What is self-harm?
Self-harm is when someone deliberately hurts themself.
Self-harm takes on many forms, some of which are obvious and others that are less so and harder to spot.
Below is a list of some of the more common self-harming behaviours
Cutting, scratching, scraping, picking at skin
Hair pulling, scalp-rubbing, eveybrow or eye-lash pulling
Nail-biting, skin biting, lip-biting, lip-licking or gum biting
Swallowing non-edible items such as batteries, coins or razors
Eating food and then vomiting, not eating, or eating in a restrictive manner
Taking an overdose, taking medication that hasn’t been prescribed for them or swallowing poison or household products
Tying ligatures around the neck or around fingers or toes to cut off the blood supply
Burning with either flames, cigarettes or heat
There are inevitably other methods of self-harm that may not be obvious
Until my daughter started self-harming, I didn’t know what it was. Nowadays there’s a lot more discussion about it. But I didn’t have any idea how bad it would get or how hard she would end up struggling to stop. If I can say anything to another parent, if you see it starting, get help straightaway before it becomes ingrained.
Self-harm and surviving sexual or violent crime
This image has been reproduced with the permission of the model. She wants people to know just how damaging self-harm can become if left untreated. These scars which are over 2 years old are unlikely to fade.
Myths about self-harm
There are a number of myths surrounding self-harm. Perpetuating those myths can cause distress and make stopping self-harm more difficult.
Myth: Self-harm is about attention seeking
Self-harm is usually performed in a safe place, away from others and in private. Self-harm is hidden under clothes. Whilst there is some ‘sharing’ of photos and stories on social media that can create a level of solidarity, this is most often about people sharing their experience and inadvertently encouraging others to go further or to try different methods.
It’s almost never about drawing attention to themselves apart from in the quiet corner of the internet where they feel their experience may be understood.
Myth: Self-harm is a failed suicide attempt
Very often, people who self-harm are doing it to stay alive not to end their lives. Self-harming stops them taking more drastic steps towards suicidal thoughts or behaviour.
There is a correlation between people who self-harm and who take their own lives and sometimes an act of self-harm can have fatal consequences. Most people who self-harm are very clear about their motivations for each incident and are able to distinguish between a suicide attempt and self-harm.
Myth: Parents should treat self-harm like other unwanted behaviours
Punishing children or young people for self-harming increases shame and self-loathing and could make it more likely that they will do it again. Showing deep concern and a level of understanding about the reasons to need to self-harm is more likely to help. An urgent appointment with your GP should get the right professionals involved.
Myth: It’s easy to stop self-harming
Self-harm is an addictive behaviour because apart from being dangerous, painful and damaging – it works. People self-harm to either create pain to stop the numb dissociative effects of severe trauma or to physicalise a mental pain that they can’t process. The act of self-harm releases endorphines which makes someone who self-harms feel better. Unfortunately, if someone has found a really effective way to deal with extreme trauma or emotional pain, encouraging them to try something less effective can take a long time.
Because self-harm is an addictive behaviour, the level of self-harm required to achieve the same effect is likely to increase over time. Someone who scratches may move onto cutting and the cuts can become so severe that they require surgery or do permanent damage to movement and feelings.
The reason people self-harm may change over time. Guilt and shame, self-loathing because of their trauma, disappointment when they start to have thoughts of self-harm again or complex difficulties with relationships (for example) can form deep layers of trauma and emotional pain that can take years to unpick and resolve. Relapses are common as with any addictive behaviour and it can take several failed attempts to stop self-harming permanently.
It is incredibly difficult and courageous to attempt to stop self-harming and anyone working towards that goal deserves praise and support
Myth: Only women or girls self-harm
Self-harm is most common amongst women and girls but it is not unusual in boys, men, people who don’t assign themselves a gender, people who are straight, gay, bi, LGBTQ and trans.
Signs of self-harm
Everything seemed so innocuous at first. Looking back, it all started at least two years before we recognised it as self-harm. Toe-nails hanging off, rubs and scrapes, that sort of thing. It wasn’t until the cutting with blades started that it became obvious. I wish so much we’d known what to look for and noticed earlier.
Wears long sleeves and remains covered even when it’s hot
Starts opting out of swimming or other sporting activites that involve exposing skin
Has unexplained sores or scratches
Iron or other vitamin deficiency
Avoids physical contact and shows signs of pain
Pencil sharpeners disappear and are found without the blades
Is secretive about their bags and pockets
Safety razors are found broken or in bits
Possessive about certain areas of their bedrooms
Develops skin infections from seemingly minor scrapes
Disappearing towels, toilet paper, napkins and first aid supplies
Running out of medication before it should, disappearing medication that belongs to someone else, empty pill packets
Disappearing to the bathroom after meals, refusing to eat with other people, becoming picky or refusing certain food groups
What to do
Plan for the future
- Building resilience, getting good psychological support, encouraging empowerment and raising self-esteem will help reduce the risk of self-harm
- Have open and honest discussions about self-harm. Children in secondary school will know about it and will know other people who do it.
- Acknowledge the increased risk of self-harm with survivors of sexual or violent crime and be vigilant.
- Don’t ignore a spate of seemingly unrelated scrapes, cuts or other injuries, especially those that appear without witnesses
- If your loved one is mature enough, discuss with them their risk and explain the addictive nature of self-harm.
- Encourage them to talk to someone if they feel it’s something they might feel the need to do.
- Make sure you have a clear idea of how your loved one is using social media. For young people, monitor their use, know their passwords and keep electronics out of bedrooms for as long as you can.
At the first sign of self-harm…
- Never assume it’s a phase that will pass – seek specialist advice.
- Accept that this isn’t something you will be able to stop by restricting your loved one’s movements, by nagging, checking or supervision. You are more likely to increase stress and break trust.
- Store EVERYONE’s (including vitamins and even pets) medication in a locked box. If there is a lot, flight cases or hard suitcases have locks. Reduce the quantity of medication you store to a minimum and pick it up weekly, rather than a month at a time.
- If your loved one spends time home alone, take medication with you in your car. Leave it locked in your car overnight and sleep with the keys under your pillow.
- Remove all razor blades, safety razors or shavers with blades from the house. Use hair removal cream or change to an electric shaver.
- Switch to roll-on deodorants.
- Make sure your smoke alarms are working.
- NEVER show your child open wounds or bleeding self-harm cuts as a warning. It may trigger them to cut if they’ve already started to self-harm.
- Never get angry or punish someone for self-harm – you will increase the negative feelings they have about themselves and increase the likelihood of it happening again.
If self-harm has become a significant issue
- Keep a diary and see if you can identify triggers for self-harm or a pattern of behaviour.
- Ask for specialist support – some mental health trusts act as regional centres of expertise for self-harm.
- If your loved one is young, avoid sleepovers at other people’s houses if you cannot have a frank conversation with the adults in the house about the risk of medication or razors.
- Reduce the number of household products such as bleach in the house and try to keep these locked up somewhere. Consider less harmful cleaning materials but realistically it’s all poisonous so lock it up.
- Keep ice-cubes and elastic bands on hand and show your loved one how to use both as an alternative for more dangerous harming behaviour.
- Keep a stock of bandages, wound plasters, steri-strips and antibacterial cream at home.
- Take any deep wound or longer than 3cm for treatment at A&E, an urgent care centre or your GP if they can deal with minor injuries.
- Be aware that although it is illegal to sell razors or medication to children, in supermarkets or pharmacies, these items are usually on the shelf and are small. They are very easy indeed to shoplift.
- Make sure any locks on bathrooms or bedrooms can be opened from the outside in an emergency.