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Self Harm in Young People:
Better Care Needed for this Hidden Problem
A parent's guide to self harming. Why do people self harm? Does your child self harm? Are you self harming? Want help to stop?
This guide describes my attempts to help those with this experience, lists related internet sites and organizations that have helplines and trained staff so that sufferers can get help. It also provides background information on how self harm is identified and managed. It offers suggestions on how parents can help their children, and, to get help for themselves.
What is Self Harm and why do 1 in 10 teenagers do it?
Just think about that for a moment. One in ten young people are self harming. This means that in the average classroom there are 3 young people so traumatized by life that they are crying out for help in the form of self harm.
The most common types of self harm are probably self cutting and self burning. But eating disorders, like anorexia, binge-eating or binge-drinking and self-induced vomiting are also forms of self harm. Then there are other actions classified as self harm, such as hitting solid objects, head banging, deliberate poisoning, self biting, hair pulling and cutting, overdosing, picking wounds so they don't heal, the ingestion of foreign objects and deliberate limb breaking.
Self harmers use violence to the self as a means of coping with intense emotional trauma, pain, or distress. It is far more likely to affect younger people, but it can occur in any age group, and increasingly self harm is showing up among the elderly.
Are you self harming?
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Are you the parent of a self harmer?
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It is estimated that around 170,000 people each year deliberately harm themselves. Of these, around 80,000 of those who attend the casualty department never receive a phychological assessment or follow-up. This is despite the fact that the risk of committing suicide after self-harming is 100 times greater than the average risk in the rest of the population.
You'd think that self harmers would be 'in safe hands' at hostpial, but there is growing concern and evidence (and I can back this up with personal experience) that self harmers sometimes receive a poorer standard of NHS care than other patients that were deemed to have sustained their injuries by accident. Self harmers are classified with drug addicts, drunks, glue sniffers and other groups who are in the same vicious cycle of tranquilizing their anxiety by inflicting harm and pain to themselves.
There is a deep seated feeling among some health care staff that self harmers of all kinds, clog the system, and consume resources that should be allocated to the 'deserving'. Charactistically, this goes with a general lack of patience when dealing with self harmers, right alongside the sarcastic or cutting remarks, that demean the self harmer, and sap their already low self esteem. Indeed, Professor Paul Lelliott, the director of the Royal College of Psychiatrists Research Unit, is reported as saying; "There are still examples of people having wounds stitched without anaesthetic, the idea being 'well you cut yourself without anaesthetic, so why should we use it?'" How barbaric is that??
This is not to say this sort of thing happens in all hospitals, and is not representative of the feelings of all staff. Many casualty staff are highly sympathetic and understand there is an underlying cause to the actions of a self harmer, which may require the efforts of other fields of medicine to resolve.
New Guidelines to Standardise Care for People Who Self Harm.
The National Institute for Clinical Excellence (NICE) have issued new guidelines to standardise care for people who self harm in England and Wales.
Dr Tim Kendall, a consultant psychiatrist and co-director of the National Collaborating Centre for Mental Health, is reported to have said: "Self harm and suicide have now become the third leading cause for life years lost after cancer and heart disease in all age groups. Few people providing care in casualty understand why people self harm and don't know how to help them effectively."
- Firstly, the new guideline makes recommendations for the physical, psychological and social assessment and treatment to be offered to people in the first 48 hours after a self harming incident. This covers all acts of self harm.
- Everyone who it is believed to have self harmed, should be offered a preliminary psycho-social assessment when at the triage stage.
- Proper care of a physical injury should not reflect a patients willingness to undergo psycho-social assessment or psychiatric treatment.
- Self harmers should receive the same care, dignity, respect and privacy as is offered to any other patient. Healthcare professionals should be supportive and take into account the distress of the self harm patient, over and above the nature of the injury.
- Accident and Emergency departments should have activated charcoal available at all times for self harm patients who have self-poisoned or overdosed.
- Always use proper anaesthesia and/or analgesia if treatment for self injury is painful.
- All staff who come into contact with people who self harm should receive appropriate training.
