Managing self-harming with counselling and support

Recently released figures for the south-east of England show the number of young people who need support with self-harm is increasing. Recent NHS data indicated a 51% rise in 11-18 year olds self-harming. Self-Harm UK estimates around 13% of young people aged 11-16 will try to harm themselves at some point, and suggest that this figure could be even higher. Help for self-harm is available, but the longer the habit persists, the more difficult it becomes to break the pattern and stop.

Self-harm includes a range of behaviours, from the well-known signs such as cutting or burning with cigarettes to lesser recognised acts such as picking at skin or hair, scratching, or punching hard objects. Self-harm is any behaviour designed to hurt yourself. It can be a form of self-punishment or a way of trying to manage painful feelings.

Treatment for self-harm

Someone self-harming may have strong feelings of shame which leads them to conceal it. They could be struggling with an underlying condition such as:

  • Depression
  • Anxiety
  • Anorexia
  • Body dysmorphia
  • Obsessive compulsive disorder
  • Substance abuse
  • Low self-esteem

In working out the best approach to treatment for self-harm it is important to understand the motivation behind it. It may be to signal distress, for example, an attempt to cope with the emotions involved in the onset of depression, or possibly a cry for help because of ongoing abuse. Sometimes an attempt may signify serious suicidal intent and it is always important for the thinking behind it and intent to be explored and understood.

There is help for self-harm. This may involve outpatient visits for sessions with a psychologist or a psychotherapist. If an act had serious suicidal intent then inpatient treatment or intensive community support may be required. This would then encompass a combination of group and private therapy sessions with a psychologist, and can also involve family sessions, talking therapies, or medication. Most self-harm acts are not failed suicide attempts.

Repeated self-harm can become like an addiction. Dialectical behavioural therapy (DBT) may be appropriate for those who have recurrent episodes of self-harm and require a psychological intervention. DBT is a form of cognitive behavioural therapy that focuses on impulse control and managing emotions by providing a person with skills to help them cope (the skills' four elements are: mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness skills). A harm-minimisation approach may be useful for young people who self-harm recurrently, this can help manage scarring and help those who feel compelled to self-harm stay safe whilst doing it.

It is crucial to approach someone self-harming empathetically and caringly. Young people are often looking for support and help at this time, but may be scared or ashamed and fear that they will be criticised or punished for self-harming. The likelihood is that they are in intense turmoil when they self-harm. Counselling can help young people to open up and deal with their issues in a healthier fashion.

Self-harm guidance for parents

Parents of a young person who self-harms can be confused and frightened. You may struggle to understand why your child is doing it, and wonder whether there is anything you could have done to stop it.

Don't panic.

In most cases while it may indicate serious distress it is not a suicide attempt. Try to listen to what they are staying and understand what is going on. Don't jump to conclusions. Don't be afraid to ask for help or to take your child for help. It is something that can be addressed together.

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