will “freak out”. 

Tips: 

● Soften your facial expressions and body language. Project a calm image. 

● If they’ve told you how they feel acknowledge the feeling e.g. “I hear you telling me you’re feeling upset and hate yourself”. 

● If they’re younger and they’ve come to you it is important to talk to them on the same physical level- e.g. both seated so you can maintain eye contact. 

● If talking is difficult, find a comfortable way of doing it. Some parents say their best conversations happen in the car or whilst walking. Other ways might include when doing a task together- washing up, playing a game etc. 

● Notice how you are feeling but keep it to one-side for now and manage those feelings later. Right now it’s about listening to them, not giving your opinions.

● Assure them that they are still loved no matter what. For a child to understand that they are still loved and have value even if they do something you disapprove of is so helpful. When we make conditions of worth we are telling people how they must be to gain our approval. This can lead to your child feeling even worse about themselves.

What to do next:

• If you are really struggling with your own feelings about your child’s self-harm it is important you deal with them. Ignoring how you feel won’t work- the feelings will come to the surface. It might be an idea to seek counselling for yourself. Alternatively using Young Minds Parent Helpline might be useful for you: https://youngminds.org.uk/find-help/for-parents/parents-helpline/

• Find professional support for your child. Places you can find it include school, GP and CAMHS (Child and Adolescent Mental Health Services), local charities and organisations, and private counselling. The benefit of private counselling is that there is a much shorter wait for support and you can pick the type of therapy you want rather than having to take what is offered and it is not time-limited.