- All people who have self harmed should be assessed for future risk of self harm or suicide.
- Health professionals should take account of emotional distress as well as physical distress.
- Medical staff should not delay treatment because it is self inflicted.
- Acts of self harm by the elderly should be regarded as evidence of suicidal intent until proven otherwise.
- The key phychological characteristics associated with risk, in particular, depression, hopelessness and continuing suicidal intent, should be identified.
Hopefully, this statement won't be true for much longer!
Who are These People who Self Harm?
The truth is you could be in the same room with one and not even know it. Sat on a bus, in a queue at the Post Office, definitely at the Doctors surgery, and, if you have children of school age, any school age, they will probably know of someone close to them who is a self harmer.
1 in 10 teenagers are self harmers. Self harm rates in the UK have been increasing and are now among the highest in Europe. It is true that many young people injure themselves and are treated at home. Either through severity of the injury or fear of ridicule, or a hundred other reasons, many of these cases do not come to the attention of health professionals or the health services. None of these young people receive counselling or medical help, and risk infection or a decline in their mental health. Also, these cases aren't on any database and so go uncounted, meaning there is much that goes unnoticed.
What Drives Young People to Self Harm?
Dr Tim Kendall also said: "There is no one cause for people self harming, but very often abusive experiences in their past are significant factors." This is not always the case of course, young people can have difficult or painful experiences at school, at work, or with relationships.
Very often, they can find themselves on the wrong side of the law for something fairly minor, and this degenerates into quite severe and persistent offending behaviour. There may be episodes of bullying or discrimination at school or at work. Death, divorce, physical or sexual abuse, degenerative or terminal illness, all affect people in different ways.
These are quite big things, but it's not always the big things that cause the most pain or emotional trauma. A failed exam, getting the sack, being rejected for a part in the school play or being laughed at when taking a tumble in the sports field. What about finding yourself taking care of an ageing or sick parent? A spell in prison or discovering that you are pregnant when you hadn't planned too?
Most people cope with these things well, but then most people are able to communicate well when they need help, pass the buck when they can't cope any longer, make decisions that resolve a testing situation and know where to turn for the right kind of aid. Self harm is the ultimate control over oneself, when other parts of a self harmers life may be out of control.
I've worked with lots of self harmers, and they, without exception, all have one thing in common; They want to stop! Some can, some won't, some do...... and some can't.
One thing is certain....self harming makes for a pretty profound statement.
What are the Effects of Self Harm?
Self harm is almost always closely associated with a traumatic event of some kind. One in which the self harmer has intense feelings. He or she may feel distressed, confused, highly charged emotionally and unable to express how they feel, either to ask for help or to understand or act on any advice given. They may feel angry, frustrated, fearful, guilty, anxious, extremely sad or lonely or worthless.
With no other sensible alternative (from the self harmers point of view), the self harm episode can be seen as a way of coping with these intense emotional feelings and pain, for which there is, apparently, no other outlet.
The after effect of the self harm episode is a great 'come down' from those dizzy emotional heights. The body's own biochemistry kicks in and endorphins are released into the system to combat the pain. This produces a great sense of comfort, relief, calmness and wellbeing. There is a danger here of the self harmer becoming addicted to inflicting injury on themselves on a physical and mental level, as a way of recreating this state on a regular basis. The short lived 'fix', which endorphins are, can be likened to the short 'fix' provided by a cigarette. For the self harmer, this addictive behaviour can become very difficult to control and the need to self harm can become overwhelming.
You Are Not Alone
However lonely a self harmer may feel, it may be helpful to know that you are not alone. Many people self harm and come through it, and out of it, to see a much brighter day and future. Below is a list of resources for you to visit and contact. Some have forums where you can 'talk' to, and leave messages for, other self harmers. Many of these people, let's call them 'Recovered Self Harmers', who have won their battles, come back to these forums to leave little messages of hope to those who are looking to help themselves get off the self harm train.
Some Techniques That May Help You Fight Back
This is by no means exhaustive, and it requires you to have the discipline to think to do them BEFORE self harming.
