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 think continuing to be there for her is going to be most important. You sound like a great parent.

Unlikely there will be a referral to CAMHS given she's 17 and would likely still be on the waiting list when she turns 18 so will be discharged from childrens services.

When you talk about going back to the therapist, do you tell her she needs to go because you're worried and although she's 17 you can't sit back and not help?

Sounds really tough OP.

www.youngminds.org.uk/parent/parents-a-z-mental-health-guide/self-harm/

Have a read of this - you might find it helpful.
DS self harmed, badly, for several years but his mental health has stabilised lately. He says it is a coping strategy. I try and encourage more healthy/positive coping strategies. I hate that he vapes and smokes but it's preferable to the horrific self harm.

I wonder what she's looking at online. I also wonder if anything triggered it such as assault or bullying.

I was going to recommend Young Minds and Papryus which are mental health organisations with resources for young people and their families including helplines.

You might also find Side by Side or the National Self Harm Network useful.

I would insist that she carries on with therapy. You might find BACP helpful if she doesn't get on with the therapist. Maybe choose one together and get her involved in the process.

@VastlyDifferent has linked to Young Minds above - ring their parents helpline on Monday for really solid advice.

As a I would with an adult I would get them away from social media/phones and get them out walking. I took my dc'#s phone off them and it was the best decision I ever made

I'm a mental health nurse (I don't work in CAMHS though), and I self-harmed for many many years, which was my inspiration for becoming a nurse!

Self-harm has lots and lots of different functions- self punishment, liking the blood, pain to distract from emotional pain, etc. For me personally it was because I truly hated myself and felt I deserved it, and tbh it also became addicting and some days I did it just because it was part of my routine.

Firstly, a bit like with alcohol, you won't stop someone self-harming unless they're ready to. You're better supporting someone to ensure they use sterile blades/have access to good materials for wound care. There are places that are 'safer' to cut, such as tops of thighs.

That's not to say you can't have a really good conversation with her about self-harm and try and get her to agree to a couple of things. For instance, locking her blades in a box in a locked drawer. The physical barrier gives you more time to think and requires more planning, as self-harm is typically quite impulsive. If you're close, encourage her to come and sit with you until the feeling passes, doing whatever she needs, even if it's just sitting in silence. The thing with self harm is, it happens when your emotions are exceptionally heightened, but your emotions never stay that way forever, they always come back down. You could also do things like encourage her to wait 15 minutes first, then if she still feels she needs to self-harm, she can. There are lots of other things you could encourage her to do first, such as draw on herself in red marker, twang an elastic band, hold some ice, or etc. Different things work for different people. There is also an app called Calm Harm- you can kind of select why you feel like you want to self-harm, and it will suggest activities for you. If she relapses, it's important to let her know she's not a failure and help her to not judge herself, as recovery from self harm is not linear. If I'm feeling very sad, my first thought tbh sometimes is still to SH, but I don't anymore. You totally can recover, so please hold that hope for her. She will probably feel lots of shame, so please keep trying to talk to her about it. Don't shy away from it.

Make it very clear that you are not trying to shame her and that you understand it is a way for her to cope with some probably very difficult feelings. Frame it that you love her and that she is loveable and that her body does not deserve hurting or punishment, which is why you'd like to help her.

I'd also encourage her to write about it after it's happened. Get her to think about her feelings and what led up to it, how she was feeling when it happened, and how she feels after. SH often works initially, but then just makes you feel crappy later on and the endorphins wear off. If she doesn't really know why she self-harms, this might help her insight there and to spot what kind of situations are triggering for her.

Sending you lots of love OP. Self-harm is horrible for the person (it's feels shameful, it's not something we're usually proud of) and it's horrible for families to see someone they love harm themselves like that.

I was a chronic self-harmer, and I made it out the other side. Your daughter can too. I don't feel ashamed anymore. It was there when I needed it, but I don't anymore.

Good luck, and please DM me if you need a listening ear. I'd never judge, as I've been there and I've heard it all at work!

The only link I see is school made her get worse. So, I’d take her back out of school right away while you get to the bottom of this. She is a bright kid and can do school work from home at her own pace or even take a full school year off with no impact to life chances/opportunities.

What sort of therapist did she see? Has she been assessed for ND given her struggle with social situations and making friends AND her inability to verbalise and identify emotions/triggers- this would mean that regular CBT for self harm given by therapists would not work. If she is ND, she would need therapy adjusted to match her ND to help her move from self harm to self care.