How to explain self harm to a child

[whatohwhattodo]

I have posted previously about a relative with eupd.

The situation has escalated and they are currently sectioned although like to be released.

They self harm - at home mainly tablets but also cutting and burning themselves. My oldest dd has got very upset that she could not visit them in hospital (the ward was very volatile and I was not comfortable with her going)

My question is how is best to talk about it if they both (7+11) see all the scars and burns. There are some old ones they have seen but they are very faint. These are current and blistered etc.

It's also a very real prospect that he will actually die possible in near future from accidental overdose and I have no idea how I would discuss with them in an age appropriate way.

Anyone?

If I were you, I would seriously take a step back & think how about you can put the kids first - go minimal contact until relative I’d on proper road to recovery.
Such a damaging thing to know about at such a tender age imo.

I can't - its my sister and they are very close to her so very hard to step back. Parents live couple of hours away so it's me that has to deal with events when they occur. Oldest is in tears because I think she's worrying because we haven't spoken about why she is in hospital.

I had to cancel my daughters birthday party today as we got told she had been resuscitated after putting a ligature round her neck.

As the hospital wouldn't talk on the phone I had no choice but to go just in case she was on life support.

It's so hard.

Even if you don’t take my advice, at least this will bump your thread.
You’ll be helping everyone in the situation if you say that your sister has gone away for a few weeks to.. Scotland?
A) your children won’t be worried like they would be hearing the word hospital
B) your sister wouldn’t feel as guilty as children won’t think she’s in hospital worrying about her
C) you won’t have the guilt of your children worrying and the pressure and stress of your sister feeling worse.
Worth a try. I really do think it’s just too sensitive and adult to explain to Primary aged kids (and tweens).
Good luck and I hope your sister makes start to recovery soon. It’s a long, hard and painful battle but I have every faith she can overcome this with a supportive sister like you.

I was a strong minded child who'd done lots of hospital visits and looked after my grandmother with dementure many times. My grandfather was unwell and granny had a bad turn so was sent to a secure mental health hospital. 30 years on its still vivid. I was grabbed by another patient who thought I was a relative and wanted to know why I hadn't visited - she was really angry. Another patient tried to get me to let them in the lift to exit. Staff were very quick to deal but it was a horendous experience that I couldn't process at the time, the saddness I felt for those people was very consuming and too much to process. Its a really good thing you dont want to expose your children to the same.

I think i'd go along the lines of they are unwell so this particular illness, that's very rare and not contagious, makes them have lots of accidents and forget when they've taken tablets and when they haven't so they sometimes take too many and the wrong ones. The hospital help them to remember what they've taken and try to stop accidents.

Then let them ask questions. Try to keep the facts as simple as possible.

Oh bless you and your poor ill sister.

I don’t know what to say.

As to visiting, my experience is that even on the most volatile wards ( in fact especially on the most volatile wards) there will be a visitors room where you and your lovely caring DD can visit her aunt

Oh this is just devastating. I was about to say I’d protect the children too however you can but this sounds so urgent and hard. I am so sorry. I certainly think you should be as honest as you can without burdening the children with things they can’t understand or aren’t ready for.
If they ask questions could you explain mental illness in very gentle terms eg some people sadly have mental illness which makes their lives much harder and can make them very unwell (and add anything y can to help them like luckily most people don’t have it and it’s important we all support those who do). Id also try to avoid them knowing the deliberate nature of anything they notice - but what a very hard time for you and especially when needing to put your sister first . I do hope she finds all the support and recovery she needs

Is there any advice on MIND / other mental health organisations about age appropriate explanations of mental health illness?

I hope you don’t need this, OP - but this book is recommended by bereavement charities for coping with the aftermath of suicide, including explaining to children

www.amazon.co.uk/Special-Scar-2nd-Experiences-Bereaved/dp/0415220270/ref=mp_s_a_1_2?s=gateway&keywords=a+special+scar&tag=mumsnetforu03-21&qid=1567802619&sr=8-2

(book is ‘A Special Scar’)

I'm going to try local carers centre and see if they can help. Hopefully I am going to get some support sessions for me from them.

Her ward is through 3 locked doors so even that is hard to explain and she was (and probably agin now) is on 121 observations.
And she has burns and cuts over herself and has barely eaten for a month now so not sure I even want them seeing her like that.

The oldest is y8 and her school seems quite on board with mental health support so was even considering calling them and finding out what advice they can offer - she may even have covered all this already.

It's so hard to know what to do.

For now, just say she is too poorly for visitors except you - it's true.
When she goes home, if any questions are asked about scars or marks, just say Aunty X had a poorly head which meant she didn't think about things like most people do, (explaining poor mental health a bit more if age appropriate), so she sometimes hurt herself without meaning to, but is feeling a bit better now.

