How do you discipline a teen who self harm's?

[Heather2000]

Hi, my daughter is 14. She's autistic, has high anxiety, and we've discovered she self harms. She was placed under CAMHS, but they said she wasn't a severe case. She was seeing the school counsellor, but stopped going. She has another counsellor who she currently sees once a week.
She used to be the sweetest, funniest, kindest girl, really affectionate, and we were a close family. It's me, my husband, her and her younger brother. When she went back into school after lockdown the anxiety started, she started seeing the school counsellor who said she was autistic.
Over the last year she's withdrawn from family life. I put dinner on the table and she picks her plate up and takes it to her room. She doesn't want to watch a movie or play a game, she doesn't want to come on family days out. We had a family holiday booked for later this year but now I'm going with our son and my husband is staying behind with her.
I don't know what triggers the self harming, but I think it's mostly school anxiety. Little things she says about the noise, why don't people say what they mean, having to wait for other people's reactions in conversation because she doesn't get jokes and sarcasm. I think she's masking all day in school, then comes home and has 'post restraint collapse,' and needs time alone to recharge. So I understand that if she's been dealing with people all day in school that she needs time and space alone in the evening.
What's really upsetting is the way she speaks to me. She hates me. She's apparently moving out on her 18th birthday. I bought her a jumper she wanted, it arrived yesterday. She was out with her friends (she has a lovely group of friends and a lovely girlfriend, they've been dating for I think about 8 months, not that she tells me anything!) I put the jumper outside her room (I'm not allowed in) for her to check she was happy with it, before I removed the tags and washed it. My husband picked her up from her friends yesterday evening and she went straight upstairs to her room without speaking to anyone. I left it a bit, then took her a cup of tea. She opened the bedroom door and reached for the mug. I saw fresh cuts on her hands, she must have just done them. She took the mug and shut the door without speaking to me. This morning she's just walked into my room with her new jumper, dropped it on my bed and said 'I thought you would have washed it,' in her usual hostile voice (she never used to speak like that) and walked out.
I know she likes clothes to be washed before she wears them, but I like to make sure she's happy with them before I do that, as then I can't return them if they're wrong. She won't try clothes on in shops. I'd like her to say 'thanks for the jumper mum, I love it. Please could you wash it?' or even better wash it herself as she's perfectly capable!
But I'm so scared of causing her to self harm that I let her speak to me like this. I don't ask her to do any chores around the house at all. She send me a WhatsApp saying what she wants for dinner, she doesn't eat the same as the rest of us so I have to cook different meals. She won't cook for herself as she doesn't have time,' she always has too much homework. She's a good cook, I've always cooked from scratch and used to get them both to help. Because I can't ask her to do any chores I then don't ask her brother to as it isn't fair. So for the last year they've barely lifted a finger, not even emptying the dishwasher, making a sandwich or anything.
Every article I read about self harming talks about supporting them, why they're doing it etc. I can't find anything that tells me how to discipline her. How do I say 'That was rude, don't speak to me like that,' when she'll go and cut herself? So I'm basically a doormat, a scratching post, and I can't stand up for myself for fear of what she'll do. A few months ago I asked her to dust the living room, which she used to do as her weekly job (takes less than 10 minutes!) She gave me back a mouthful of attitude and I told her not to speak to me that way, she was being unfair and unreasonable. I did raise my voice. She came downstairs later looking like something from a horror film and we had to go to A+E. We were in the hospital for 21 hours, from A+E to the pediatric ward. The counsellor there was trying to get her to see that she lives in a house with other people and everyone has to contribute to the running of the house, but she refused to agree to any compromise.
I can't risk another A+E trip now, I think we'd be waiting there 3 days to see anyone! And I don't want my beautiful girl to have permanent scars because I asked her to empty the dishwasher. She's doing brilliantly at school, her reports are all excellent. She has a lovely group of supportive friends. It's just at home she's awful. She's terrible to family members as well, just puts noise cancelling headphones on and blanks them. I kept secretly crying in the loo Christmas day as it was so different to every Christmas before, I'm constantly apologising to family for her behaviour.
I don't know what to do. It's not fair on my son, he's 12 and sees his sister talk to us like dirt, she's horrible to him as well. I don't know what to do. I'm crying every day, I feel so lost. A year ago I never could have imagined our family being in this situation.
Does anyone have any ideas on how I can approach her about her rude way of speaking and her attitude to the family? I'll email her counsellor tomorrow, maybe they can bring it up with her. I don't know what to do. Please don't suggest taking away her phone and laptop, school homework is all apps and websites, plus she streams music to sleep and has study WhatsApp groups with her friends. I'd love to take it all away and see if she comes back to us, but I don't think it's realistic. Maybe in summer after her mocks!
Sorry for how long this is, it's all bottled up inside!

Mindreframed is the site x

Good lord I was a lot like your daughter OP. If it’s any consolation I bitterly regret my attitude and I am so pink and fluffy now. I grew out of most of it and now have wonderful relationships.

This.

DD is waiting for the intial consulation for ASD and ADHD, long waiting list.

