How to help dd?

[woodentrees]

Last year dd took a number of overdoses, not attention seeking ones, serious given antidotes and stays in hospital overdoses. All medication is now locked away. Since then life has improved a bit for her, she has a nice boyfriend, is managing to ignore her controlling father and is doing okay. However she is self harming and doesn't seem to know why. She seems to dissociate. These aren't wee scratches they're using a tea towel to stem the bleeding cuts and gouges. I was literally picking bloodied lumps of flesh out of the sink today. How do I help? Mental health services do see her, but seem to think that it's okay for her to do this. I'm bloody scared she's going to get an artery one day, she's come close once or twice. She says she doesn't want to die.
I don't know whether to sympathetic/empathetic or strict. Any ideas much appreciated.

Had the same experience with DD. A mixture of medication and a very good PRIVATE therapist got her to stop. Mental health services through the NHS were utterly, utterly useless.

Is she on any anti-depressants? Could you afford private therapy?

Thank you! She is on duloxetine. I can't afford a private therapist, but I do know that there are two in a nearby city that offer graduated fees according to income. I will look into it. Thank you. I just want her to be well and happy and to know how amazing she is.

Mindfulness techniques could also help. I'm sure you can get a good book with a CD that could teach her.

Also talk to the GP about whether increasing the dose of Fluoxetine might help.

She can't increase the dose. It is actually duloxetine, works slightly differently to Prozac, to which she is allergic. However, the doctor did change things in the week and has suggested she take the whole dose at once, rather than the split dose. Hoping...

I would try getting a a referral to an nhs psychiatrist as it sounds like she needs a full mental health assessment and a medication review. Hope things improve for you and her to.

In the short term for dealing with her self harm make sure she has a full first aid kit. Also try making her a distraction box.

Concerned
Distraction box, brilliant idea! Thank you!

If she has a dissociative illness and distraction box is unlikely to work unless she knows grounding techniques.

Specialist Trauma Service such as SLAM or the Tavistock would be my advice - if you aren't in London they may be able to offer advice on a service closer to home.