Matthew D. Selekman

Schools can reduce the likelihood of self-harming epidemics and manage student difficulties when they occur by following a few practical guidelines.

However, both research and practice-based wisdom indicate that the majority of self-harming adolescents do not meet the criteria for diagnosable DSM-IV¹  psychological or personality disorders, have never had suicidal thoughts or attempted to end their lives, and have never experienced sexual or physical abuse (Selekman, 2009). Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress.

Preteens and adolescents today are growing up in a highly toxic and materialistic world. They are bombarded daily by violent, sexualized, and self-destructive media messages and themes that encourage them to grow up rapidly and become junior adults. They also have too many daily choices regarding specific material “must-have” possessions, extracurricular activities, dressing and fitting in with popular peers, possible college attendance, and so forth. Several stressors play a major role in fueling self-harming behavior among adolescents today.

Fitting in with Peers

In adolescence, being rejected by your peers is the equivalent of social death. The peer group is much more demanding today than it used to be, and it changes at a frenetic pace. Adolescent students who lack strong social skills often struggle to stay afloat and may resort to extreme behaviors endorsed by more popular and powerful peers; they may experiment with cutting as their entry ticket into the high-status, inner-circle clique. Adolescents who can’t afford highly prized popular possessions like the iPhone or designer clothing may resort to stealing them.

Many adolescents and children also spend far too much time online, communicating with their peers on Facebook or on MySpace—or “Mean Space,” as some people now call it. Some adolescents have been victimized by peers who play the on-and-off befriending game or spread terrible rumors about them as a form of underground psychological warfare. I have worked with a number of adolescents who were the victims of these vicious and emotionally devastating character assaults. Fitting in and staying connected to socially well-positioned and popular peers become more challenging because of the intense politics of these social networking sites.

Overloaded Stress Circuits

Another frequent complaint I hear from both self-harming and other adolescents is feeling overwhelmed by multiple life stressors. In addition to juggling their social connections, the students are trying to manage massive homework loads and are often pressured by their parents to perform at a high academic level. Some adolescents are growing up in achievement-oriented families, in which the parents put undue pressure on them to get straight As. In addition, the parents often push their adolescents to schedule too many extracurricular activities to make them as attractive as possible to top colleges and universities. To cope with the stress, some of the more emotionally vulnerable adolescents turn to self-harm, resort to eating-distressed behaviors like bulimia, or engage in substance abuse.

Quick-Fix Solutions

Adolescents are growing up in a media world where one of the most popular messages is that we must obliterate stress and other problems as quickly as possible. What better way to get rid of all your problems than to take a pill, which many advertisements on TV suggest is the ultimate solution for physical, psychological, and behavioral difficulties.

In some cases, adolescents may witness their parents abusing prescription medications, smoking, and drinking for stress relief. The message they receive is that stress is a bad thing—that people can’t channel it into constructive activities but must quickly eliminate it.

Self-harming adolescents have discovered that their brain chemistry can serve as a 24-hour pharmacy (Plante, 2007). When adolescents self-harm, their bodies immediately secrete naturally manufactured endorphins into their bloodstreams to protect them from physical pain. These endorphins rapidly numb the emotional distress they may be experiencing. As with drug addiction, longtime self-harming adolescents not only report feeling loss of control, compulsion to engage in this behavior, and physical tolerance of the pain but also experience mild withdrawal symptoms like anxiety and irritability when they abstain from self-harming (Selekman, 2009; Whitlock, Muehlenkamp, & Eckenrode, 2008). Thus, self-harming has become one of the most popular painkilling and sedative drugs for youth today.

Emotional Disconnection and Invalidation

In families of self-harming adolescents, emotional disconnection and invalidation are common family dynamics. For whatever reason, one or both parents are not emotionally and physically present to comfort their adolescents when they are emotionally distressed. When the parents are present, they tend to respond in invalidating ways, such as by yelling, threatening, becoming hysterical, dishing out extreme consequences, distancing themselves, or not listening. So some adolescents take matters into their own hands—they self-harm to soothe themselves.

