the following information has been sourced from www.cyh.com

Self-harm

If you are close to people who choose to cut or burn themselves, it can be really tough to cope with, and hard to understand.

The reasons people harm themselves are complicated. Self-harming usually does not mean that a person wants to commit suicide or that they are looking for attention. Usually when people harm themselves, they are suffering a great deal inside.

what is self-harming?

Self-harming is when people cause themselves physical pain that alters their mood state (how they feel inside). Some people harm themselves because they feel disconnected and isolated from everybody, and hurting themselves is the only way they feel real or connected.

Young people can have self-harming behaviours such as:

• cutting their skin with knives or any sharp object
• burning their skin
• hitting their body with an object or fists (like punching the wall)
• deliberately falling when doing something like extreme sports
• picking at their skin
• swallowing pills or sharp objects
• pulling at their hair (hair pulling can also be a habit).

Eating disorders, alcohol and drug addiction are other ways that people harm themselves physically and mentally.

why do people start harming themselves?

Self-harming can be a way that people deal with feelings of:

• helplessness, despair and low self-esteem
• anger, loneliness, shame and guilt
• not having control over their life
• being 'out of it' - so the only way to feel 'real' is to cause physical pain to themselves.

Some self-harm is related to severe emotional pain. When people have experienced abuse or violence, it often re-appears as emotional pain in later life.

• Some people have said that when they hurt themselves physically, it helps take away the emotional pain.
• Self-harm may make internal pain visible on the surface - it is showing that there is a problem that needs to be addressed.
• Self-harm is a way that people punish themselves for something that they think is wrong.

People who harm themselves...

• may have difficulty expressing their feelings verbally
• may dislike themselves and their bodies
• may do it because of difficulties with relationships
• may do it because of mental health issues such as depression, anxiety or stress.

It is important to understand that whatever the reason for self-harming behaviour, there are more positive ways of dealing with the troubling feelings.

why do people keep harming themselves?

Some people say that self-harming is an addictive behaviour.

• Behaviours, when they become addictive, can be just as hard to give up as an addictive drug.
• When people get into a cycle of self-harming behaviour, it can become their main way of dealing with problems, and can start to have very negative impacts on their lives.

myths about self-harm

• One myth is that people who self-harm do it for attention. Research suggests that about two thirds of young people who self-harm don't even tell anyone, so they can't be looking for attention.
• Another myth is that people who self-harm do it because they have a mental illness. Some do have a mental illness like depression, but about two thirds of young people who self-harm do not.
• One more myth is that people who self-harm do it because they want to commit suicide. This is also false, as most self-harmers do not attempt suicide. In fact, many feel that it protects them from suicide.

the risks of self-harm

• By expressing themselves in this way, they may not be dealing with the underlying issues, such as depression or emotional pain.
• People usually do it when they are on their own, and this can be a really isolating experience - they may not get the support they need to work it out.
• There is a risk that one day, without meaning to, they may go too far, and seriously injure or kill themselves.
• If they don't feel that people would understand, they may have to lie and cover up their cuts or burns. A lot of young people find this secrecy really difficult to maintain and stressful to deal with.
• Cuts can become infected if not looked after, and can cause permanent scars.

It is important to recognise that self-harming is not well understood in society, and is not seen as an acceptable way of coping with problems.

• This could make things more complicated, as they may have to lie and cover their cuts up.
• They will also have to deal with the disapproval of other people who don't understand what they are going through, and who make hurtful comments like, "Pull yourself together", or "Ignore her, she's only doing it for attention."
• We are often judged by the way we look, and others may not understand why some people have cuts or scars on their body.

ways to help

It is very difficult to stop self-harming without having other ways of coping to replace it. Changing any kind of behaviour is difficult, and deciding to change is a decision that only they can make for themselves.

As with any kind of addiction, they must be kind to themselves and understand that they may fall back into old patterns of behaviour from time to time - but this does not mean they have failed or that they should give up trying.

'Yet' is a very important word. They could try saying "I haven't managed to give up YET" - then try again!

What is important is that they do keep trying, and that they get the support they need to get through it. Some of the things that you can help and encourage them to do are:

• taking themselves away from risky situations - something as simple as removing themselves from the presence of knives and razors works for some people.
• trying to focus on something around them, rather than the pain they may be feeling.
• making a list of supportive people that they can talk to, who understand their situation - people like yourself, your partner, other relatives, teachers, friends of the family and close friends who know them and their situation well.
• if they are not getting the help they need and nothing is changing, then talking to a professional - eg. a counsellor, doctor, psychologist, psychiatrist.
• thinking about their alcohol and drug use - is it too much? Are they more likely to hurt themselves if they've been drinking or using drugs?
• trying deep breathing and relaxation, maybe you could learn to do this together - see the Teen Health topic Stress - learning to relax.
• writing in a journal - recording how they feel and the reasons why they might want to harm themself. Be aware that your child may not want to share this with you so it is important to her that you allow her this privacy, until such time as she is ready to share with you.
• looking at the reasons why they harm themselves and asking themselves the question, "can I do something about this or does something else need to change?"
• remembering that self-harming is something a person chooses to do, but it is not an effective way of dealing with a problem - the problem will stay until it is dealt with once and for all.

You can suggest that your child changes her method of self-harming by:

• trying something like holding ice cubes in their hand - cold causes pain but is not dangerous to their health.
• wearing a rubber band on their wrist and snapping it when they feel the need.
• using a red pen to draw on the areas they might normally cut.
• working it off with exercise.
• learning to confront others, making their feelings known - check out our Teen Health topics Assertiveness - what it means, and Assertiveness - stick up for yourself.
• making a list of reasons why they are going to stop cutting, and setting themselves some realistic goals to help stop it.
• calling a crisis line if they feel that their behaviour is becoming dangerous - see our list of numbers at the end of this topic.

General

• Recover your life website:
  http://www.recoveryourlife.com/
• To search for a helpline in in your state check out Helplines Australia
  http://www.helplines.org.au
• HandsOnScotland 'Self-harm'
  http://www.handsonscotland.co.uk/
• First Signs - run by people who have personal experience of self-injury
  http://www.firstsigns.org.uk/