Is Self Harm the Same as Attempted Suicide?
- Phone a friend.
- Ask someone close to talk to you. Just chat, it may help to reduce anxiety.
- Say 'STOP!' out loud.
'I choose not to harm myself.'
'I choose to feel calm and relaxed'.
'I choose to have a better day today'.
- Try to analyze what's going on at the moment to make you feel this way.
- Thing about what's got to change to make you want to stop?
- Keep a mood diary. Write down how you feel about things.
- Count down slowly from 10 to zero.
- Put on some music that doesn't make you feel depressed.
- Try to find music that is opposite to what you normally listen to. This is not as daft as it sounds. It's not unheard of that what we listen to makes us the way we are or the person that we are.
- Do breathing exercises. Slowly and deeply, in through the nose, out through the mouth. Just a few at any one time, otherwise you'll hyper-ventilate.
- Make sure you are not alone. You are much less likely to go through with self harming if you are with other people.
- Go and find some company. Out for a walk if necessary.
- Company can be a parent, grandparent, brother, sister, cousin, friend, teacher, social worker, your counsellor.
- If there is no one in that list who can help you, ring one of the numbers below.
The truth is that sometimes, yes it is! The tragedy is that sometimes, yes it does!
The facts are that normally the two are not connected. People who self harm are often angry, frustrated and feel worthless. Self harm is a way of coping with these stressful or difficult feelings. Often a person who self harms may feel that this is the ONLY way they have to communicate how angry, or how depressed, or how frustrated or how distressed they feel.
Some self harmers have cried themselves to exhaustion and this is the next logical step for them. Others fear that their anger, aggression and emotion are so out of control they cannot trust themselves not to hurt someone else, and so they hurt themselves instead.
How Black is Your Kettle?
We all take action and behave in a way that means it is possible to cause ourselves harm. Some of us smoke, some of us drink excessively, some take drugs. Whilst smoking and drinking are not consumed because they will make us suffer injury, nowadays they are consumed in the full knowledge that they will do us harm. Likewise, driving or riding in a car without a seatbelt, is dangerous. We all know that, but thousands and thousands of people do it, as a calculated risk, every day. Dangerous Sports are called that because more than a few people who partake of them are now in wheelchairs.
When a close friend or relative goes in for lung cancer, or a liver transplant, we don't say, they are undeserving because they smoked themselves stupid or drank themselves into the ground, do we? We expect the best that medicine can do to help them.
I only point this out because it would be nice if self harmers were treated as 'in need of the system' instead of just 'consumers of the system'.
With the right support, the right care and the right treatment, self harmers can come through to a rosey future, with all traces of their past lives swept away. Cuts heal, scars fade, tears dry up, the hurt goes, and the patient remembers how to smile again.
I wish you all peace and the strength to choose. Phil.
Related Resources: National groups and internet links
If You're Still Here!
The National Institute for Clinical Excellence (NICE)
Mid City Place
71 High Holborn
London WC1V 6NA
Tel: 020 7067 5800
Fax: 020 7067 5801
Visit Website: www.nice.org.uk
The National Self-Harm Network (NSHN)
PO Box 7264
Nottingham NG1 6WJ
Visit Website: www.nshn.co.uk
Committed campaigners for the rights and understanding of those who self-harm.
The National Children’s Bureau (NCB)
8 Wakley Street
London EC1V 7QE
Tel: +44 (0)20 7843 6000
Fax: +44 (0)20 7278 9512
Visit Website: www.selfharm.org.uk
A key information resource for young people who self-harm, their friends and families.
102-108 Clerkenwell Road
London EC1M 5SA
Tel: 020 7336 8445
Fax: 020 7336 8446
Visit Website: www.youngminds.org.uk
YoungMinds is the national charity committed to improving the mental health of all children and young people.
Bristol Crisis Service for Women (BCSW)
PO Box 654
Bristol BS99 1XH
Tel: Office/Admin 0117 927 9600
Helpline: 0117 925 1119
A national voluntary organisation that supports women in emotional distress.
They particularly help women who harm themselves, with telephone helpline, groups, publications and training.