Further, extreme emotional disconnection from their parents often leads self-harming adolescents to gravitate toward other disconnected and often unsavory peer groups, an affiliation that tends to reinforce their self-harming behavior. Adolescents may feel that they belong and are respected in these groups. However, their involvement may expose them to other self-destructive behaviors, such as bulimia, substance abuse, and risky sexual behaviors.

Another factor that contributes to emotional disconnection in families is the computer screen. Developing emotional intimacy by means of a screen of some sort has become much more important to some adolescents than having human contact. Brazleton and Greenspan (2000) found that children and adolescents spent, on average, five and one-half hours a day in front of a screen. On the basis of what I hear from adolescents and parents in my private practice, this figure has gone up. Close to 70 percent of 8- to 18-year-olds have a TV in their bedroom (Taffel, 2009); laptops or personal computers have most likely replaced many of these.

Parents often do not provide firm guidelines for screen usage and do not regularly monitor the Web sites their children visit. There are many toxic Web sites and so-called online support groups for self-harming individuals where adolescents can witness people brutalizing their bodies, see other graphic images, read poetry and stories with self-harming themes, and learn new methods for self-harming.

Fears About the Future

Some of the self-harming adolescents with whom I work are anxious about whether they’ll get into college or be able to pursue certain career paths, especially given the current grim economic situation. Some have seen their parents lose their jobs as well as their retirement savings. Some have had difficulties finding part-time jobs because few places are hiring.

Those whose college attendance depends on getting a scholarship may experience high levels of anxiety about not letting their parents and themselves down with their academic and extracurricular performance. Self-harming and other equivalent behaviors can give some students temporary relief from these anxieties and fears.

Signs and Symptoms

On the basis of what we know from clinical experience and research as well as from the adolescents themselves, most adolescents who self-harm tend to cut or burn themselves on their arms, legs, abdomens, or the bottoms of their feet, all places they can cover up. Many self-harming adolescents wear pants and long-sleeved shirts even when the weather is warm to cover up their scars, fresh cuts, or burn marks.

We have to worry most about those who cut or burn themselves around their eyes and on their necks. These students—as well as those who deliberately display the scars, cuts, or burn marks on their arms and legs—are often waving a red flag, indicating they’re in emotional trouble. In many cases, a friend or peer will become alarmed and seek out a teacher or other school staff member to share his or her concerns.

Many self-harming adolescents have difficulty managing their depressed, anxious, and angry feelings. In some cases, they cannot articulate their feelings, possibly because of repeated invalidation in their interactions with their parents. Self-harming, bulimia, and substance abuse are adolescents’ solutions. Anthony Favazza, a leading authority on self-harming, found that close to 50 percent of his female patients had concurrent problems with bulimia (Favazza & Selekman, 2003).

On a cautionary note, tattoos, body piercings, or dark Goth-looking makeup and clothing may not indicate self-harming. There is a difference between self-decorating to be cool—as a symbol of peer group tribal connection—and engaging in these behaviors to rid oneself of emotional demons.

What Schools Can Do

School personnel need to be familiar with the territory of adolescent self-harm. They need to understand the common causes, signs, and symptoms; the difference between self-harming behavior and suicidal behavior; constructive and empowering ways to respond; and effective treatments.

Schools can provide two major interventions on the junior and senior high school levels that can help reduce the likelihood of self-harming epidemics.

Intervention 1: Create a Support Group

Once you have red-flagged self-harming students, you can refer them to an on-site intervention group that capitalizes on their strengths to teach them how to become more resilient, effectively cope with stress, and take on leadership responsibilities in their schools and communities.

I have developed one such model that improves students’ coping skills—the Stress-Busters’ Leadership Group.²  Over nine sessions, students look at their strengths and “protective shields”; learn skills related to mindfulness, meditation, loving kindness, and compassion toward self and others; focus on finding balance and harmony in their lives; learn how to navigate family minefields; and acquire effective tools for mastering school stress. Ideally, a male-female cotherapy team of school social workers, psychologists, or counselors is best for gender balance. However, one counseling professional can also effectively run the sessions. (See p. 50 for a description of a session.)

