Question from a concerned parent
“I found sharpener blades in my son’s room. He is 14 and I am scared. I don’t know what to do.”
Answer from Anxend experts
Thank you for reaching out to us! This is probably one of the most stressful situations a parent can face but know that you’re not alone.
Self-harming is unfortunately very common among teenagers and navigating through this challenging situation is something many families face.
It is important to note, that while self-harm is sometimes viewed as a step towards suicide, it often bears no relation to any suicidal intent.
In fact, most people who hurt themselves describe self-harm as a way of staying alive and managing severe emotional distress.
If you feel that your child is at risk or in crisis, and you immediate or emergency support please don’t hesitate to consult the crisis services below.
Here are several crisis services available to you:
A&E: If your child is at immediate risk of harm to themselves or others then please take them straight to A&E.
Hope Line UK: works with those that struggle with thoughts about ending their life. It is a specialist telephone service staffed by trained professionals who give non-judgemental support, practical advice and information to children, teenagers and young people up to the age of 35 who are worried about how they are feeling or anyone who is concerned about a young person. The helpline can be contacted via telephone (0800 068 41 41), email (pat@papyrus-uk.org) or SMS (07786 209697)
Samaritans: Tel: 116 123 (24hr) - www.samaritans.org - Online and telephone support for young people and families
ChildLine, Tel: 0800 1111
Extended Hope, out of hours: 01483 517898
What is self-harm?
Self-harm refers to any behaviour in which an individual intentionally inflicts physical harm upon themselves, such as cutting, scratching, burning, hitting, punching, slapping, or employing other methods to cause pain or injury to their body.
The notion of purposefully causing harm to oneself contradicts our innate survival instincts, and it can be challenging to comprehend, yet, self-harm is increasingly prevalent among teenagers, with research indicating a significant rise of 22% just in the last year.
Why do children self-harm?
There are many reasons why children may self-harm, however, it is usually reported as a way of dealing with very difficult feelings, painful memories or overwhelming situations or experiences that are happening in the present or have been experienced in the past, but it can also happen for an unknown reason. The reasons can also evolve over time, and they will certainly vary from person to person.
Self-harm was once thought to be a response to stress, however, saliva samples show that the stress hormone cortisol is lower in self-harming teenagers and this finding lead researchers to further investigate the neurobiology of self-harm.
Unsurprisingly, it was found that self-harming teenagers have distinctive brain and physiological activity in response to pain and to the sight of blood.
For example, while most teenagers feel terrible when they experience physical pain and their pain intensifies sadness, anger, and frustration, teenagers who self-harm are calmed by pain and anger, sadness, and frustration disappear when they harm themselves.
Furthermore, it was found that among those teenagers who self-harm, pain and the sight of blood lower the activity in the amygdala, where the brain locates the rawest, reactive feelings, leading to the conclusion that their primary motive for self-harm is emotional regulation, which is our ability to modify our emotions to achieve a certain goal or to enhance and/or inhibit our emotional experiences and expressions.
Emotional regulation is something we develop over time, and for one to be able to regulate emotions, we first need to be able to recognise emotions.
So, it is not surprising that children and teenagers would struggle to regulate their emotions as they have not yet developed their prefrontal cortex, and therefore, lack emotional recognition skills.
As children develop, their emotional skills evolve from recognition to internalisation and self-regulation and continue to develop during adolescence, and as they mature, their neurobiological responses return to normal.
This explains why self-harming is more prevalent among young people and demystifies myths and ideas around self-harm by showing that self-harm is not “sick, bad, attention-seeking” behaviour, but a problem with young people’s neurobiological responses.
Some common reasons for self-harm are:
To cope with developmental stressors such as bullying or exam pressures
To cope with overwhelming big emotions
To end dissociation and feel alive
To have control over “something”
To punish themselves
For example, children may hurt themselves if they're overwhelmed by difficult feelings such as sadness, guilt or hopelessness or as a way to express these feelings, especially if the child finds it hard to put them into words.
Moreover, physical pain can be used as a distraction from the emotional pain they're in, and, in some situations, children hurt themselves because they feel they need to punish themselves for not being ‘good enough’.
4 main theories about why people self-harm:
For many sufferers, their experience would be a combination of some of these.
Endorphins are chemicals released in the brain. They have many different effects but seem to help people relax and think clearly as well as diminish the impact of negative emotions.
Interestingly they also seem to reduce pain and have been called the body’s natural painkillers. Physical injury triggers endorphin release, so it is possible that people who self-harm are discovering the way that endorphins really do help to decrease their emotions and help them to relax.
Emotions, much as they may be difficult, are a normal and vital part of the way our brains work. They are designed to grab our attention, and they need to be processed.
If our experience of emotions is to find them very overwhelming, and we do not know how to deal with them, we can get into a cycle of trying to just suppress and push them down without ever dealing with them.
