talk to me about self harm please

[MitchyInge]

my 17yo has started again, after a long break (couple of years or so) - she has previously been hospitalised for anorexia and has a few serious suicide attempts under her belt

I find it v difficult to understand self harm, it seems to be independent of actual clinical depression and she just says she doesn't know why she does it or what, if anything, precipitates it

grateful for any light anyone can shed

i can help as she sounds like me.

what do you want to know?

Self harm means different things to different people.

SOmetimes even for me it's different.

I self harm because i need a release: from internal pain, from my own frustration.

But i do it because to feel real pain is fine but emotional pain is a bit hard to cope with.

WRT to anorexia, the physical act of self harming means that I am back in control for a while and "Ana" is not.

I also have been known to rty and cut out the bad bis, break fingers so i have something else to concentrate on.

(Sorry just a quick post but i wanted you to have a quick reply as you sounded desperate)

I used to do it as a way of displaying my hurt. Ie. I hurt a lot on the inside, I want the outside to match. At the time, I did not realise this, but it was definitely a subconscious cry for help. Ie. I wanted an outsider to notice my hurt and to help me feel better.

It is only with retrospect that I know this, at the time I was totally oblivious as too wrapped up in the hurt to realise anything else.

I hope things get better again for your daughter.

Things got a lot better for me. I am extremely happy and successful now years down the line. It took my gaining confidence in myself and learning to love 'me', the real me. That started for me with meeting the love of my life and I built on it slowly from there. Now I have to be careful not to be over confident and smug - but I always remember how low I have been.

I suppose I mostly want to know how best to support her, what alternatives there might be for her to try next time whatever it is that kicks off the self harm arises - is it a response to a sudden flood of negative feelings (self-loathing, distress?) or to the absence of feeling anything at all?

I know only she can answer that and that what might be true one day will not necessarily be the case another day but even so, am in the dark.

thank you for the replies, I missed them while stumbling over my own post a bit

the issues around food and depression are not so opaque to me, it's the cutting and burning herself that I don't understand or know how to respond to - other than practically, helping her to clean and patch up (actually all I did was pass things through the bathroom door)

I probably asked too many questions as she has clammed up, suppose it was good that she told me but wish I knew how to react helpfully?

these forums may be a good place to start. I am pretty sure there is a section there for carers - i can't look at it too long at the mo - sorry.

There are lots of things she can do instead depending on her need at that time.

Holding an ice cube onto her skin (feeling pain)
drawing the red marks (visible marks)
Exercise - not so good if she has issues with this anyway
Holding wrists under cold running water...

I wear a hair bobble around my wrist from time to time which i ping if i can feel myself needing to feel something "normal".

It's not always negativity either. When i was really bad i would have a fab night out with friends but punish myself when i got home.

The suicide attempts - for me- came from feeling so worthless that there was literally no point in me being around.

I wonder if she can be helped to accept and use another, less destructive way, to show/release the pain inside.

And work on the pain inside, change how she feels about the world and herself so she does not have the pain/hurt/anger... whatever bad feelings she has.

That is where I would start. But, I don't know your daughter.

Personally I find this information helpful.

I SH to a very limited extend (using my nails rather than sharp implements and I do it either to move huge pain from the inside to the outside to make it somehow more managable (ie during really awful flashbacks, memorably when being raped (in my head) during a bible study group)

or because I feel so dissociated and far away from everything that I do it to feel something and stay with it.

In both cases it helps if someone I trust/who knows holds me/my hand.

sorry i x posted then!

Her being able to tell you she has done it is actually a HUGE thing. She needs to feel that it's ok to feel like that.

Does she dance? Do art? or anything?
Immersing herself in that may help her.
In the meantime, a stocked first aid cupboard and sympathy i think.

SOrry i can't be more helpful.

kentuckyfriedpenguin : I am not deliberately regurgitation aspects of your good advice; I keep adding mine, then seeing yours!

lol i was about to say the same to you!

It appears that we see the same type of solutions; they are just so difficult to achieve in real life. Importantly for me, they are completely do able as I am full blown proof.

It is very hard to change your whole world and whole perspective of it and yourself though.

Just a thought OP, but she may know why she does it, but is too ashamed to admit the reason. Or, it may be that the reason is subconscious. Or she may deny the reason even to herself.

I was a self harmer from the age of 13-18, as others have said its a way of letting out pain (feelings inside).

A friend of mine was told to put an elastic band around her wrist and to pull it (twang it) when she felt the need to harm herself, so she could still cause the pain but without scaring her arms and causing infection.

I had no help for my self harming, my parents just used to tell me off as they thought i was doing it for attention. The last time i self harmed i went too far, i badly cut my arm with glass and really scared my best friend (who was with me).

I hope she manages to get the help she needs, it sounds like she has a great understanding Mum to support her.