Students who have completed the program often stay involved in prevention work in their schools and communities. Graduates serve as ideal gatekeepers for identifying self-harming students and for getting them to see a counselor or participate in a new group. Finally, groups like these can reverse self-harming and other self-destructive behavior epidemics in schools by accentuating at-risk students’ strengths and honing their leadership abilities.

Intervention 2: Educate Responding Adults

Adult inspirational others serve a major protective function for at-risk children and adolescents (Anthony, 1984; Selekman, 1997, 2005, 2009). These can be teachers, coaches, extended family members, family friends, neighbors, clergy, and community leaders. Adult inspirational others are often compassionate, possess strong social skills, and are good at identifying and accentuating the strengths in children and adolescents. They consistently make themselves available to young people for connection, support, and advice. In every school, some staff members have served this role for at-risk students without even knowing it.

Eight practical guidelines can help adults effectively respond to self-harming students.

1. Because teachers and school nurses are often the first responders, it is crucial that they be respectful listeners to self-harming students; validate the students; build trust; and serve as a bridge to get the students to a school psychologist, social worker, or counselor for further help. If the self-harming student has a strong relationship with the teacher, it may be useful for the teacher to sit in on counseling sessions. Teachers and school nurses should ask the student these questions:
   • How can I help you?
   • How has the cutting helped you?
   • How does cutting fit into your life right now?
   • I’m happy to be there for you, but I also need to connect you with one of our social workers because of our school policy. Would you like to see a male or a female social worker (when the option is available)?
   • If I can arrange it, would you like me to sit in on your first meeting with your social worker?
2. At all costs, school personnel need to avoid responding to self-harming students with disgust, anxiety, or fear. They must not lecture the students about the dangers of this behavior, play detective and ask to see their cuts or burn marks, or interrogate and further invalidate them. Instead, they should strive to understand the meaning of this behavior for the student, how the behavior has been helpful, and how they can now be helpful to the student. It is important to remember that each self-harming student’s story is unique. Self-harming students need to know that teachers and other school personnel care about them and are available for emotional connection, support, and advice when needed.
3. Once a referral is made to the school counseling staff member, the counselor needs to determine in conjunction with his or her supervisor and the student whether the school can successfully counsel the student on-site or whether parent involvement is required. For students who have just begun experimenting with self-harming or who have engaged in this behavior only intermittently, a trusting relationship with a school counselor may generate alternative coping strategies. I recommend that the student also participates in an on-site intervention group, such as the Stress-Busters’ Leadership Group.
4. If the student has been self-harming regularly and is engaging in other self-destructive behaviors like bulimia, substance abuse, and risky sexual activity, the school needs to contact the parents immediately for referral to a private practitioner or community-based program for family therapy that specializes in treating these adolescent behavioral difficulties. Concurrent participation in an on-site intervention group is also recommended.
5. For students who have been self-harming regularly; who are cutting themselves more deeply; or who are cutting or burning themselves around their eyes, necks, and private parts, this is a medical/psychiatric emergency. These students should be taken immediately to the nearest hospital emergency room for evaluation.
6. Although only a small percentage of self-harming students become suicidal, if these students have not responded well to both on-site and outside counseling, struggle to cope with multiple life stressors, and clearly voice suicidal thoughts, they need to be immediately taken to the nearest hospital emergency room.
7. Identified school personnel who have been serving as inspirational adults for other disconnected at-risk students can provide added support to self-harming students who are trying to reduce or stop engaging in this behavior. These adults can closely collaborate with the involved counseling staff members for guidance and back-up if necessary.
8. Graduates of intervention groups who are interested in schoolwide prevention work help identify at-risk students who are self-harming, get them to counseling staff, and spark their interest in participating in a new group for added support. The school can ask these graduates to cofacilitate new intervention groups and get involved in the school peer counseling program.

