DD is self-harming - it's escalating and I don't know what to do, please help?

[whycantwegoonasthree]

My DD1 is 17, and has been self harming (slicing her thighs) for about 6 months – the past few weeks it has gotten much worse. We got her in front of a therapist a few months ago, and that seemed to help, to the point that I thought she'd stopped.
On returning to school though it became hard to find the time in her schedule to see the therapist and she stopped going. I kept trying to get her to go back but she's flat out refused.
I'm trying to get her to go back but she says she can't... I've tried to get her to talk to me about why it happens, or what tiggers it - but she says she doesn't know.
We usually have a very open dialogue, and a good relationship - at least I think we do. But I'm totally out of my depth here and don't know what to do.
She cut herself so deeply that we had to see a GP because it got infected. He asked about a therapist - and I said that she had seen one in the past and we were planning to go back - should I have pushed for a referral to… I don't know? CAMHS? This was only a day after I found out she's cutting again - and I only knew because she was frightened about this big cut.
I'm so frightened and confused - and really don't know how to help her. I ust walked into her room – I knocked but confess didn't wait for her to say "come in" – like I usually do - her legs were really bloody - althougb when I cleaned her up the cuts weren't that significant – I kind of got the feeling she wanted me to see?
Some context because I don't want to drip feed: She's a fab student and a bright kid who loves her school work, but finds friendships at school hard. She was doing a sport competitively, but got injured, and is about to quit it, because she hasn't managed to get back to fitness – largely because she won't do the exercises the physio is asking her to. I know all these things are linked - but don't know what to do about them/where to start. Her father and I are divorced, but amicable - although she has a strained relationship with him, and wants to stay here.
Please help – I'm lost here.

I am so sorry what a difficult thing to have to go through with your daughter.

I don’t have too much advice from a parent point of view but I was in your DDs shoes when I was younger. The urge to self harm is an all consuming force that was so so so hard to quit. Even when I did not want to do it anymore, it took me a while to stop. People used to tell me it wasn’t a true addiction, it really was. The urge will stem from something deeper too, low self esteem or a little amount of love for herself maybe?

As much as it sounds counterproductive, using an elastic band on my wrist to flick and inflict a bit of sting was really useful to satisfy the urges in a safer way until I was ready to stop. Maybe finding a safer alternative could be something to discuss with her, show her that you are listening, are understanding and want to support her and help her transition out of this.

Love her hard, I’m sure you do, but really show her that you are there for her and show her that love. Show her how important she is. Once she knows how worthy she is, she will start to think twice about inflicting so much towards herself. Sending hugs and well wishes to you both

This sounds so so hard and sad for you all :( CAMHS could be a good idea if the GP can make a referral, even if your daughter doesn’t want to speak with them they may be about to give you some advice around ‘safe self harm’ to prevent serious injury or infection. Similar to PP some people put ice cubes on their wrists and other ways to satisfy the urges. Along with making sure knives/medication and things are locked away Incase of an impulsivity? This is an abosulte guess I have no personal experience of this. I do know that CAMHS have a service called
‘harmLESS’ which I believe is designed for people who have contact with a young person who are self-harming and how to have conversations/find ways to support them. Another idea could be that if your daughter feels like she is struggling with an urge to self-harm and is unable to verbalise this, whether she could send you a message or code word so that you are aware and can support or distract her in some way? Someone I know used to have an ornament on the mantelpiece and the young person would turn it to face the other way if they were feeling low in mood or like they were about to self-harm, they agreed that when this happened they would go out for a drive or a walk as a distraction and there was no pressure on the young person having to talk about this out loud. Not sure if any of that would be helpful in your situation but hope things get better for you both soon 🫶🏻🫶🏻

When my dd was self harming she said it was all about the control. The rush of pain was like a dopamine hit and calmed her down. We saw a doctor who referred us to a therapist. Dd saw two or three different people before she was assigned a nurse that called her every week for about six weeks. Dd was doing it in response to being bullied by a former friend. The therapist was very good and I think it helped her to talk through it with an impartial expert, rather than us who were obviously too close although we tried to be as supportive and understanding as we could.

