What we are going to talk about today is a subject that can be quite confusing and upsetting – self-harm or Non-Suicidal Self Injury (NSSI).
Is there anyone in your family or friends who self-harm?
I know it can de difficult to understand why would our children harm themselves!
Today I would like to give you a short overview of why our young people self-harm, how it happens and what can we do to support them.
I will give you an illustration of the “mechanics” of self-harm, so you can better understand what’s going on in our bodies when we do it.
Do you know when we go to the gym? With every intense movement, we are in fact provoking minuscule injuries in our muscles. This is not self-injury, because the intention is to improve the strength of our muscles. But paradoxically we feel better after exercising. The reason we feel better is that our body releases endorphins when is injured. These endorphins are a “good feeling” group of hormones. We also feel better because we did overcome a challenge and that, once again, releases a feel-good hormone – dopamine. The same mechanism is in place when we drink that last glass of wine, knowing that the next morning we will be struggling, or that second piece of the cake when we are at risk of diabetes.
So, when young people self-harm the same type of hormones are released and they will feel temporary relief.
But relieve from what?
From emotional pain!
This means that self-harm is in fact a secondary symptom. It happens as a coping mechanism to deal with emotional suffering.
If we want to support our children we need to focus on the unmet emotional needs behind self-harm and provide ways for them to learn skills to fulfil these needs in a healthy way.
We all need to live in a safe environment, receive and give attention, feel connected with other human beings, have a sense of control and achievement, have a purpose, etc.
The most valuable thing we can give to our kids is to teach them the skills to fulfil their emotional needs in a healthy way.
Self-harm has a typical cyclic pattern.
Emotional suffering comes from several difficulties: unmet emotional needs, rumination, negative comparison with others, black and white negative thinking, low self-esteem, past trauma and adverse childhood experiences, etc.
When these feelings and thoughts take them to a point of emotional overload and panic, the young person will do anything to make them feel better. They see self-harm as an option or the only option.
In the majority of the cases, the young person is not suicidal. They self-harm as a way to survive, as a way to cope and continue living.
Of course, it happens that they can eventually go too far, and seriously hurt themselves. But,
Essentially, self-harm is a coping mechanism so they can stay alive.
As we have seen before, they feel temporary relief due to the release of certain hormones and because they expect a sense of control, or they can eventually get the individual attention they so desperately need.
In my family, we were a lot of people – 5 children! Not much individual attention was provided, as we were both working parents. My daughter started self-cut when an important person in her life moved to another country. When non-judgemental individual attention was provided she was able to stop immediately and never went back.
This temporary relief vanishes, and it is common for them to feel ashamed.
However, because their emotional needs are still unmet, and the negative thinking continues, the cycle of emotional pain, temporary relief from self-harm and shame can continue. It is a cycle.
How to spot self-harm?
Most of the time there is an element of secrecy around self-harm. So, how can we as parents look for signs of self-harm?
First of all, we need to be aware of when some kind of traumatic event occurred recently or in childhood. We would look for signs of low self-esteem, like putting themselves down, comparing to others negatively, isolation, fear and anxiety, concern about what people think, sadness, demotivation, withdrawing from activities they used to enjoy, etc.
We can also notice if there are some changes in their eating or sleeping patterns, especially if they wake up during the night.
And then, there are more concrete signs, like wearing long-sleeved clothing, need for privacy, too long stays in the bathroom, plasters, knives, razors, disappearing, unexplained bruises, cuts, marks or burns.
So, how can we support our children?
First of all, talk to them. Don’t be afraid to talk to your kids about this. They need your support. And you can support them. Even if you are feeling confused and worried.
Yes, talk to them and when you are talking… mostly listen.
We as parents want to give them solutions, our solutions. We want to protect them. But the more we protect the less prepared they are for the challenges life throws at them.
Now that you know why and how self-harm happens, you can approach your child by showing interest in understanding their point of view and their own particular reasons to do it. And then you can listen to their input in finding a solution together.
If you are open to talking about it, knowing that self-harm is a coping strategy, you can start by asking some questions.
Here are some important questions to ask your children
You can ask if they are would like to reduce or stop hurting themselves (never assume they want to stop).
If they are willing to try it there are some questions you can ask that will help you both to understand what is going on. For example:
When did it start? What was happening in their lives at the time?
You can share and understand what was the main reason behind the behaviour.
You can also ask about the current triggers:
When do you most feel like doing it?
It can be bullying, arguments with friends, school pressure, feelings of rejection, problems due to sexuality or pregnancy, discrimination, bereavement, unexpected changes, alcohol or drug use, feeling lonely, feeling unworthy, etc.
Another good question is:
How do you know you are starting to feel bad?
What do you feel in your body? What are you thinking? What are you doing? With whom are you usually?
This way your child can start to identify the triggers and feelings that precede the urge to self-harm.
Another very important question is:
Did you ever manage to cope without hurting yourself? What have you done in that particular moment that helped you through?
What else helps you feel in control?
You can explain that we have two important parts in our brain, let’s call it rational mind and the emotional mind. The emotional mind is always looking for danger to keep us safe. It is like a security guard. The problem is that sometimes this “Security Guard” is overly cautious and not very accurate. He cannot distinguish a tiger from a cat.
So he sees a cat and thinks it is a tiger. To keep us safe, he uses all our energy to protect us from that tiger. So, the blood goes to our arms and legs, the heartbeat increases, and all our body wants to move – If we don’t move, we start shaking, feeling pain in our chest and over breathing because our body is preparing to move, and move fast.
This shuts down our rational mind. We don’t really need to make mathematical calculations or creative paintings or even talk. What we need is to run or fight.
All of this is because our “Security Guard” confused a cat for a tiger.
You can ask your child what strategies he would like to engage in that can eventually calm down this “Security Guard” and release the energy accumulated in the process. Is there any type of exercise they enjoy?
Running, dancing and singing, skating, walking in nature, playing with a ball, gardening, hitting cushions, etc.
Any type of movement would be beneficial when they start feeling bad.
Another important way of sending a message of safety to the security guard is to breathe out longer than they breathe in. You can breathe in on a count of 4 and out on a count of seven. Or playing any wind instruments, like harmonica or saxophone, or even blowing bubbles. Al these are activities that send a message of calm and safety to our “Security Guard”… so they can see it is just a lovely cat out there, not a tiger.
Listening to music is always a way to relax and engage.
They can also replace the self-hurting with something similar but less dangerous – Holding ice cubs in their hands, taking a cold shower, clenching and relaxing their muscles, etc. This will release the same type of hormones without harm.
Expressing their feeling is very important, being it by talking to someone they trust or writing a letter they can later dispose of, expressing their feelings and frustration by writing poetry or songs, etc. Writing and talking is a way to engage the rational mind, as it is to do any creative activity or detailed calculations. And the rational mind is the only one that can help us find solutions to our problems and learn skills to fulfil our emotional needs.