Self Harm in Young People

What is Self Harm?

Self harm is a way of coping for young people especially when there is a need to express difficult emotions. These emotions might not be easily expressed in other contexts. Physical pain sometimes is easier to deal with than emotional pain because it is almost visible and tangible. However it is important to understand that this only gives someone temporary relief and does not include dealing with underlying emotions and issues that an young person might be facing in his/her life. Some people engage in self harm for short bursts of time, whereas for some it is a long term, chronic problem, almost a ritual.

Why Do Young People Harm Themselves?

The reasons are varied and there is no one accurate answer to this question. 

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It temporarily relieves pressure and pain.

It helps one feel something other than feel completely numb, to feel alive.

It externalizes emotional pain, so you feel pain outside rather than inside.

It could be self soothing behaviour for someone who has depleted resources within and without.

It could be a form of self nurturing, especially when tending to wounds for someone who was not shown love and care.

Self harm could be a way of asking for help indirectly.

Let's play True and False!

 Here are some common myths about self harm that have been challenged with facts.

1. Young people who self harm are attention seeking.

False- They are trying to cope with the painful feelings/pressures they experience.

2. Young people who self harm use it as a way of releasing tension and feelings.

True – It is sometimes said that physical pain releases some of the emotional pressure.

3. It is easy to stop harming yourself.

False- You find young people harming themselves because that might be the only way left for them to cope. The underlying feelings are the main issue to be focussed on.

4. Young people who self harm are usually feeling suicidal.

Mostly False- Self harm is not always an attempt at ending one's life. It is more a way to cope with extreme stress and emotional pain. However there is always a risk of those self harming attempting to end their lives at some stage.

Factors that Influence Self Harm in Young People

Young people in Sri Lanka have numerous challenges related to growing up, academics, parental pressure,mental health problems etc. Different people deal with these pressures in different ways, some adaptive and some maladaptive. Each young person copes in a different manner when compared to peers in the same age group and it is important to take heredity and the environment into account as well. The life context of the adolescent or the child would also play a role in influencing coping ability and coping skills. Parenting also plays an important role here, in order for the person to learn adaptive coping strategies.

Other influencing factors might include...

·       Relationship problems

·       Poor body image

·       Bullying

·       Exam stress

·       Failiure

·       Loneliness

·       Not having someone to talk to

·       Guilt

·       Rejection

·       Trauma/Abuse ( sexual/physical/emotional)

·       Substance misuse ( Alcohol/Drugs)

·       Low self esteem

·       High impulsivity

·       Lack of problem solving skills

·       Teenage pregnancies

·       Bereavement

How do Young People Self Harm?

·       Cutting

·       Biting self

·       Burning,scalding,branding

·       Hair pulling

·       Head banging ( against a wall)

·       Picking at one's own skin

·       Breaking bones intentionally

·       Reckless driving/sports

·       Unsafe sex/promiscuity

·       Drug/Alcohol abuse

Note: This list is not conclusive

What are the Warning Signs?

·       Withdrawal from activities the person once enjoyed

·       Spending increased amounts of time alone

·       Prolonged time spent in the bathroom/bedroom

·       Sharp objects like scissors,knives,razors dissappearing from their usual locations.

·       Unexplained cuts,bruises,scars,burns.

·       Wearing long sleeved t-shirts/shirts at inappropriate times

·       Blood stains on clothing,bedding and towels

·       Frequent accidents

·       Unexplained smell of Dettol/Savlon/Surgical spirits

·       Frequent mood fluctuations

·       Changes in eating and sleeping patterns

·       Irritability

·       Low self esteem

·       Feeling worthless

·       Previous attempts

Self harm might not be identifiable at first, because it is often subtle and the young person might not want anyone to find out. This is where open communication between children and parents, an open,safe environment and a listening ear becomes extremely important. The adolescent might self harm because of the lack of safety and trust in his/her relationships,familial and otherwise. Cutting might be the only anchor they can find. Everyone deserves feelings of safety and this should be emphasized on in parenting.

There is no one social strata, ethnicity,religion, caste or creed when it comes to self injury. It is not only the unfortunate adolescent or child in a rural village that would self harm, but it happens right under our noses even in Colombo 7. It is easy to live in a cocoon of comfort,luxury and illusional safety, and think that this sort of thing will not happen to my son or daughther. However it does come as a rude shock for some parents, when they finally open their eyes to notice that cut on their son's forearm. Distraught, angry, ashamed, confused, guilty are some of the feelings a parent might encounter at that moment, but this could be minimized or avoided. It is preventable. Love, respect and affection is all what you need sometimes, coupled with non-judgemental compassion, and not so much a psychiatrist or anti-depressants.

What do I do if my Son/Daughter Self Harms?

Try not to panic. I know it is easier said than done, but stay calm and ensure the child's safety.

There might be injuries that require immediate medical care. You know what to do, call 1990 and ask for an ambulance.

Now, just listen. There is no need to judge, criticize or blame yourself or the child. Just be open and available. The young person needs compassion, love and kindness. This is sometimes powerful, way more than what a doctor or a therapist can offer.

Ask about thoughts/plans of ending his/her life. Ask directly, don't beat around the bush.

Allow the young person to be in control. Listen to his/her views, and keep him or her informed of every step that you take.

Consult your son or daughter on how they would like to be supported. Are there any immediate concerns? Threats to their safety? Anyone else they'd like to talk to? Anything they need?. Ask them, and ask with respect.

If you and your child arrive at a place where a collaborative decision has been made to seek help, then visit a psychologist or a trained counsellor.

“ Hope is the thing with feathers that perches on the soul-and sings the tunes without the words-and never stops at all”- Emily Dickinson