Self harming teenager

[GnomeDePlume]

Apologies for this. I just need to write this down.

I am starting to think of the self-harm as being a parasite, like threadworms or head lice. It isnt the person, it is something feeding off the host teenager. Also, it is contagious.

And like thread worms or head lice it is extremely unlikely to clear up on its own.

My DD first started self harming about 2 years ago when she was 13. This outbreak was apparently in response to a difficult, bullying friendship. It was apparently just a week of scratching and cutting herself with scissors.

We reacted by surrounding DD with love and tried to help her build her confidence and distance herself from this bullying friendship. It seemed that the problem was solved.

Then about 6 months ago I noticed marks on DD's legs. Not cuts this time. I asked DD about them and got brushed off. I wasnt sure what the problem was but I was fairly sure it wasnt totally innocent. At the same time DD was 15 so I didnt feel in a position to force her to get help except in the practical sense of going to see the nurse to make sure that the marks on her legs were healing.

DD started leaving her legs exposed but was now covering her arms. Once or twice she would not cover up completely and I would see a mark. I asked her about these marks and would get brushed off.

Fast forward to yesterday. DD came downstairs with vomit on her clothes. In the early hours she had taken a shed load of paracetamol and other over the counter tablets. She was vomiting, feeling very ill. On medical advice (we are literally round the corner from our doctor who DH saw within 5 minutes) DH took DD to A&E. DD is now in hospital receiving treatment to protect her liver while the tablets work through.

Now looking back I can see that we made the mistake of thinking that the initial self harming would cure itself. It didnt and I wonder if our treatment made the problem worse by both rewarding the self harm and also pushing it out of sight. We didnt talk about the self harm, we wanted DD to focus on what we saw as the cause.

This was our mistake. We should have got help immediately for that first outbreak. Now the infection of self harm is worse. DD is older so her self harm has got more sophisticated. What a mess this is. We didnt do enough. We didnt take this seriously enough. Because of that DD has risked her life.

I spoke to the nurse in the children's ward where DD has been admitted. They see half a dozen or more self harm patients a week. So there are probably hundreds of families going through this today. If you are one of them you have my heartfelt sympathy.

My DD has been self harming. Have found CAMHS beyond useless. DD took herself to GP in the summer because she wanted help. CAMHS took ten weeks to assess and then offered group therapy for six consecutive weeks which would have meant missing half a day a week of school which would have had a negative impact. Meanwhile DD could have escalated to an overdose. When I asked fir a private referral I was told to find someone off the internet.

What CAMHS offered dd was so inappropriate and inaccessible they have breached my trust and confidence in their professionalism. Fortunately gp has helped with a private referral now and if dd needs more we will go the Priory route.

So sorry you are going through this too. What the thought dd would tell her classmates about her disappearance every week is beyond me. How they thought falling behind in a key A'Level would help her is beyond me. All I can say is that where we live the CAMHS service is just not fit for purpose.

I am sorry you are going through this as well ripeningapples.

We have found CAMHS a bit hit and miss. The individual CBT DD has received has been helpful I think. The group stuff has been too much of a 'one size fits all'. There was a session yesterday for both parents and young people which seemed to focus to a huge extent on social media. Relevant to some but not to others. A bit of a waste of time for us and that was the only session offered to parents.

DD has now been referred to a psychiatrist to look at the possibility of prescribing ADs.

On the plus side we are talking about it more. I think that the elephant in the room is getting addressed a bit more.

We're going through this too. DD (15) is self-harming again. Last I heard of it was a year ago, but she has really messed up her arm with cuts. She hid it from me, but it was discovered at school and she has said they are going to call me. She doesn't seem noticeably depressed, and the self-harm seems to be in response to anxiety and to control panic attacks. She is seeing a counsellor at school and has been for a while, but I'm not sure whether to seek further professional help or whether this counselling is enough.
GnomeDePlume you say you had regrets about how you handled your DD's self-harm, what would you advise? My instinct is to try not to overreact and to not overly focus on the self harm, but just to support DD to manage her stress levels. But I don't want to under-react either.