She is seeing a therapist for anxiety since May last year. We always have a 10 minutes joined session and always are talking about how to put strategies in place. Some sessions are fully joined for practical reasons so we know what DD learns to deal with her attacks.

I would see if you can choose a different therapist. I would also make clear that a certain behaviour is required, we just had a long talk about the fact that DD can't understand why we see some behaviour as rude, she is simple not able to make a connection. We insist on joint meals, DD doesn't eat when stressed and lost so much weight, we have to monitor her food.

"Normal" discipline never worked, neither positive nor negative consequences unless it's really related to a specific incident.

Still trying to figure out how to reply on here!

@Soontobe60 it certainly wasn't a surprise. I asked when she was at preschool if I had any cause for concern, and I was told no, she has eye contact, she's verbal, she's hit all her milestones. I asked again in primary school as she was averse to strong smells, strong tastes, loud noises, had issues with labels in clothes, itchy clothes etc. Again, I was told she was fine, beyond fine. Frequently doing work of a year or even two years above, best behaved child in class, teachers loved her. I kept digging and found the term 'highly sensitive person,' which described basically how my daughter presented. So I bought the books, read the articles and went with that. After the school counsellor suggested autism I had a long conversation with a friend who's a speech and language therapist for non- verbal children. She sent me loads of info about masking and how autism presents in teenage girls. I sat down with my daughter (she still talked to me then!) and we went through the articles. She told me things I didn't know, like she packs and repacks her schoolbag multiple times per evening as she's terrified of forgetting something and being in trouble. She had most of the traits if autism, except she has eye contact. The school counsellor said the old term for it would be 'high functioning,' but said no-one uses that now.
We went to our GP with the evidence last March and are at the start of the referral process. But 3 professionals have said autism, and my daughter agrees. Autism certainly wasn't a bolt out of the blue.

@Cyberworrier thank you, I'll have a look!

@orangegato no regrets, I bet your loved ones are just delighted to have you back. I know I'd forgive and forget the last year of pain in a heartbeat. I'm glad you're in a better place now.

@reluctantbrit Yes, long waiting lists here too!

I think she's been 'unmasking' at home, and doesn't realise that we now perceive some things as rude. I think I'd going to have to start gently asking her to use a different tone of voice and phrasing when she's speaking to me. She eats small portions of very specific foods, I have 14 meals that I cycle through for her, She eats more when she eats alone so I'm fine with that, although I miss her at the table. (I have checked outside her bedroom window to make sure she's definitely eating as well!)

My dd is like this but she won't engage with any counsellors. CAMHS have signed her off .

@duvet thank you so much. I'm glad things are getting a little better with yours! It's encouraging to hear!

@bellac11 I think you could be right about boundaries, maybe she's trying to see how far she can push it, so I need to push back a teeny, tiny bit if she's being rude.

@AutumnIsMyFavouriteSeason I'm so sorry, I hope yours is doing better with her food intake now. It was actually about 6 months after her 13th birthday that things started to go sideways! So maybe that means in a few months it'll start getting better?! I can hope!
I'm so glad you're able to hug your daughter and hold her hand. I'm not allowed near mine anymore. The poor dog gets a lot of random hugs from me now!

@Januarysux I'm so sorry that you're going through this as well. I think riding it out is the only way. 'The only way out is through,' a friend of mine says. Best of luck xxx

@genericeric5 that's really kind of you, thank you so much x

Ross Greene The Explosive Child

• the B team FB group for support in learning the method.

He also has useful talks on youtube and a podcast. I find the podcast more relateable, although the book has examples, the podcast has real life stories with people making mistakes and the hosts help them through that. The book is a bit scripted/perfect.

That was not meant to be a bullet point, I typed a +

@ittakes2 Thank you, I'll look everything up! I definitely think I'm the scratching post because previously we were so close. I think (hope) she knows deep down that I'll always be there no matter how horrible she is to me. I'm the soft landing. She can take it out on me and I won't give up or stop loving her. So I guess it's a compliment really...?! But I think the boundaries need to start coming back. I always give her a few hours alone after school to decompress, but after that we need to see manners making a return!

I am just writing now so that I get the updates as I could have written your post. I'm at work now but will answer properly later although maybe not with advice, but with understanding and an equal need to find some sort of help with this

@BringBackCoffeeCreams Thank you, I'm so sorry that you went through that but I'm glad to hear you're all out the other side. There's hope!

@handmademitlove she definitely has always had sensory issues. Once we were heading on a family day out, that she'd requested to a place she had chosen. Whether from overexcitement or what I don't know, but all of her clothes were 'itchy,' there was nothing she could wear comfortably. So I suggested she just put her pyjamas back on and we went out like that. She was 12, and she's tall so looks older, but I don't care. She had a good day out and that's all that matters!

School is definitely overwhelming, and it's the first year of GCSE so the pressures really on now.

