Being There, Effectively: how to support a teenager who self-harms

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According to leading mental health charity YoungMinds, approximately one in ten young people struggle with their mental health in some way. The official NICE guidelines tell us that "rates of self-harm are much higher [...] in adolescents and younger adults", and data gathered by HSCIC shows that young women between the ages of 15 and 19 are significantly more likely to self-harm than other comparable demographics.

The friends, families and parents of these teenagers often don't know what to do to support them, though, and it can be difficult and stressful to figure out how best to respond. Everyone is different, and there are no hard and fast rules--but there are a few general guidelines that are worth bearing in mind if a teenager you know is exhibiting self-harming behaviour.

Accept that you might not be able to understand their motivations.

There are as many reasons for self-harming as there are people who do it, and most people who self-harm have different motivations on different occasions. TeenMentalHealth.org has a very useful list of some of the reasoning behind self-harm, but it isn't exhaustive; this is a difficult topic to understand, and you may find that the person you're talking to about it doesn't always have a clear idea of their reasons either. Rather than constantly asking them why they do it or trying to explain why their reasons don't seem sensible to you, it's more helpful to take what they tell you at face value and accept that you might not be able to understand it on a personal level. Otherwise, you could lead the person you're talking to to feel as though they have to justify themselves in a way that makes them feel even worse than they already do.

Understand that self harm is rarely the real issue.

Self harm is generally not an illness in and of itself. In some cases it's a symptom of a mental health condition, like Borderline Personality Disorder; in some cases, it's a coping mechanism for difficult feelings, like a person who impulsively kicks something because they're angry and frustrated; in some cases it's a form of self-medication, like having an alcoholic drink because you're feeling stressed. It's almost always the case that self harming behaviour isn't the real problem--so it's important to try and support them to deal with the root cause of their feelings rather than focusing simply on this single symptom. Trying to stop 'cold turkey' without tackling the real issues can lead to frequent relapses, which are demoralising and often contribute to m=more severe self-harming episodes.

Help them to keep themselves safe without judgement.

It can be tempting to do everything in your power to keep someone from harming themselves, and it's a very natural and understandable impulse. Whether you do that by watching them extremely closely, by asking them to show you their arms or legs to "prove" they haven't self-harmed or by trying to limit their access to the tools they use, this is pretty much always the wrong approach to take, however. It can cause the person you're trying to help feel as though they're in conflict with you--at the very time they need to know that you're on their side. It's much more helpful to ensure that they know you're there for them and to encourage them to come to you before they self harm to see if there's anything you can do to help them with what they're feeling. If they do then hurt themselves, try not to get angry or behave in ways that they perceive as judgmental; instead, ensure they have any medical treatment or first aid care they might need, and when they're feeling a little better, talk to them about what could have gone differently and how else they could have managed those feelings.

Self harm is a complex subject, and one that's frequently misunderstood. It's possible to educate yourself about it, though, and the people in your life who have practiced self-harming behaviours will be grateful for it.

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22 June 2016