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One of the most distressing things a parent can face is to find out their child is self harming. The very person you are committed to protecting and keeping safe is injuring themselves, and doing so quite deliberately. Self harm takes many forms and is always associated with an underlying issue. While this can be a psychiatric disorder, it can often be traced back to insecurity, low self esteem or poor body image. Whatever the cause, as a parent, guardian or carer, you will want to know why they are doing it, and help them stop.

The team at BEST Advice went to the Royal College of Psychiatrists in London and asked them to help us in the preparation for this article. They run an excellent website which deals with all manner of problems and were kind enough to let us use parts of it in this section.

(The following information is copyright of the Royal College of Psychiatrists and are reproduced with their kind permission. BEST Advice would like to thank the College for their help and support in the preparation of this section.)

What forms can self harming take?

Self-harm happens when someone hurts or harms themselves. They may:

• take too many tablets
• cut themselves
• burn their body
• bang their head
• throw their body against something hard
• punch themselves
• stick things in their body
• swallow inappropriate objects

It can feel to other people that these things are done coolly and deliberately – almost cynically. But someone who self-harms will usually do it in a state of high emotion, distress and unbearable inner turmoil. Some people plan it in advance, others do it suddenly. Some people self-harm only once or twice, but others do it regularly - it can become almost like an addiction.

Some of us harm ourselves in less obvious - but still serious - ways. We may behave in ways that suggest we don't care whether we live or die – we may take drugs recklessly, have unsafe sex, or binge drink. Some people simply starve themselves.

What makes people self harm?

Emotional distress – people often struggle with difficulties for some time before they self-harm:

• physical or sexual abuse
• feeling depressed
• feeling bad about yourself
• relationship problems with partners, friends, and family

If you feel:

• that people don't listen to you
• hopeless
• isolated, alone
• out of control
• powerless – it feels as though there's nothing you can do to change anything
• Using alcohol or drugs – it may feel that these are as out of control as the rest of your life
• If you want to show someone else how distressed you are or to get back at them or to punish them. This is not common – most people suffer in silence and self-harm in private.

How common is the problem? The Facts

Self harming is more common than is often thought with around 10% of young people self harming in some way. That said, self harm isn't restricted to youngsters and people of any and all ages can, and do self harm.

Statistics tend to show that self harming is more prevalent in women, and that it tends to be more likely to occur amongst Gay and bi-sexual men and women.

About 1 in 3 people who self-harm for the first time will do it again during the following year. About 3 in 100 people who self-harm over 15 years will actually kill themselves. This is more than 50 times the rate for people who don't self-harm. The risk increases with age and is much greater for men. Cutting can give you permanent scarring, numbness, or weakness/paralysis of fingers.

Are people who do this mentally ill?

Most people who self-harm are not mentally ill. However, some may be depressed, or have severe personality difficulties, or be addicted to alcohol and drugs. But they all still need help - the risk of killing yourself increases after self-harm. Everyone who self-harms should be taken seriously and offered help.

How can I help a friend who self-harms?

It can be very upsetting to be close to someone who self-harms, but there are things you can do. The most important is to listen to them without judging them or being critical. This can be very hard if you are upset and perhaps angry about what they are doing. Try to concentrate on them rather than your own feelings – although this can be hard.

Do

• Talk to them when they feel like self-harming. Try to understand their feelings, and then move the conversation to other things
• Take some of the mystery out of self-harm by helping them find out about self-harm perhaps on the internet at the local library
• Find out about getting help - maybe go with them to see someone
• Help them to think about their self-harm not as a shameful secret, but as a problem to be sorted out

Don't

• Try to be their therapist. Therapy is complicated and you have enough to deal with as their friend, partner or relative
• Expect them to stop overnight – it's difficult and takes time and effort
• React strongly, with anger, hurt, or upset - this is likely to make them feel worse. Talk honestly about the effect it has on you, but do this calmly - in a way that shows how much you care for them
• Struggle with them when they are about to self-harm – it's better to walk away and to suggest they come and talk about it rather than do it
• Make them promise not to do it again or make your involvement with them the basis for an agreement for stopping
• Make yourself responsible for their self-harm or become the person who is supposed to stop them. You must get on with your own life as well. Make sure you talk to someone close to you, so you get some support

What help is there?

Talking: Talking can help you to feel less alone, to see your problems more clearly.

Self-help groups: People with the similar problems can provide support and practical advice – and, believe it or not, sharing your problems in a group does help

Help with relationships: Group therapy can often help you to sort out difficulties in getting on with other people

Talking Therapy: Problem solving, Cognitive Behavioural or Psychodynamic psychotherapy

The Royal College of Psychiatrists website is well worth a visit at www.rcpsych.ac.uk as it has more information in self harming as well as dozens of other topics. Do remember though that very often in cases of self harming professional help is required, and we therefore recommend that if your child is self harming that your first port of call should be your family Doctor.