This 32-page booklet explains
1. Possible reasons for self-harm:
"Many find it almost impossible to understand why young people harm themselves, and how it could possibly help them to feel better. By deliberately hurting their bodies, young people often say they can change their state of mind so that they can cope better with ‘other’ pain they are feeling. They may be using physical pain as a way of distracting themselves from emotional pain. Others are conscious of a sense of release. For some, especially those who feel emotionally scarred, it may be a way to ‘wake up’ in situations where they are so numb they can’t feel anything. Overall, self-harm is a way of dealing with intense emotional pain."
2. What "self-harming" behavior might look like:
"...cutting, burning, scalding, banging or scratching one’s own body, breaking bones, hair pulling,
swallowing poisonous substances or objects..."3. More vulnerable populations
"Young people in residential settings like the armed forces, prison, sheltered housing, or hostels and boarding schools; lesbian, gay, bisexual, and transgender young people; young Asian women; young people with learning disabilities."
4. Myths and Stereotypes
“Some people do it for attention... that doesn’t mean they should be ignored. There are plenty of
ways to get attention, why cause yourself pain? And if someone’s crying for help, you should give them it, not stand there and judge the way they’re asking for it.”
5. How to talk about self-harm
"Some young people have said that the reactions they got when talking to health workers was unhelpful. In this case you can always seek further help. Many GPs and nurses will be sympathetic, and know how to help and no-one should be put off from seeking help because of negative attitudes."
"If you are a friend of the person who is self-harming, you might have some of the same reactions that a parent would – disbelief, fear for your friend, worry about what to do for the best. The person may tell you but want you to keep it a secret. This can leave you feeling distressed and isolated, with no-one to talk to yourself."
6. Getting help
"Most young people who have found help say that having someone to listen to them and help them to work on solutions to their problems and stresses is the most helpful thing of all. This is why counseling or another type of talking therapy is useful."
7. Substitutes for self-harm
" Young people have shared their most successful ones with us, and these are:
- Using a red felt tip pen to mark where you might usually cut
- Hitting a punching bag to vent anger and frustration
- Holding an ice-cube in the crook of your arm or leg
- Getting outdoors and having a fast walk
- Making lots of noise, either with a musical instrument or just banging on pots and pans
- Writing negative feelings on a piece of paper and then ripping it up
- Keeping a journal
- Putting elastic bands on wrists and flicking them
- Making a collage or artwork"
Click here for The Cutting Edge: Non-Suicidal Self-Injury in Adolescence by Janis WhitlockClick here for a printable copy of ways a nurse/therapist can help (see below)
Self-harm Seminar
How nurses and therapists can help
1. Be willing to talk about it
2. Assess for history of trauma, abuse, and neglect
3. Don’t engage in power struggles (telling the patient to stop, giving ultimatums)
4. Reframe the behavior as a coping strategy
5. Teach cognitive techniques (restructuring, undoing cognitive distortions or unhealthy thinking styles)
6. Identify the cycle of self-harm. Explore ways to short-circuit the cycle
7. Teach client how to experience and express anger in healthier ways
8. Teach clients how to label and articulate a broader range of emotions
9. Offer stress reduction/relaxation exercises (mindfulness meditation)
10. Teach affect management skills. Autonomic Nervous System worksheet.
12. Encourage journal writing to enhance awareness and insight
13. Address control issues
14. Address issues of shame/self-punishment
15. Teach assertiveness
16. Provide alternatives to self-harm (you may or may not like some of these suggestions)
17. Address your counter-transference issues (guilt, anger, fear, sadness)
18. Explore pharmacological interventions
19. Remember the work takes time
20. Allow your clients to stop on their own terms and in their own time.