Eating Disorders Association (EDA)
103 Prince of Wales Road
Norwich, Norfolk NR1 1DW
Tel: Adult Helpline: 0845 634 1414
Tel: Youth Helpline: 0845 634 7650
Fax: 01603 664 915
Adultline Email: firstname.lastname@example.org
Youthline Email: email@example.com
Information and help on all aspects of eating disorders including Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and related eating disorders.
Chris, P.O. Box 90 90, Stirling, FK8 2SA
Tel: 08457 90 90 90
Visit Website: www.samaritans.org
ChildLine is the free 24-hour helpline for children and young people in the UK.
Tel: 0800 1111
Visit Website: www.childline.org.uk
Free 24 hour helpline for young people experiencing any problem
SANE, 1st Floor, Cityside House
40 Adler Street, London, E1 1EE
Tel: 0845 767 8000
Visit Website: www.sane.org.uk
A telephone helpline for anyone experiencing mental health problems.
Talk to Frank
Tel: 0800 77 66 00
Visit Website: www.talktofrank.org
Free confidential drugs information and advice 24 hours a day, talk to FRANK.
If you're still here, you probably have loads of questions and no answers. If you are a parent of a self-harmer, you may be wondering exactly what you did to cause this destructive behaviour, why this is happening to you, your child, your family, and how could things have reached this low? Blaming yourself is a normal reaction, and of course, you may be in shock. If you are a self-harmer, you may be feeling confused about why this has gotten so out of control. To talk in confidence about your self harm, or any issues surrounding self harm, please go here: When all you wanna do is talk.
If you're still here, then you may be looking for something else! Someone else to turn to!
Or just another way, another approach, to this problem. Maybe your a desperate parent who has just reached the end of the line..........
Well, I have to tell you, not that long ago, so did I!!
Since the death of my own teenage son from a drugs overdose, I've been working with people, children mainly, who self harm. That's what prompted me to look to self healing, which lead to many complementary therapies, which led to Emotional Freedom Technique (EFT). Maybe it was the other way round, but that's not important.
What is important is that EFT is one of the most powerful stress, anxiety, self doubt, fear, phobia, craving, depression and pain reducers known to man. Combine this with other therapies and healing, and you've got an unstoppable combination of good.
This is the approach I take and I've seen it work, over and over again. Young people, self harmers, from all walks of life, are given tools that allow them to take that vital step up and over the pain, step through the depression, and learn to leave it all behind, facing the future with renewed conviction and confidence.
I don't advertise myself as a Self Harm Therapist. But, I am someone who cares pationately about giving self harmers the tools they need to help themselves overcome the reasons for their self harm. Self harmers need help to come to terms with what they're doing to themselves, understand the reasons for those self harm episodes, and help, when alone or with support, to stop harming themselves, before they really do go all the way and cause harm that is not treatable. Self harmers also hurt other people, particularly parents, girlfriends, boyfriends and siblings, who may also be traumatised by self harm episodes.
How do we do this? I don't expect you to bring up the past, kicking and screaming your way to righteousness. That's NOT how it's done. EFT is gentle, Therapy is gentle, Healing is gentle. Gentle on the mind. Gentle on the body. Gentle on the soul. Powerful as can be!! But gentle.
Obviously, any help I can offer is restricted to the United Kingdom on a personal or appointment level. To see how your location compares to mine please visit the contact phil page, where you will find an address and phone number.
One word of caution: It's no good dragging your child down here in hand-cuffs or forcing them in some other way, even though, I know, as a parent, you will get to the point where you will do just about anything to save them from themselves. Better to say something like; I've heard of this guy who works with young people who self-harm. He tries to help them find out who they are and help them to build on the positive aspects of their lives and to overcome the negative.
What's important is that it must be the Self Harmers decision to seek help.
Nobody else can make this decision for them.
If this seems an appropriate route for you please
contact me or
Please Note: Healing and therapy are my profession, therefore, please understand that I do make a charge, for my time and expertise in this field. Phone time is charged by the hour and details can be found above, or click here for more information. Thank You.
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