The advice we were given was that we couldn’t do anything. We couldn’t ask to see, we couldn’t ask her to stop or explain herself. We couldn’t put any pressure on her at all. It was completely out of our control and it is a horrible feeling. I do sympathise. All you can do is offer as much help and support as you can. It’s good that you’re close and hopefully she can talk to you about it all. I do wonder if there is a reason behind it. I hope you can get to the bottom of it and help her address it.

I can’t give advice, but only sympathy, and personal experience and perhaps some
hope long term! My younger sister started self harming at 15, also developed anorexia, depression and anxiety. It was so hard to watch, she’s said it started off as a way of control in a world where she felt like she had none but then it spiralled (probably due to not eating) she developed an imaginary person that I won’t name for her sake that she said used to convince her not to eat. All this started from her friendship group turning on her which we took to the police and little was done! She’s now in her mid 20s has moved, studied at university and has an amazing job and I’m glad to say she’s happy and hasn’t relapsed since about 18-19, the most important thing is to do what your doing, listen and offer love and support, my mum did move my sister room after she started to seek help after attempted S (she also refused for a long time) and that she did say helped her recovery. I am so sorry your going through this as a mum of a young girl I can sympathise even more so now! Just remember this isn’t your failure as I know my mum bashed herself, some people just find life harder or have a worse throw of things, but just remind her, where she is now isn’t permanent and there is always sunshine at the end of the storm, even if it feels like she’s stuck now, it’s not permanent, also, make sure you look after yourself too, reach out for support when you’ve had a hard day.
i hope things get better for you all. 💜

Really hard and no easy answers. I would trust your gut that she wanted you to see and wants, to some extent, for you to intervene. Ask for a sit down, can we think together about how bad this still is for you, how much you are hurting and can we work out a plan? My bottom line is I want you to be ok and to start being kind to yourself.
Can I take away your blades (if not can we keep them somewhere not immediately in her room)
Can we think about safer self harm (can she crunch ice cubes in her hands, plunge her face into a bowl of iced water for at least 20 seconds which initiates a soothing response, can she draw on her legs with a red pen)
Can she use one of the self harm prevention apps for ideas and to self monitor (the aim is to build a list of things she can do to tolerate distress longer and discharge it in different ways)
One of those ways might be to do some vigorous exercise (punchbag, sprints, press ups).
Would she like to be with you at her most risky times, playing a game or doing a puzzle
Would she go back to the GP with you to get a referral to a suitable local service
What positive interests and connecting with others can she do (exercise, quiet leisure and social)
Making a plan with you and knowing that you will stick to it will feel like some control and safety
Even if she fights you on bits of it, being prepared to stay in the thick of it with her will mean a lot
Send her all the links you find to helplines and services
Agree that you will talk again and that you are going to ask if it's been good/bad/indifferent and you won't over react but you'd like her to be honest with you about it. Ask to see her legs once a week or so.

Manager of a camhs service here,
Lots of good advice already and the fact your dd is showing you and is open about her self harm is really positive.

Keep encouraging dd to share about her self harm, talk about keeping her sharps clean and how to clean wounds.
Try and normalise her showing you the wounds, especially important if they have been deep and infected.

This does warrant a camhs referral due to the severity, but your dd does need to understand it's not a magic fix, and effort will be required to get better and improve.

Lastly, a previous poster is correct, self harming is usually linked to feeling in control. So may be beneficial to have a conversation about dd's schedule and education, is she coping? What would make it more manageable.

My dd is self harming also. We got cahms referral. I discovered she was on various self harm threads on telegram and tumblr so have deleted those apps from her phone and insisted on parental control of her phone to check she’s not on those.

i am very sorry that you are going through this. I have been in this position with my son. The circumstances appear v similar but every child is different of course. Please do me if you would like to know about my DS.
in short, he was second year of A Levrks when the wheels came off. Five years later he is not better but the self harm is not happening. When he became ill he was looked after by CAMHS for a couple of years.