MajesticWhine how does your DD feel about the counselling? Does she feel it is helping? Not all counsellors work for everyone. I think that there is a tendency to prescribe counselling but just like with antibiotics not all counsellors are right for all problems.

Let your DD know that she can say if the counselling isnt working for her. There is a lot of pressure on teenagers to conform and just accept what they are issued with by the adults around them. At 15 (same age as my DD) your DD may not yet feel confidant to say 'this isnt working for me' especially if it seems like everyone around her is telling her 'this is the cure'.

Obviously I dont know you or your DD but for us I think that we were too worried about setting DD off on a spiral of increasing the scale of the self-harm. This time we have talked to DD as soon as we saw it starting again.

My feel is that this isnt something which is cured more that each outbreak has to be tackled.

We are taking more of the head lice approach. The outbreak of self harm is an absolute. Just like with head lice. Each outbreak has to be treated.

With what I know now I would look to get more help if it is possible.

She is happy with the counsellor. She has seen her for well over a year though, and the self-harm has come and gone and come back in that time. So I guess counselling is fulfilling a supportive role that is not doing any harm, rather than actually having any impact on the symptoms. A bit like combing through for nits without quite getting rid of them all, to use your analogy. I will talk to DD some more and make it clear that we could get different help if she wants to. Thanks.
I hope things improve for your DD. I would be interested to hear what the psychiatrist says.

I find the head lice analogy strangely comforting. I didnt fail as a parent if my DCs got head lice. I do think that self harm is a parasite therefore I have not failed as a parent if my DCs self harm. I have only failed when I havent treated it.

I'm probably deluding myself!

The headlice analogy sort of works for me. I used to be on red alert for them so nothing took hold. I feel I need a toolkit to help dd but it's hard to access.

DD has her first counselling session on Friday. I have had a 1.5 hr briefing with said counsellor. Have also contacted Young Minds who have escalated me to next tier support which is a 50 minute phone call to support me to support her.

Meanwhile I have made a formal complaint about CAMHS and shall escalate to my MP if necessary. I dread to think what happens to young people in my area whose parents can't fight their corner or who don't have the means to pay privately for their care.

I'm not sure if I'm more upset about ed's mental health ir the fact that services who are supposed to help have been so spectacularly unhelpful.

I'm another one who has effectively given up on CAMHs - endless waiting and then insufficient support and a completely inappropriate counselling offer which only served to make things worse. Currently waiting to hear about their next offer, but fear it will be a group therapy CBT session which will take place during the school day. DD will hate the group approach and get stressed about missing school. I have been fortunate enough to find, and just about manage to afford, a good private counsellor which does seem to be helping and I am likely to stick with this rather than go with CAMHs. This counsellor seems to be combining exploration of the issues that DD has, with practical suggestions for managing her anxiety. She is also I think giving DD a sense of having control about what is done with and to her, which is important. Picking up on comments earlier in this thread, after two years of on and off self harming I now realise I should have pushed harder for intervention and support at the beginning. Like others, I thought we could deal with it as a "blip" but now realise it is a symptom of quite deep rooted anxiety. Good luck to everyone dealing with this horrid situation (I like the headlice analogy!).

Blimppy our experiences sound similar. We didn't have too long a wait because I was pushing. We were offered CBT therapy during school hours though. Inaccessible, detrimental impact on School performance, which is something she stresses about, not confidential, etc. Just totally inappropriate. So poor that they didn't tell us three months ago that services were only available 9-5.

