Self harm can be a scary topic for adults , children and teenagers. It is often something that is very difficult to talk about and can bring up feelings of shame and can have some stigma attached. It is important to remember that self harm can often be a learned coping strategy to cope with feelings or overwhelm and/or to deliberately cause oneself harm or pain.
Often people do not know exactly why they are self harming and it can be distressing to be asked WHY when they do not know why. Sometimes life can feel so overwhelming, and self-harm becomes a coping strategy that is developed. It is really important that counsellors and psychological wellbeing practitioners do not judge or make assumptions , and that we are always taking this seriously. In some cases self harm can be linked to suicidal thoughts and ideation, so it is important we take time to check this out with the young person.
If we can help a young person feel safe and able to regulate their emotions in a way in which they are not causing themselves pain and are putting themself in danger, we can then begin to explore gently with them what has led them to self harm and build in other ways for them to cope.
How I explore this in the counselling room :
I find that when I am working with young people , using the YP CORE form can be a good starting point to explore thoughts of self harm. If for example a young person were to answer that they “sometimes” had thoughts of wanting to hurt themselves – I would gently explore this but let them know that they didn’t need to share anything if they didn’t want to. If they were comfortable talking about self harm thoughts and if they had done so recently, I would ask them if they could show me where they had cut and if they were able to look after the wound. It is also key that we ask if anyone else knows about this.
Alternatives to Self Harm
Trying to delay the self harm - when the thought comes into the mind, trying to put it off for five minutes . Encourage them to set a timer on their phone initially for five minutes and then gradually increase this to six minutes, seven minutes.
Find a ways to physically get rid of some of that tension ,
Use a stress ball
Hitting a cushion
Screaming loudly
Squeezing an ice cube.
Putting an elastic band around their write and pinging it when they feel the urge to self harm
Going for a run/walk/cycle.
*Using a red marker pen , encourage the teenager to draw on the area they would cut themselves.
Creating a Safety Plan
Creating a safety plan can be another way to delay a young person acting on thoughts of self harm , as it allows them to pause and follow through steps before they self harm.
This can be something that can be a shared experience for you and your teenager and you can make it as creative as you like, using different colours or materials or it can be a checklist done on a computer.
Safety Box
Depending of the severity of the self harm, it may be useful to create a safety box. This could be filled with items such as plasters, clean blades, antiseptic wipes, bandages.
Try putting the items you would self- harm with in a difficult to access safe place or in a box with sellotape around it. It gives you time to think about self-harming.
If you are concerned about a young person- encourage them to speak to their GP or a trusted adult. It’s also important we acknowledge the difficulty in sharing what they have with us.
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