Truth Hurts

Discovering your child is self-harming can be a terrifying experience for a parent. Suddenly, your perfect baby is cutting chunks out of themselves,” says Judi Barker, manager of the YoungMinds parents information service, which runs a self-harm helpline. “Parents can often feel very shocked. They can also feel guilty, frightened or ashamed because they didn’t know something was wrong – they are also often wondering whether it was a suicide attempt.”

Due to its often secretive nature, it is difficult to determine exactly how many children and young people self-harm. However, official statistics reveal that one in 10 children and young people aged between five and 16 had a “clinically recognisable mental disorder” in 2004, and a significant proportion of them self-harmed. For instance, of the 4% of children in the UK with an emotional disorder – such as anxiety or depression – one in four said they had tried to harm or kill themselves.

Self-harm is more common among girls than boys. Though more boys than girls have a mental disorder – 11.4% of boys compared to 7.8% of girls – studies have shown that girls are more than twice as likely to self-harm [see factfile]. According to children’s charity NCB, the most common forms of self-harm are cutting and burning, but it can take other forms including: taking overdoses of tablets or medicines, self-punching, pulling out hair or eyelashes, or sniffing/inhaling harmful substances.

“Children will often deny it and that is difficult for parents,” Barker says. “Our advice to parents is keep the channels of communication open so the young person can talk, then you may be able to find out what it means to the young person involved – some young people feel better after self-harming.”

Parents and carers often can’t comprehend why their child is behaving in such a way, explains Jill Eastham, manager of Carlisle-based charity Self-Injury Support.. “Often the initial reaction of parents is fear and panic – when someone sees their child cut themselves, they can’t understand it. They often assume something really terrible such as psychiatric illness, but this is not necessarily the case.”

There are a variety of ways in which parents of self-harming children can get help. Organisations such as YoungMinds offer parents or carers a free 50-minute professional consultation, and also publish leaflets and booklets covering self-harm issues.  In some circumstances, parents may be referred to local child and adolescent mental health services or to a counsellor or therapist.

However, Eastham says this is not always the best approach. “Parents often feel they need to get help, such as contacting a GP or treating the injury, but this is often not the reaction the child wants as often self-harm releases feelings,” she says. “Parents want to protect their child and often they’ll try to take away a razor blade they’ve found in a bedroom, but it doesn’t work. Often self-harming is stopping a feeling getting worse, parents shouldn’t rush to take away the coping mechanism.”

According to the National Self Harm Network, a charity providing support for people who self-harm, one of the most common myths surrounding such behaviour is that a course of psychiatric treatment can solve the problem. “Psychiatry has had little success in helping individuals who self-injure – neither drug nor behavioural treatments can address the issue of self-worth,” a spokesperson for the charity says.

Eastham argues that children who self-harm do not necessarily need professional help, and may simply need to speak to a non-family member who accepts that self-harming is a necessary outlet for their feelings. “Outside help doesn’t have to be someone with special expertise – often the situation needs someone who understands that this is something they need to do,” she says. “In this area, we have a Connexions service and a lot of young people will talk to them as it’s someone they know and someone outside the family.”

Family therapy is another approach to tackling the problem. This is a method currently being used by Commonsense Associates, a multidisciplinary team of psychologists, therapists and family workers, based in Hove, Sussex. “Family therapy is one of the best ways of handling it,” says Commonsense Associates child forensic psychologist Melanie Gill, who is working with one family which includes two children who are self-harming. “The children grew up with very controlling parents who constantly put them in situations they didn’t want to be in. Eventually, the children’s rage turned inwards and they started self-harming.” Gill’s approach involves trying to alter the way the parents view their children. “We’re encouraging the parents to see the children as independent and we get the family to talk about what we call ‘fluffy things’ rather than self analysis like ‘you’re self-harming because…’ – it requires a level of honesty, but the parents were desperate and they were willing to try new things.”

Useful resources
Parentline Plus Helpline: 0808 800 2222
YoungMinds parents’ information service: 0800 018 2138
www.selfharmuk.org  (National Inquiry into Self Harm)
www.nshn.co.uk (National Self Harm Network)
www.parentlineplus.org.uk
www.selfharm.org.uk
www.youngminds.org.uk/selfharm
www.teachernet.gov.uk/teachingandlearning/library/self-harm/

Reality Check
Clare Evans is a senior practitioner at Bromley Y, a charity offering counselling and support to children and young people who self-harm. The charity – which works closely with Bromley Community Drugs Project – also offers help to parents and carers through support groups.

“The parents of children who self-harm can be terrified or they can get angry or upset and say ‘you will stop doing this.’ But this doesn’t really work as the self-harm has become habitual and it works for them – there is an endorphin release when somebody harms themselves,” says Evans.

“We often work with the child confidentially – though if the child is under 16, the parent has to know they are coming here. We work with the parents separately, often because either the child won’t come to counselling or the parents are at the end of their tether.

We will reassure parents. We do a parent group where we get the parents to support each other. There’s a real fear that the children want to kill themselves but that is not necessarily true.

Parents can experience absolute terror or shame that their child is doing this and they didn’t know anything about it. We find ways to help parents understand adolescence – we aim to broaden parents’ understanding of what’s going on with their child. We try to approach the problem from a different perspective. 

There may be a parent who is using punishment because their child is being abusive to them. But grounding their child, for example, is not going to change the situation. We say to the parents ‘you both want to get on, let’s look at what else you could be doing’. It’s our view that punishing the child never works.

When parent groups have had reunions, we’ve found they have set up phone circles which in the majority of cases are helping. There’s often a lot of shame for parents in saying they don’t know what to do.”

Factfile
‹ Self harm is most common in children over 11 and increases in frequency with age. Though it is uncommon for very young children to self-harm, there is evidence of five-year-olds trying to harm themselves.
‹ A study carried out in Oxford in 2000 by Oxford University found that 700 per 100,000 females aged 15-24 – compared to 300 per 100,000 males in the same age group – were admitted to hospital following an episode of self-harm.
‹According to NCH, self-harming is often linked to difficult episodes in a young person’s life, such as: unwanted pregnancy; being bullied at school; disputes with parents; parental divorce; abuse; rape; bereavement; and entering care.