If this is the only thing we know to do, emotions can build up much like air in a balloon - and as the pressure builds, it can feel like you might burst!
Many who self-harm talk about how it helps them ‘release’ those emotions so that they can get on with what they need to do at that moment or face another day.
Some emotions in particular, like anger or frustration, also trigger a strong desire to do something - hit out or fight. If these emotions are the ones building up, self-harm can stem from pure frustration, hitting out and turning that emotion onto yourself rather than expressing it outwardly in other ways.
Another theory of why people self-harm focuses on the way it can help people communicate or validate powerful emotions - to others or to themselves.
For many of us emotions are not easy to describe or articulate. This becomes even harder if they are extreme or very overwhelming because powerful emotions like these actually start to shut down our rational brain making it hard to think clearly.
A physical wound can be a kind of visible illustration of that emotional pain – much easier than putting it into words. however, it’s important to be clear – this does not mean that people deliberately and specifically wound themselves to illustrate what they are feeling.
Self-harm can be more of an instinctive way of illustrating that emotional pain- a way of saying this is how bad I feel.
In fact, although very few people consciously aim to harm in order to communicate (for example, most self-harmers actually hide wounds), the most common reason given for self-harm is that the sufferer yearns to have people hear their pain and to validate their distress (i.e., to say that they understand and that it is ok to feel that way).
Some people who self-harm do so in a very structured and considered way, with a very clear routine of how they harm and what they do afterwards.
Sometimes this pattern of self-harming ‘allows’ them some time afterwards for self-nurturing behaviours which they might otherwise feel guilty for. This is combined with the relaxing impact of endorphin release, meaning that self-harming can become part of a strategy to try to lift mood or cope with low feelings.
How to talk about self-harming:
Whatever the nature of someone's self-harm, it's important to remember that this is a strategy they are using to cope with difficult and painful, often frightening, emotions.
Simply asking them to stop, by a feat of sheer willpower, is unlikely to be successful and may even mean that emotions build up and lead them to eventually harm more seriously.
An important part of managing self-harm is therefore about helping the self-harmer to explore other things they can do when feeling low, sad, or angry - and gradually starting to use these more positive strategies to either delay or replace self-harm.
Breaking the cycle of self-harm takes time, it is not something that generally happens overnight, but it is possible.
The first step is to acknowledge it and talk about it.
Being open to make questions and discussing self-harm will not only help the self-harmer to open up about what is troubling them but also help us to protect them.
When engaging in a conversation about self-harm, remember that this is a difficult topic for the self-harmer, therefore, it is extremely important that you remain calm and show yourself comfortable about the topic.
This is about them, so, give them the time and space to feel safe and comfortable to talk about it, empathise with them, listen to what they say and relate back to them, validate their feelings, speak clearly and without prejudice or judgment, respect them and remind them that you’re there for them.
Ask direct questions as this can validate their feelings, thus making them feel comfortable and therefore creating a channel for direct conversation. Always take them seriously and assess for risk, and when appropriate, offer to help them find specialised support.
Tips to parents on how to approach their child who self-harms:
1
Avoid asking the child lots of questions all at once
2
Keep an eye on the child but avoid 'policing' them because this can increase their risk of self-harming
3
Consider whether the child is self-harming in areas that can’t be seen
4
Remember the self-harm is a coping mechanism. It is a symptom of an underlying problem
5
Keep open communication between you and the child and remember they may feel ashamed of their self-harm and find it very difficult to talk about
6
Talk to the child but try not to get into a hostile confrontation
7
Keep firm boundaries and don’t be afraid of disciplining the child. It is helpful to keep a sense of normality and this will help the child feel secure and emotionally stable
8
If you feel confident, you can ask the child whether removing whatever they are using to self-harm is likely to cause them use something less sanitary to self-harm with, or whether it reduces temptation. This can be a difficult question to ask and if you are not feeling confident to ask this, seek professional advice
9
Provide alternative coping strategies: Assist your child in recognizing alternative methods for managing negative emotions, such as taking a break, engaging in healthy distractions, practising positive self-talk, and developing the ability to identify and express their feelings. The objective is to support your child in extending the time gap between experiencing a feeling and engaging in corresponding behaviours.
10
Stay connected with your child's school. It can be beneficial to reach out to your child's teacher or school staff to inquire about any observed behaviours or statements, as this can provide you with a more comprehensive understanding of the situation.
All of these are merely suggestions aiming to assist you in comprehending the underlying message your child is attempting to express through self-critical statements and/or self-harming behaviours. If you feel that your child may need a risk assessment, please seek professional help.
If you suspect that your child's intense emotions and behaviour stem from anxiety, we encourage you to take advantage of our free anxiety test below.
We are here to help!
Ana Pereira
Lead Psychologist
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