Young People and Self-Harm

What do we mean by Self-harm

Self-harm is defined in the National Institute of Clinical Excellence guidelines (2004) as “an expression of personal distress, usually made in private, by an individual who hurts him or herself”.

Self-harm is more common amongst young people and people who suffer with mental health problems.

Self-harm and Self-injury

In the UK Self-harm is termed to cover all self-abusive behaviours though it can be useful to differentiate between self-harm and self-injury.

We characterise self-harm as a way to indirectly cause harm to self-whereas self-injury is more direct and causes direct physical pain.

Facts about Self-Harm

The UK has one of the highest rates of self-harm in Europe

People with Mental Health problems are 20 times more likely to self-harm

The average age to start self-harming is 13

The ratio of boys to girls is 1:4

Over 13% of secondary school pupils engage in some sort of self-harming behaviour

Why do Young People Self-Harm

Young People who intentionally hurt themselves do so often because they lack the coping skills to deal with difficult emotions

They may feel overwhelmed by painful emotions they have not experienced before and have not yet learnt other way of expressing them

Some examples of Self-harming behaviour:-

  • Dangerous Driving
  • Drug and Alcohol Abuse
  • Gambling
  • Over or Under Eating
  • Perfectionism
  • Sexual behaviours that puts self at risk
  • Smoking
  • Staying in abusive relationships

Some examples of Self-injury:-

  • Carving/branding/marking
  • Cutting/burning/scolding/scratching
  • Head banging
  • Insertion of objects
  • Picking and pulling skin
  • Pull out hair/eye lashes
  • Self-punching/bruising/bone breaking
  • Strangulation/suffocation

Contributory Factors

  • Abusive relationships
  • Conflict with Parents
  • Insecurity
  • Isolation
  • Low Self-esteem
  • Past Trauma
  • Peer pressure
  • Rejection
  • Relationship breakdown
  • School pressure
  • Unrealistic expectations

What's the point

People often describe a feeling of euphoria when they have self-harm

The injury itself releases endorphins into the blood stream resulting in a “natural high”

The pursuit of this feeling is what sustains self-harming behaviours, which become habit forming and ultimately addictive

Cycle of Self-abusive behaviour

Experience of negative emotions – sadness, anger, despair etc.

Tension – inability to control emotion – use of dissociation to cope with tension

Act of self-harm – cutting, burning etc.

Positive effect – endorphins released; tension and negative feelings dispel

Negative effect – shame and guilt over act of self-harm and then cycle starts all over again

How can you help

Showing understanding

Helping the Young Person to express their feelings openly

Reassuring them that they are not alone

Receiving what they say respectfully and positively

Encouraging them to talk about past or current events that trigger the cycle of self-abuse

Encouraging them to talk to others – parents, friends, teacher etc.

Support them in seeking out a Counsellor

Strategies that can help:

Setting small goals to help reduce Self-harm – Never suggest stopping straight way as the harming will only be done in secret.

Offering coping skills to help manage difficult feelings such as exercising or listening to music

Talking about the “15 minute rule” – this is when they feel they need to self-harm, they wait 15 minutes to see if they still need to harm

Helping the Young Person to identify triggers

Noticing and affirming small achievements

Measuring progress

Celebrating increased self-awareness and ability to manage own behaviour