Self Harm

It is behaviour which is carried out deliberately with the intention to cause harm, or cause pain or cause injury to self. This behaviour can be occasional, frequent, compulsive or repetitive.

It is different from acts which belong to a wider category of behaviours which are self-destructive or which are harmful to self (poor eating, binge-drinking) and does not include eating disorders.

Self-harm is increasingly found among young people- it can begin at Primary School age and it can continue well into adulthood and is often a cause of concern for families.

It gives the individual a situation where s/he is in control and provides them with a way of getting relief. Self-harm is a way for the person to cope with difficult feelings.

It is sometimes viewed as private and shameful but it truth hurts no one else and it is reported to improve mood, release tension and decrease emotional pain. The most common reported forms of self-harm are cutting and paracetamol overdose but this may be overlooking the effects of punching walls and doors which is often done by young males without being properly recognised as self-harm.

It is estimated that less than 15% of those who self-harm end-up in hospital but in spite of this small proportion it remains one of the most common reasons for adolescents presenting at hospitals. In fact about 13% of young people report that they have self-harmed at some point.

Self Harm Risk Factors:

People who self-harm are more likely to have low self-esteem, to be depressed and anxious. They are facing problems in life and may be less good at coping /dealing with them.

  • They probably focus on the emotional reactions to problems.

  • They may not have wide social support, blaming themselves.

  • They may tend to drink, smoke and use more recreation drugs than others of their age: drug use is one of the strongest predictors of self-harm for both males and females.

Certain factors are known to be significantly associated with self-harm, such as socio-economic deprivation, living in care, and a disrupted or disruptive home life. Themes which are known to be associated with self-harm include:

  • Hopelessness

  • Problems with family

  • Depression

  • Guilt

  • Anger

The triggers for self-harm such as abuse, bullying etc. are unlikely to be resolved over-night which means that changing their behaviour can be a slow process. It is possible that self-harm can also turn into an addiction. Therefore it can be a great struggle to stop even if you want to, the same way as it would be for somebody trying to give up smoking or drinking to excess. Individuals may need a great deal of support to move away from using self-harm as a method of coping.

Link between self harm and suicide

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There are links between self-harm and suicide. Most people who self-harm do not become suicidal but more than half of people who attempt suicide have a history of self-harm. Self-harm is very often a coping mechanism, therefore it is very difficult for someone to stop without learning new ways of coping.

Treatment for self harming

There is no single form of treatment which has been found to be always effective in stopping or significantly reducing self-harm among young people, but some interventions do positively affect other factors associated with self-harm in this population, such as depression and emotional control.

Interventions for helping young people who repeatedly self-harm usually have to be available to them for long periods because no one-off or short-term therapy has been found to be effective.

People have said that having someone to talk to who showed understanding and respect was extremely helpful and was an important part of their treatment and care. Many stated that they wished they had had access to such support before they overdosed.

One group of young women said that those professionals with whom they were able to communicate most effectively were non-judgemental and sympathetic.

Many young people have said that being monitored, or having their means of self-harming taken away from them, does not prevent them from self-harming. This is because they often find alternative means, such as not eating, and can feel more distressed because they feel they have lost a means of control and have had responsibility for their own actions taken away from them.

"Safe" ways to self harm

There are “safe” ways to self-harm. There are different behaviours that people can do which give an emotional outlet without causing harm. There are helplines and chat lines which are available for people to talk to in the moment.

It is really important that people recognise the pain and the distress which are causing the people to self-harm and focus on that rather than become distracted by the self-harm: (unless there is an immanent risk to the person’s life in which case this will always need to be prioritised.