More Than Just a Problem

As provocative and perplexing as this behavior may seem, we must not lose sight of how bright, creative, and talented many self-harming students are. With compassion, guidance, and support, we can empower self-harming students by being respectful listeners and accentuating their natural gifts.

Matthew D. Selekman. (2009). http://www.ascd.org. Helping Self-Harming Students.. Retrieved May 23, 2012, from http://www.ascd.org.”

How Do I Deal With My Son/Daughter’s Self Harming Behaviour?

It is frustrating for parents to find out that their child is self harming. It is really hard to understand

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why people cut themselves, especially if they are very dear to us.

Here are 10 Top Tips for Self Harm Help to guide parents

1. Avoid taking things personally. Even if their actions  appear to be manipulative, it generally is not a case of manipulation 
2.  Educate yourself. Backing yourself with the proper self harm awareness knowledge will help you learn how to support your child in the right way. 
3. Take care of yourself. While it is really distressing to realize that your child is self harming, find time to recognize that you also need to adjust. Find time and make sure you also take care of your needs as well as your child’s. You are the important person in this equation, because you need to ensure that you are there tomorrow for both of you. 
4. Be supportive without being imposing. Negative emotions can be triggered sometimes when parents impose what they want on their children, intentionally or otherwise. A better alternative is to let them know that you care for them and you will always be around when they need someone to talk to. Be the first to open up but not be too demanding of them to disclose anything to you. And if your child finds it comfortable to be more open with others, that is ok. Sometimes we need go into protective mode from our loved ones because we don’t want to hurt them. Your child is the same with you. The main thing is that they are talking to SOMEONE. 
5. Be there. Although it is heartbreaking, you have to let your son/daughter know that you are willing to help and will always love him or her no matter what. Reassurance is the key here, and then some. 
6. Encourage them in positive ways. Assurance is something that any child yearns. Express to them that you care even if you don’t always understand where they are coming from, but you will be empathetic and sympathetic to their needs. It is also to acknowledge to yourself that it is difficult for you and you also need someone to talk to about your concerns and feelings. This is am important factor in being able to support your son/daughter. 
7. Observe. Notice the times that your child is upset or moody. Self harm is sometimes hidden because self harming pupils and youngsters shy away from people due to their self harm and or low self esteem. 
8. Avoid impulsive overdoses. You can keep medicines locked up and other sharp edged tools hidden in discretion to prevent your child from overdoing the damage. 
9. Seek professional help. If you realize that things are already getting out of hand, seek out self harm help to assist your son/daughter in managing their situation. 
10. Analysis of the situation. Sometimes it can be easier than others to identify what sparked off your son/daughter’s self harming behaviour. Is there something obvious that happened today, last night or recently that you can think of that may have caused him or her to engage in this current self harming incident? A compromise on both sides may be an option and a way forward if it will ease the situation.

 We know it is not easy, however, even if you make a start on just one of the above pointers that will help you in moving in the right direction.

Proper treatment at the right time is important for fast recovery and coping. It should not be mistaken to be merely seeking attention because self harm reasons range from many aspects and backgrounds as well as experiences. And disclosure by people who self harm can be varied as one can share it with a friend and not with a family member or vice versa. You may know someone who self harms, maybe even closer at home, and hence the resource materials for teachers have been created to give training for self harm help.

How Self Harm Training Can Help

The thirst for knowledge is natural given that there is a shortage of proper self harm help or training provision. Self injury is already a complicated issue alone, as there is the emotional pull on the young person self harming as well as those supporting them, for instance, teachers, parents and friends. Training is vital because it can encourage people to explore their self harm awareness and enhance that inner understanding of the issues faced by those with self harming behaviour. Training will further delve into the facts of why people cut themselves and the impact supporters can have on the health, well-being, and recovery of the person self harming. Through proper preparation, skills can be developed to battle self injury and influence faster recuperation. Perhaps the most significant part of professional training against self harm is gaining know-how, comprehension of the symptoms of such behaviours; confidence to be able to differentiate a real suicidal attempt from self harm; and be aware of instances where immediate action is needed.