Worst bit is that dd read up about camhs and went to the gp the day after her gcse's finished. She asked for help all on her own and I am so proud. The gp phoned me straight away to talk to me about it. DD is 16. Paradoxically although gp phoned me before the referral now I have made a formal complaint to CAMHS about the inappropriateness of their offer they have said that they can't investigate without dd's permission because she is 16. They can only share the findings with her permission. I have had to say no because this will stress her further. Seems a bit of a closed shop. Not much thought seems to be given to the needs of the vulnerable teenager.

Two GPs have now said CAMHS is hopeless and their is a problem here. Yet there is no signposting to accessible private services with help for parents who are lay people and inexperienced in the mental health field. It is neither helpful nor joined up. The NHS cannot or will not provide a service yet there is no support in relation to the alternatives. In my area there are 419 BACP counsellors. How on earth Am I supposed to navigate who is and isn't the best or even good enough. Fortunately the lively doctor at the practice recommended someone. But why should it be so hard when the mental health of one's teenager is so important? I feel in need of counselling just from trying to navigate this let alone the fact there must be something dreadfully wrong with my parenting if my DD has to harm herself - or she may have an underlying serious medical condition re her mental health. Not that any of the professionals seem to care.

Anyway I have made an appointment now to see our local MP about how bad the CAMHS service is and the lack of responsiveness amongst those surrounding it who one would hope would be more helpful.

Feeling very distraught that my DD has been so failed and my powerlessness to deal with this. I can pay privately but I should be able to seek advice to ensure what is put in place is tried and tested and a,safe pair of hands.

Even BUPA don't have recommendations vis a vis panels of assessed counsellors. It's DIY or go the,whole Priory route which seems like over kill. If the first line counsellor doesn't work though that's what we will have to do. There is just so little sound advice out there and I can't understand why. I honestly feel that if I didn't have to keep going for dd then this could drive me to doing something to stop the awfulness of it all. I have never in my adult life felt so stressed and powerless.

Ripeningapples, there are certain types of professionals who I think are better placed to work with teenagers and to work with self harm. You probably know all this, but Clinical psychologists will have received training with children and young people. Some of them go on to specialise in child / adolescent mental health, so they would obviously be the best to go for. Expensive though. Other types of counsellors / psychotherapists, even if they are accredited with a reputable body (one of UKCP, BACP, BABCP), do not necessarily have the right skills to work with teens, unless they have done a specific training in working with children. You can ask them, or check their website. Also, in terms of the type of therapy, my personal opinion is that CBT is more helpful in this situation (i.e. self-harm in teens) than other approaches.

It can be quite hard to identify the right person and sometimes you have to meet several.

Thanks for responding. Awake again in the small hours sick with worry.

I understand all that you say. I don't understand why, when the nhs/camhs for which we all pay claims not to have the resources to help our young people, cannot provide more support and sign posting to ensure our young people can access appropriately trained support. Surely this would provide safe care as an intervention to prevent escalation, ensure resources are used for those who need them most whilst ensuring the right care for all.

It's a minefield for the uninitiated and seems an area where no help is available. I guess if the counsellor isn't right for dd (and I thought she was lovely) then the only alternative will be a full psychiatric assessment with the Priory but I've heard variable things about them.

Young Minds haven't called me yet.

Should have been clear that dd was offered group therapy by CAMHS, not individual CBT.

Blimppy we were in exactly the same situation with group therapy offered in the school day. Same day fir six weeks. A'Level tuition missed. DD didn't want to miss school. The person who assessed her knew she was starting a new school and that some of her worries centred around having been unhappy at school. I am baffled that any sensible person attuned to the needs of my daughter could have thought it appropriate. The offer didn't take my daughter's needs into account.

Ripeningapples I think that some of the problem is that the first response is very much a 'one size fits all'. It is cheaper that way and does mean that it looks like the problem is being dealt with.

I was at a parents' workshop last week. On the whole very unhelpful. Lots of focus on how to handle 'bad' behaviour (eg taking away smart phone and replacing it with a brick, grounding etc). Also how to deal with social media problems.