That sounds sensible to let school know in case they can be helpful. I also would be honest in telling your dc that you are worried about them seeing her as she isn’t herself and is in a bad way and it is upsetting even for a grownup . It’s not the same but I remember a family bereavement being harder as a child when there was mystery around it as it was kept from me. So I do think children can feel safer if they have a sort of idea even if they need to be protected too

I also think you should take a step back, I know of social services being involved when children have been subjected to the types of behaviours you've described.

@EveningLight

Yes I think it's the fact that she has no idea what's going on that is harder for her as I guess she is imaging all sorts.

@howu2

They haven't seen anything. My sister lives by herself. My concern is going forward that they will see scars.

But also if the worst does happen how do you explain it - do you make up an illness they had so they don't know the truth?

I just don't know and as she was resuscitated today it's something I need to think about pretty hard and be prepared for.

OP - I think you need to prepare for explaining suicide (worst case) and have suggested a bereavement charity book above. I wouldn’t lie about it being a road accident etc (they will find out later) but find an age appropriate way of explaining their aunt’s illness.

You need support for yourself too - you are focused on your desperately ill sister and how to manage this with your children - but what about support for you and your psychological well-being? Again mental health charities are there for the families as well as those with mental ill health and you should avail yourself of their support for you

I would tell them that she's ill, but that it's her brain that is ill. Her brain is not working properly and she is in hospital so the doctors can try and make it better. The doctors have said she is too ill for visitors just now. It's funny when it's your brain that's not working properly, it needs quiet and calm. If it's a physical part of your body that's broken then your brain can still cope with visitors so it's different.

If they see scars later I would simply say she hurt herself when she was ill. That's the truth. If they ask how she hurt herself I would probably just say "I don't know, she's feeling better now, let's not worry about it".

Do you think they would accept those answers or would they push for more detail?

If they ask a question it's ok to say "I don't know." I would say something like "brains are way more tricky to fix than arms or legs because we can't actually see how they work, so it can take a while to figure out what's gone wrong and how to fix it"

I don't know what I would say if the worst happens and she dies. That is much harder. If it was an overdose you could say her brain got mixed up and she took too many pills. I don't know if I would enter into any discussion at this point, even with the older one, about her doing it with the intention to harm herself. But I'm no expert, that's just my gut feeling.

My 13 yr old has a good friend who is self harming and I am finding it very hard to find the right things to say. I have just gone with "her brain is doing all sorts of funny things and she's not thinking straight". So far that sort of seems to have been enough but I can see the cogs whirring even if the questions are not quite out there yet.

Do you have someone supporting you? This all sounds really hard.

The truth is hard, but I think children can trust the truth more than they can trust some fabricated story. A simple truth would be 'sometimes, people are hurting on the inside and they think that hurting on the outside will make that better. But it doesn't. Auntie didn't know that, so she needed/needs help from the doctors to understand.'

My children have all experienced their Nanny becoming very ill, and visited her several times in the relatives room at psych hospital. There's no getting away from the fact that she's (still) very ill, even though she is home. Because I've been honest with them, they know that she's very ill, will take a long time to get better and she loves them very much, but just can't remember what she wants to say most of the time (meds which nobody will review, another story in itself).

I dont tell my dds anything aboit my dsis with BPD and we don't see her anymore. She needs to get help before we can start to mend our relationship.

I wouldn't even begin to explain self harm to an 8 year old. Let them have a happy childhood.

@Sewbean

I have been in contact with the local carers centre who provide support to family members. They are arranging some telephone support sessions and also putting me on the waiting list for counselling. The telephone one is around ways to handle and manage it - ie stepping away for your own sake when needed. They are also running some workshops for relatives of people with eupd to get info / suppprt from others in a similar position so I am going to try and attend them.

I have just now had a call back from ooh mental health services for this area as whilst in a secure unit on 15 minute obs she has got hold of a knife / scissors one day and something she used as a ligature the next. So we are concerned for her safety if she goes back in that unit when she gets discharged from a and e.

They have told me we have to push and push to get her admitted under a section 3 for treatment. Not just a 2 for supervision.

Thank you all for suggestions on wording - they seem to have right balance I think. The 12yo is not stupid and she knows something is up.

@Aridane

Thank you for the link to that book - I will have a look

How are you op? I hope your sister is still being looked after and is safe for now

This seems a good way of explaining from Lougle

sometimes, people are hurting on the inside and they think that hurting on the outside will make that better. But it doesn't

@Sewbean

She now transferred to a different hospital and is on 2 to 1 constant observation. She is also not allowed any personal belongings.

So hopefully she is as safe as can be for the moment.

It was however quite distressing seeing her as she is very angry and agitated - in her mind she just wants to go home and harm away to her hearts content and it's her right to do so!

There is no reasoning with her.

Being in there is agitating her more but it's keeping her alive hopefully.

Oh OP