Training courses have been established to help supporters to empathize with those individuals who deliberately injure themselves and for them to be in a better position to provide more relevant or appropriate self harm help.

In a world full of judgmental attitudes, it is always touching and encouraging to know that there are those – even though not related to us by blood – who really care and will always lend us a hand whenever and wherever we need them to.

The Self Injury Awareness Day is an annual worldwide self harm awareness campaign which happens on 1 March. It is similar to other Awareness Days which includes people generally being more tolerant of someone else’s plight.   Raising more awareness about Self Injury may help people pluck up the courage to tell someone that they are inneed of self harm help. Additionally, it is an opportunity for organizations to create more efforts and opportunities in raising self harm awareness to improve the number of individuals aware of self injury. In the hope of increasing self harm awareness, people are asked to wear orange ribbons, wristbands, and beaded bracelets. The goal of this Self Injury Awareness Day is to stop the stereotyping revolving around self harm and provide resource materials for teachers and medical professionals alike.

What happens during Self Injury Awareness Day?

Just like other Awareness Days, support groups tend to organize awareness Events or opportunities to spread more information regarding particular actions that people could take as most people are not aware of what self injury is about or have no real understanding of why people cut themselves. A lot of us try to cope with our own problems in different ways. Some people drink too much, eat too much, or smoke too much, assault others through means of domestic violence or just pick fights as a means of coping with their problems and anxieties. Whilst others self injury as their way of coping.

What Can Schools/Colleges do To Raise Awareness?

Self Injury Awareness Day (SIAD) is the day that many support groups and concerned citizens from all walks of life attempt to improve, raise, and increase self harm awareness. Raising self injury awareness could include promoting SIAD by:

• Emailing your friends/family and contacts to tell them about it
• Show support for SIAD and young people who self harm by wearing orange, which is the colour for self injury awareness.
• You could wear orange ribbons, clothes, wristbands
• Hold  creative  self injury awareness drawing competitions at school
• Self injury awareness poetry competition at school
• Have an awareness event at school, to include the whole school and perhaps invite visitors in
• Invite parents in for an awareness session
• Let local media (TV/radio) know  of your event and thus helping to spread the word about SIAD

It is on this day that debunking of stereotyping and self injury myths happen.

In particular if the awareness and event takes place at school or college, it may give students the confidence to seek the support from your support services that they may not otherwise do as we know there are students at school or college who are self harming without anyone knowing, given that self harm is a private act.

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The main thing to remember is that people who self harm are hurting and in emotional pain and more than likely physical pain too depending on the nature of their injury. It is likely that they want to stop wearing the long sleeves in summer or baggies used to cover up their injuries. They want the help but don’t know how to ask for it and fear being ridiculed. A small step forwards on your part could make all the difference in a youngsters life and could help them to deal with their challenges without having to fear being judged and insulted.

Self Injury Awareness Day is an opportunity to help individuals who deliberately harm themselves to really express their hidden emotions and seek the help and real attention that they have been deprived of but have always needed.

Self harm comes under a lot of names – self mutilation, cutting, self injury, deliberate self harm – but all refer to one thing, hurting oneself to ease the burden of deep distressing emotional symptoms. Furthermore, it can also come in many various forms such as cutting (being the most widespread form), burning, hitting, picking skins, scratching, and pulling the hairs out.

Self injury is detrimental to young people’s well being.  Consequently,  support  for self harm help has been created and developed and resource materials for teachers are also given to increase self harm awareness  and self harm help as well as to find ways to stop self harming pupils, where possible.

Self injury or self harm is generally not suicidal but a coping mechanism and a way of regulating deep emotional pain.

7  Top Self Harm Help Strategies

Here are the Top 7 ways to stop self harming or minimize it:

•  Cognitive behavioral therapy or CBT

Self harming is only a symptom of deep emotional distress. CBT can be used to help individuals recognize and learn to address their  feelings in rather healthier ways.

