How we feel about self-harm, effects how we respond.

 

One of the issues I work with frequently with teenagers is self-harm. Self-harm can feel complex and overwhelming to parents and school staff who see it as a destructive behaviour. It is extremely distressing for the young person and also for the parent that feel powerless to stop it.

It is destructive in its nature but is also a coping strategy to regulate feelings that feel powerful and overwhelming. When I worked in a school counselling team, school staff used to describe it as attention-seeking, but in fact, it is attention needing. What do I mean by this?

The teenager is trying to understand and regulate these difficult emotions and is seeking to connect. What self-harm provides is a frequent return to a regulated state that the person has ultimate control over.

Many young people report that it feels like a release of tension and agitation, that the tension release is freeing. In counselling and other arenas such as a supportive conversation at home, the teenager needs to work towards recognising and managing distressing feelings. First, they would need to identify the triggers to these feelings and work towards finding more functional ways of regulating them. This could be through dance, exercise, expressive drawing etc. This requires some flexibility from you and your teenager to try out things they wouldn’t ordinarily consider.

Depressed teenagers feel a sense of numbness to the world. They feel detached and disconnected. It’s like the window screen of life has a thin layer of fog, keeping the teenager from feeling alive. In these client’s self-harm serves to help the teenager feel quickened and restored. Temporarily they feel connected again. I feel it’s a bit like an electric shock that brings them back to life. Activities that give the same sensation such as cold-water swimming would help in this instance.

 

Another reason for self-harm could be a way to care for themselves and elicit care from Adults in their life. When they care for cuts and bruises it is an opportunity to be caring towards themselves. To give themselves love and kindness and for other people to show this to them as well. In these cases, young people could start to understand that they deserve care and attention without self-harm. As a parent you could really concentrate on finding ways where the young person can physically care for themselves. Such as skin care routine, massage,

Tumblr have lots of suggestions and pointers on self-harm and self-care.

The other more concerning reason young people self-harm is that they do it to punish themselves. This is sometimes because they hold very high expectations for themselves and believe they haven’t met theirs or somebody else’s expectations or they believe they deserve to be punished. Some young people I have worked with believe they are inherently bad and bad people need punishment. It is a longer more complex therapeutic process, but work involving self-esteem, challenging negative thoughts, being truly heard, can work towards a more positive sense of self.

This book: The Self-Esteem Workbook for Teens: Activities to Help You Build Confidence and Achieve Your Goals. Can help with self-esteem.

If the young person is conscious of the scars once they have healed, then bio oil helps a lot with lightening the colour and healing the skin.

It remains still a mystery why some people continue to self-harm and continue to do it into adulthood, when some people lose this behaviour in late adolescence even when therapy has been provided. The important thing is to keep the communication lines open and to try and not show your own distress to the young person as this perpetuates the young person’s guilty feelings.