None of which is helpful if your teen is essentially well behaved and the 'only' problem is the self-harm.

One thing CAMHS did say was to keep going back if the first (second, third) response doesnt help.

My DD is getting individual CBT through CAMHS. She has also had a referral to a psychiatrist. Possibly it helps that her referral was a crisis one from the hospital.

So keep going back and saying that what is being offered is entirely inappropriate.

Thanks for responding gnome. I get the impression that because we have turned down their offer there is nothing to follow. Hoping the counsellor will be able to support her.

What makes me so cross is the inappropriateness of the offer on so many levels. Combined with the facts that it was offered after an assessment and just means my daughter's needs haven't been considered at all. Whether it's a resource or competence issue I don't know but it means I have no confidence in the next level up.

I'm really sorry your daughter escalated. That must have been awful. I'm feeling very worn down as a parent at the moment especially as dd doesn't want dh to know so I'm handling it on my own.

She had her first session with the counsellor tonight. I thought the counsellor was lovely when I spent 1.5 hours with her last week but a little voice did say to me I thought she might be too middle aged and mumsy for dd. DD says she didn't connect and doesn't know if she wants to go again.

So, CAMHS were hopeless, GP recommended counsellor hasn't worked out. Young Minds called tonight to arrange a convenient time but I missed the call.

Am feeling at a bit of a loss to be honest. Have tried to talk to dd but she's just being snippy and awkward with me. What to do?

I guess it's the Priory. What more can I do? Such a failure as a parent.

Do you have a YMCA near you? Our local one has a counselling service attached - and they are used to/mainly deal with young people.

ripeningapples sorry to hear that. Maybe it's a good thing that your DD was able to say she is not sure about the counsellor, disappointing though it is. Better than her continuing to attend and getting nowhere. Maybe she can have a think about it and decide herself whether to go back or not, or what she wants to happen next. Please don't think you're a failure. We can only do our best as parents and none of this is your fault.

We do have something called Heads Together. My understanding is that the counsellors there are building up their accredited hours to qualify and that it can be hit and miss. It worries me that dd could come into contact with youngsters who are very vulnerable indeed in that environment and be stressed further. Could only access the Saturday morning ones and a good drive away. I might give them a ring.

Young Minds phoned last night to arrange a time to talk but missed the call.

Have told dd that I want her to see the counsellor next week for my sake so that at least I feel I am doing something

Will get in touch with The Priory next week as seem to be running out of options.

I went through something similar when I was 18-19; a very close friend of mine did too, when he was 13-14. There is light at the end.

ripening - what do you know about the Priory? Do you know if you could you get an nhs referral or would it be private? I am going to look into this too.

My DD cuts herself. Does anyone have any views on removing scissors / razors / knives from the home environment or setting up a "no harm contract". I'm googling a lot of help at the moment and find conflicting advice on this.

On the plus side, removing them means they have to think twice about self-harm if the normal thing they use is not available, and maybe could give them the time to overcome the urge or try another strategy. On the downside it is not very practical to remove or hide everything from the house and maybe it is taking away their only sense of control. Or they will just find something else to use. Any thoughts?

If you end up with SS involvement or CAHMS agree a safety plan it will involve all knives being locked away, and similar for tablets.

As far as I am aware the Priory is only available privately. My only issue with the Priory is that I've heard it goes into overdrive vis a vis diagnosing other issues if there's a hint of something there and actively looks for that hint.

What exactly do you mean mummytime. As far as dd is concerned, at present CAMHS can't be arsed to offer her anything remotely adequate so a safety plan seems a zillion miles away.

I'm just telling you the procedure if you ever get that far (which pretty much means you've had a suicide attempt). So yes locking knives away is a reasonable thing.

It is tragic that often life has to be threatened before anything is done.

I know a young person who went to the doctors and asked for help, they put them on the waiting list for counselling. Before they had any hope of getting counselling they had already had a suicide attempt.