• Psychotherapy

It can be used either together with medications treating mental illnesses or simply alone. Otherwise known as “therapy”, psychotherapy actually entails various treatment techniques during which a person talks to professionals for mental health and care who will help the individual identify the problems and work through different ways to give self harm support.

• Post traumatic stress therapy

The objective of this treatment is to decrease physical and emotional symptoms which lead to self harm.

• Group therapy

Self harm training courses offers self harm awareness for anyone. Group therapy, on the other hand, is especially aimed at those who self harm, thereby talking within a group with people who  experience the same problems which can be very helpful in reducing shame associated with self injury, as well as introduce healthy ways of expressing emotions.

• Family therapy

Family Therapy addresses family history, prevailing conditions and  other related behaviour which can help both the young person who self harms and the family members to learn better communication methods and be more open and directly expressive to one another.

• Hypnosis and relaxation techniques

There are a range of relaxation techniques and approaches which will help young people and others who self harm to release some fo the stress, tension and pressure that they are experiencing, which in turn is likely to helpt o reduce self harming.

• Medications

Self harm can be a remedy for coping with depression, medications such as antidepressants and anti-anxiety can be used to minimize the early impulsive responses to stress. Best advice is always to speak to your physician and seek their advice and/or referral to any of the above options.

When you know someone who engages in self harm, you may find yourself helpless at the face of their wounds, scars, and bruises. Your own emotions and fears of the situation may override the emotional pain and suffering experienced by teenagers, which might lead you to blame self harming teenagers and self harming pupils instead of giving them support. Keep in mind that they may only be using this as a means of communicating their dilemma and confusion about their feelings and other matters and get the attention, comfort, and care that they have always wanted and needed. However distressing it can be for you, this is not necessarily their intention.

Whether people have got slight bruises, deep cuts, or others, the problem represented must be taken with seriousness, even if we don’t understand why people cut themselves. The depth of the wound, if it is cutting, does not in anyway give an indication of the depths of their despair and anguish. While some behaviours are considered attention-seeking, self harming in teenagers, self harming pupils and other people is not attention seeking. What is vital for you to know in order to be able to get the proper support for your loved ones is that self injury is essentially attempting to alleviate oneself of intolerable tension, deep distressing emotional pain and suffering.

Self Harm Awareness

Self injury should not be considered to be a wish to commit suicide unless the person specifically expresses such thoughts. The reasons why self harm is not merely an act of seeking attention is as follows:

-  It creates numbness through physical sensations and feelings become very intense

-  It is about stopping the turmoil plus confusion resulting from uncontrolled emotions

-  It is about punishing oneself because of contempt and self hatred

-  It communicates one’s needs for help

Self harming in teenagers and people is a coping mechanism. During challenging stressful and distressing times of emotional pain of being betrayed, neglected, abused, and abandoned, self injury and other physical pain relieves this tension, for a period of time. Teachers are another category of professionals that  Self harm awareness and self harm training is essential for to provide crucial resource materials for teachers to be able to offer relevant and appropriate self harm help for self harming pupils.

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Self injury has gradually become a common behaviour amongst teenagers and youths which normally occurs during secondary school as well as college institutions. With this fact, schools require more self harm awareness to detect, intervene, and prevent self harm, as much as possible, in teenagers from occurring and recurring.

How to begin?

The responsibility for self injury support and self harm counselling must begin within the school team. If the school does not have a core team, the primary action will be to assemble a team of professionals to address the issues related to the detection and management of self harming teenagers. It is also important to organize training for teachers in terms of  “help for self harm”  

What they do?

The team will be responsible for the following:

-    Responding to any self injury discoveries and confessions. They will serve as resource for teachers who might suspect, but not sure of, someone who is   self harming.

-     Communicating with the individual and referring the student to a Nurse, Counsellor or Child Protection Officer for care and

evaluation of the nature of the self harm or wounds.