@AngelsWithSilverWings I am so, so sorry for everything that you're going through. CAMHS were very quick with us, 3 days between hospital and a phone call, then a counsellor assigned two weeks later and the first visit the following week. In theory we get 8 sessions but she said in reality they see the young person for as long as is needed. I hope they can get someone to you quickly. Performing poorly in school seemed to be a huge deal to ours, the fact that my daughter is doing well is one of the reasons they deemed her as not a severe case, so by that reasoning you ARE a severe case! I really hope you get some support soon. Hugs xxx

I don't have much to add, other than to say you're not alone.

I have a DD14 diagnosed ADHD and ASD. We have the same issues regarding being asked to do what would be normal basic requirements for most teens resulting in self harm or threats of harm.

We too walk on eggshells trying to keep the very fine balance of some level of parenting whilst also trying to keep her safe.

As I said, I don't have much to add other than I know exactly what you are going through and how hard it is. Some posts on here saying things have improved for them or their children as they got older give me a little bit of hope. We all just need to hang in there.

My DD really struggled with family life for a long time. She felt the weight of expectation that she would join in with conversation and that she was expected to 'act normal'. But she struggles with processing and so following conversation with more than one person is hard, the sound of people chewing would make her ears hurt, the smell of food was too much .. almost every meal ended with her storming off. So we took the pressure off as much as possible. She could cope one to one but not with anything more. She could manage to be outside her comfort zone if everything else was calm, but if she was stressed then everything grated and her senses overloaded. Stripping life right back helped. Having a proper conversation with school about how much the school environment contributed to this helped. Routine / familiarity / low sensory stimulation helped.

yes, the unmasking is a big thing here as well. It is amazing how much came out since she started therapy and in some cases it got worse but it means, she is more honest with us.

I do hate it every now and then and it is definitely causing health problems for me (stress related insomnia, stomach ache and I gain weight as I am a stress eater).

DD is sitting GCSEs this Summer and I just applied for 4 weeks parental leave as I can't face the stress of it plus concentrating on work.

Op i dont have answers but I have a younger child who is autistic and speaks incr3dibly rudely when stressed or when asked to do anything she doesnt want to do. I feel fir you as I know how it feels to be frightened of your own childs reactions...too scared if the fall out to be strict or to push back at them.

I also bave been searching for answers

A psychologist friend used a good phrase when i asked her advice. She said my daughter is using aggressive and rude language as a tool...and the tool is working for her...so when she is stressed or over stimulated she speaks like that and people back off ..or they understand immediately that she is 'fizzy' or in the red zone or whatever language you use

So the aim is to hekp the child communicate their sensory overwhelm or distress in a different way.

Have you considered removing her from school? I just know a lot of autistic girls fall apart at secondary age. Essentially your daughter has as you say...severe mental health probkems and perhaps getting her to do chores is asking too much of her after she masks all day.

Ine thing i have found very helpful is connecting to other families of autistic children. Dont wait for the diagnosis.

I can so relate to this. My daughter who has just turned 15 was diagnosed with ADHD and ASD only last year after years of being told her struggles were to do with early years hearing loss and slow processing disorder. She's on medication for the adhd to help with her concentration but that's all the help we've had. Her private Dr said she really needs CBT to help manage her emotions and OT for help in things like time management and to help her become more independent as she grows up. She has self harmed and does so out of frustration it seems and anger at herself after a meltdown, but only very infrequently. The gp referred her to CAMHS who set me some very basic leaflets on Autism and that was it. I've spent thousands on the assessments and medication up to this point so can't afford anymore to go privately but will have to find a way as I'm so worried that as she gets older her behaviour will be less tolerated by others. Like your daughter op, mine is doing well in terms of managing her behaviour at school to a point, but then it all comes out at home. It would appear however that the defiance is creeping in at school now too, just this year, and I'm really at a loss with how to help her at the moment. We've applied for an EHCP as the gp said this would get her the help.she needs, but of course this got turned down just before Christmas.

What we have found to help so far is:-

Within reason and as healthily as we can we let her have some input into the evening meal so she feels she has a choice. She is quite limited in what she will eat but luckily she loves rice, chicken, green veg, eggs, cheese, spaghetti, and mince, so a lot of meals are adapted around that for her. She's suddenly gone off anything with shells though so baked beans, peas and sweetcorn are out for now!

When she comes home from school she can go to her room, listen to music, watch her TV or whatever else she needs to do to decompress. Usually for around 45 minutes

We give her time to process any requests to do chores and she is only asked to do 1 thing at a time.

She has a to do list in a morning with timers used (which she sets) to help her stay on task

When she is rude or nasty I try (& it's hard) not to react at the time, but to say we will talk about this in a few moments and I have to leave her to it. When she's calmed herself down then I talk to her. I've had so many instances though where its a battle of wills but like you I'm scared sometimes of how loud she's going to shout or if it's going to result in her self harming. She has admitted though (& it's been a real breakthrough) that when she's overwhelmed and stressed she likes to hurt people's feelings so that they can feel the same as her in that moment, she wants the fight as it gives her a reason in her mind to kick off and therefore vent it all out. So she purposely antagonises sometimes and I wonder if your daughter maybe has the same mindset?

As you can see I don't have the answers either but I'm glad you started this thread as there's some good information on here, and for me, its a comfort to know I' not alone in this