It helps more, i think, to hear real life examples. It normalises it.

thank you for all your thoughts and links, will digest them in a bit

had forgotten about RYL, can't go there in case I recognise her (it's a site she has used in the past) - hope she feels the same way about mumsnet

I run a site for people with bipolar, and some have a diagnosis of borderline too - I know self harm doesn't automatically equal a personality disorder - but I feel the same sort of barrier, it's a very different sort of experience. It frustrates me that I find it so hard to put myself in those shoes and understand, as much as I am moved by the obvious distress I feel helpless and yes, frustrated

will have a look at the safeline link now

I suppose it is a coping strategy for many. Just a very destructive one. Like alcohol, drugs, sex list endless...

For me it was attention seeking and a cry for help, but I did not know that at the time.

The key for me is to minimise the damage and solve the route of the problem. That seems like trying to fly to the moon and back without a rocket, but, with the right support and help, it is achievable, imo.

I SH and for me it is about punishing myself because I can not do something or complete something to my ideal of perfection. An example of this would be me failing at work to understand a task and complete it and would lead to me having to punish myself.

I stopped SH about 3.5 years but have started again because I cant cope with my current situation. The best thing you could do if you were my mum would be to listen not to judge but just be there if you know what I mean. My mum was very harsh to me and it has made me keep it more a secret now because of this.

Hi,
is your 17yo getting any professional help for this? Or would she welcome it if offered? I found having someone outside of the people I saw regularly helpful, as I would listen to their alternative strategies more, as a teen, and perhaps begin to look at the underlying causes of it. Self harm done regularly can become addictive, in the sense that it releases certain hormones/chemicals in the body (I forget the exact reason) and it can be a difficult cycle to break.

Like others have said, not judging or checking would be helpful - and providing things to prevent scarring and infection might help. Such as moisturiser, some people use bio oil, useful dressings, sterile dressings etc. Like you did through the bathroom door.

thanks all

she is just moving from CAMHS to adult services and will be seeing my old consultant psych, which is a bit uncomfortable - she doesn't want me at the appointment though (hope it is not bad to be relieved)

think DBT could be really good for her but not sure if you have to have a diagnosis of personality disorder (for which she is too young)

The fact that she feels she can be honest about the self harm is a good thing really it is x

I can only speak from my own experience, so if this isn't relevent to your daughter I apologise.

When I was a teenager I starved myself to the point that I couldn't walk in a straight line and my periods stopped. I also self harmed with a razor - still have the scars.

I concur with those who have mentioned issues about control etc but I would also like to add that with me their was a definte, identifiable cause to my problems. This was bullying. I was nerdy wierd kid that nobody would speak too. I was taunted, picked on, humiliated and beaten for years but was too ashamed to mention it. My parents were also going through a messy divorce.

I was then put on ADs and sent to various doctors the implication always being that there was something wrong with me. There wasn't. My life was wrong.

It all miraculously cleared up when I went away to uni lol.

I appreciate that I was very lucky in this respect and your daughters problems may be more deep rooted and internal. However, from my own experinece I have come to the conclusion that concentrating on changing the sufferer isn't always the best option, sometimes there are genuine external causes. I think that sometimes get overlooked in the rush to "cure" the patient.

I second Kentucky regarding the fact that she can be honest with you though - I just got accused of being an attention seeking adolescent lol.

Good luck xx

Great she is having some professional help, even though it is someone you know. Surely there is someone else in the team she could see? Rarely is there just one psychiatrist, and from my own training I know that a Dr should not have treated another family member as it can affect their views of another person.

Personality Disorders can be diagnosed once someone is in the adult system, although it can take time for diagnosis - although there are some tests they could do to rule in/out I believe.

DBT may be difficult to access, it is often regular sessions in the day and if going away to study etc they might not want to start something. Does your daughter have her own CPN, because this is someone she could see regularly, many are trained in different types of therapy - such as CBT, CAT, DBT even.

Hope things go well.

For me what helps is having someone to talk to frankly about it.

For example, my mum would get upset by it, and so I couldn't talk to her. Whereas my friend, a fellow self harmer, would just ask how I was feeling and remind me to take care of the cuts. I guess it took the focus from the actual self harming and more onto my feelings, and made me feel like I wasn't being judged.

Distraction is the only thing that worked for me, I registered with a forum for people with self harm and eating disorder problems and would go there and post till the urge passed.

thanks again, I really appreciate all the personal stories for the insights they offer

sadly things have deteriorated a bit (understatement of century) but this might not be a bad thing ultimately, as via A&E (which was via GP, she needed stitches - hope that is not too much information) she got to see a different psychiatrist and is muddling through with lorazepam and our spectacularly unhelpful crisis team until her appointment with my old consultant tomorrow

(the awful thing is dearth of adolescent beds locally and probably nationally, and at 17 think she is too vulnerable for an adult acute ward, knowing firsthand what they are like)

will see what he thinks about treating her, I don't have to see him any more so it might not be relevant