-     Making sure that the student is not suicidal after identifying the symptoms indicated.

-      Act as liaison between the parents or guardians, the student,  the peers (if and where relevant) and referral people associated with the individual after such disclosures.

-      Establish supportive roles and relationships with teenagers who self harm. If not, find someone capable of this role.

For the team or teacher to function effectively and efficiently, it is important to undertake training programmes for teachers or refer suspected yet unconfirmed cases to the key person responsible for taking the lead role in such matters.

Focus of the training of teachers

The very crucial part of this training for teachers is gaining knowledge and understanding of how to determine the symptoms and signs of self harm behaviours. Moreover, it is very important that resource materials for teachers are given during the training for professionals for them to be able to recognize what is the difference between suicidal attempts and self harm in teenagers; as well as being aware of conditions which needs immediate attention like having severe wounds requiring stitches or medical care. This is very important in giving self harm help for people.

Part of this awareness raising might include self harm awareness about things that are not classified as self injurious such as tattoos, piercings, and other bodily modifications. Individuals who have extreme and numerous body modifications may also be potentially self harming.

Self harm, self injury, or self mutilation is generally believed to be just the act of burning and cutting oneself. It has been becoming a greatly misunderstood addiction to which majority often believe the doer is simply attempting suicide because of the serious cuts inflicted on oneself. But there is more to self injury information that you need to know.

Self Harm Awareness

Self harming in teenagers include burning themselves with cigarettes or other hot tools, cutting with blades and knives, and other general acts of inflicting harm to the body such as hitting yourself against the wall repeatedly.

When they exhibit self harm behaviour, they could be absorbed in an obsessive-compulsive behaviour resulting in the infliction of physical damage in a mission to evade emotional feelings which they are unable to confront and cope up with. It is simply not just a case of seeking attention but more than that. Teenagers who self harm can end up needing severe medical treatment and hospitalization.

These results can leave not only physical body scars but also emotional ones. That being said, these are to which the sufferer can be proud of themselves but at the same time be ashamed of it; therefore hiding it from others. As self harm is generally a private act, this can be difficult for teachers to manage mental health in schools’

Who Self Harms?

As opposed to what many believe, self harm in teenagers is not the only scope in this subject. A lot of people suffer from this. It does not single out age, creed, gender, and race  although it was reported that younger women suffer the most from these behaviour. This disorder can also be accompanied by some other addictive tendencies like drug addiction and eating disorders; and is not only limited to teenagers alone.

Any who self harms may progressively become addicted to the act of self harming which can be treated by going through several self injury treatments. The act of injuring oneself is not the main issue, as it is just a symptom but the underlying emotional reasons and pain for the person self harming in the first place. If someone is attached to this, chances are they are highly secretive of this due to the fear of being confronted and even stopped of their actions.

For a lot of people who self harm, especially teenagers, they report that this is as similar to drug and alcohol addiction which they deemed as “ritualistic”. That is, someone who makes use of blades to cut oneself will follow a strict routine including having a safe place and date to conduct their so-called “ritual” in peace and without disturbance. All the items used, the method, as well as the routine will have a similar pattern always. Normal locations where they inflict pain are on the arms, legs, stomach, thighs, and even their faces.

In an increasingly globalised competitive world, people, including young people, are having to deal with various kinds of pressures and situations, much different from previous generations. This is coupled with emotional vulnerability, bullying amongst peers, de-motivation and insecurities, and which for some, becomes too difficult to deal with. For some people, self harm becomes a conscious or unconscious act that helps them to deal with these added pressures.

Though self harm trends are more noticeable among young people, it is by no means restricted to the younger generation. Due to a combination of work pressure, family, societal and lifestyle issues, adults also experience self harming behaviour that requires self harm help. A depressed state of mind  can encourage self harm as sometimes the mind sees harming the self as a means of dealing with the underlying issues. Under these circumstances, the right kind of nutrition   intake can go a long way in shaping the behavioural patterns of people with self harming tendencies.

Nutrients

Food contains various nutrients and vitamins. Each type of nutrient stimulates different organs of the body. Studies have shown that carbohydrates stimulate serotonin production. Serotonin which is also known as hydroxytryptamine is primarily found in the gastrointestinal tract, platelets and in the central nervous system. It is a major contributor of feelings of well-being: therefore it is also known as a “happiness hormone” though it is not actually a hormone.

According to Randy Sanstone, John Livett and Lori Sanstone in their article “Eating Disorders and Self-Harm: A chaotic intersection” about 25% of Eating Disorder patients are prone to non-fatal self harm. A further quarter of people with self harm tendencies and who suffer from Eating Disorders also have border line personality disorder.  Eating disorders can create other emotional challenges including a ‘chaotic inner-self’, problems in expressing oneself, stress and anger issues.

People with eating disorder challenges, deal with the issues in different ways. Some people purge themselves, otherwise known as bulimia, which has a cycle of under-eating and over-eating leading to a sense of low self esteem and needing to purge. Some people have binge eating tendencies which can also include increasing their carbohydrate intake. This can be symbolized as a stifling of their emotions; whilst others eat very little at all (starvation) known as anorexia.

Beyond Self Harm & Eating Disorder

Therapy can help people with eating disorder related self harm. Therapy in groups or individually can assist people to understand their eating habits and the functions that food plays in their lives.  Research shows that people exhibiting self harm benefit greatly from talking therapies which also focus on the underlying issues behind the self harm and/or eating disorder, and the functions that they play in the person’s life. Medical intervention is also used to reduce self harming behaviour.

 Given that self harm and eating disorder is more prevalent in schools than ever before, teachers and teaching support staff would benefit from self harm awareness training to enable them to get a better understanding of the underlying issues in order to be able to offer self harm help to self harming pupils.

Self harm behaviour and eating habits and disorders are intricately related. Research shows that focusing on the underlying issues behind these habits, however, can and does reduce or eradicate the need to self harm.

As always with everything that people want to change, the person must want to change or improve in order for any treatment to work, otherwise time, effort and treatment become counterproductive.

Then starts the challenge of knowing which is the best approach to adopt in supporting your child, in supporting yourself  and the rest of the family, and of course, dealing with the self harming activity itself. This is also coupled with the challenge of knowing where to turn for help and which professional to approach!

In addition to the above, there are the added challenges of dealing with a gamut of raw emotions such as fear, guilt, sadness, anxiety, hurt, together with self blame, blaming other family members and/or the person who is self harming, in an attempt to somehow find a way through this situation and wondering why people self harm.

In these circumstances, parents can often feel quite alone, isolated and

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frustrated. With the stigma attached to self harm and some medical professional’s unhelpful approach to self harm, it is not always an easy situation and condition to deal with or get appropriate support for. The search for real help is made that much harder with websites promoting how to self harm. That said, parents self blame, however, does not help them or the situation, but rather keeps them stuck. There are a myriad of reasons why the self harming activity occurred in the first place.

For instance, it can be triggered by simple causes like exam pressure to other complex family related matters. An open flow of information and communication is definitely the key in getting to the root cause of the self harming behaviour and gaining more self harm awareness.

Self harming activities are wide ranging and not just the stereotypical cutting. Hair pulling, alcohol abuse, gang culture, self neglect and head banging are just some other examples of self harm. It is also an activity that transcends all cultures, societies, religion and ages, starting from as young as three or four years old to senior citizens in their eighties. Indeed, some parents are themselves people who self harm and may have concerns about the knock on effect that this will have on their children.

There isn’t a typical person who self harms or a typical family that people who self harm come from.

Given that self harm is generally a cry for help, the situation isn’t just going to go away by itself! Parents require an avenue and means of getting the help and self harm support and open communication to deal with it.

One source of information is seeking advice via your local GP/doctor and another is via local counselling or therapeutic interventions.

The main thing is to acknowledge that there is a situation that needs to be dealt with if the whole family is to move forward.