Self Harm / Self Injury

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1 Self Harm / Self Injury Many self harmers find it difficult to verbalise how they feel and may have blocked off or detached from their feelings of pain, hurt, anger, etc. Self harm can be used as a way of feeling something physically which they are unable to feel emotionally. It is not uncommon for a person who self harms to say they are not angry, yet in reality there is often an enormous amount of anger inside which they are turning inwards on themselves. Self harming is a way of coping. For someone to stop self harming they need to have help with finding other ways of coping and ways of getting in touch with their feelings in a supportive environment. Anyone who self harms may need help with building up their confidence, their self esteem, and their sense of worth so they can begin to see themselves in a realistic and positive light. When a person truly values themselves it is not so easy to harm and abuse yourself. When a person values themselves it is easier to start to take care of yourself, to start to see yourself in a positive light, to start to like yourself. If you are self harming at the moment nobody can just tell you to stop doing it until you can find other ways of coping, and other ways of letting out your feelings and begin to value yourself. Take time to read the following information which can give alternatives to self harm and advice in relation to keeping yourself as safe as you can. You can learn other ways of coping and can start to value yourself. You may need a lot of support and help around you so please ask for it. Please don't self harm in secret, locked away, isolated and alone. Nobody should ever judge you for self harming. At the moment you are doing what you need to do to cope, to survive in the world, but there are other ways. There are also a number of websites listed at the bottom of this factsheet which provide information and support for people who self harm. Many sites which provide excellent support and information to sufferers can also bring up immense feelings of sadness. It may be best therefore to choose a time to access sites when you know you can call someone or be with someone for support afterwards, even if you just need a hug or to hear a friendly voice. When you feel sad, look after yourself, cuddle up with a blanket, hot drink, cuddly toy, pet, look at photos and pictures which help you to feel safe and bring a smile to your face. You may have a safe box with objects to hold which feel good. E.g. velvet, pebbles, shells, play dough etc., and remember to access help, you need to ask for it and try all the resources you need. What Is Self Injury? 'I think control's a big thing, when you can't control what's happening around you you can't control pressure from outside, from society but you can to yourself.'

2 Self injury is something you do to damage your body as a way of managing and expressing intensely difficult feelings, without intending to kill yourself. Some examples include cutting or burning yourself, bruising yourself, taking tablets, pulling at hair, or picking skin. It can go on for years without being fatal and it is more common than a lot of people think. Self injury is used mainly to keep feelings under control, rather than to get a response from other people. Many people have difficult times in their lives and feelings can be hard to put into words. Sometimes the only way to manage the intensity of what you feel is maybe to hurt yourself. When hurting yourself becomes a way of managing these pressures it means there are other things wrong in your life that need sorting out. Self injury can become compulsive, a way of coping, because the underlying issues haven't been sorted out. For a lot of people trying to stop self injury without having any other ways of coping with problems is not realistic. Without help, feelings can build up and you can end up doing more damage to yourself. It can be frightening becoming aware of how you feel, and why, but if you can do this you can begin to work out where you mean to go from here. It might be helpful to identify parts of your life that may be causing you difficulties: What was happening when you first began to feel like injuring yourself? Are you always at a certain place or with a particular person? Have you been having frightening memories or thoughts and not been able to tell anyone? What would help you not hurt yourself? Is there anything else that makes you want to hurt yourself? When you feel like hurting yourself what other ways of managing could help for a short while? Writing about how you are feeling. Curling up with a blanket, hot drink, by breathing and relaxing. Listening to music. Tearing up telephone books or newspapers. Punching pillows or cushions. Going for a run, brisk walk, dancing or any form of exercise. Talk to a friend. Have a list nearby of people you can ring. Keep your mind busy to distract your mind from harming yourself. Carry safe things in your pockets (stones, pebbles, crystals). Get a red felt tip pen and mark yourself as if you were cutting. This may give you similar relief. Try aromatherapy oils (lavender oil) and breathe it in. This can help you to feel more balanced and calm. Try elastic bands around your wrists and flick them when you feel like cutting. If you need to feel sensation when you self harm try holding ice.

3 Take a cold shower Bite into something which is strongly flavoured, like lemon or peppers, etc. Use play dough to give you something to occupy your hands. Have a relaxing bath to treat yourself. Do deep and slow breathing. How do you feel? Upset you can't keep your feelings in or maybe you can't let them out. Helpless you don't know what to do for the best. Guilty because you can't stop harming yourself, even if you want to. Scared because you don't know why you do it it's getting worse. Ignoring how you feel it's too frightening you don't know what you feel or how to deal with it. Depressed about anything ever getting better. Lonely no-one seems to understand. Trivialised in case people think you're just attention seeking. Are you worried in case no-one will listen? There are lots of reasons why you could be worried about telling someone: You might not know why you do it. Embarrassment or shame people might see it as attempted suicide. Guilty for worrying people. People being angry with you, because they think you didn't need to do it. Being judged being seen as attention seeking, suicidal or manipulative rather than doing what you can to cope. They might tell someone else who you don't trust. You will be made to stop using this way of coping before you are ready. You might not know what your feelings are; they just feel like a big pressure. What do you find difficult about telling someone? Self Injury and Suicide 'I don't cut myself to kill myself, but sometimes it can get like that'. You might have mixed feelings about wanting someone else to help, or wanting to be left to try to control your life on your own. You might want to control when you hurt yourself but at the same time be scared in case your life is at risk.

4 If you know you could be in danger of killing yourself it might be an idea to write down a survival plan of what you can do to prevent this. Who can you phone? Is there someone you can tell? If you can't ask for help yourself, is there someone who could do this for you? When you feel like killing yourself, it's hard to remember anything good, or that anyone has ever said anything nice about you. When you are not feeling suicidal, write a list of what these good things are. Keep it with your survival plan. You could also keep photos or other reminders of good times, because feeling so bad will pass. The suggestions above may help you through it. Who Can You Trust? Write down the reasons why you should or shouldn't tell people. It can help you decide and be clear about what your worries are about telling someone. Where and when would you tell them? What would you say? You could practise saying it out loud, or with a friend. Picture how these people would respond if you told them. Is there another way you can get the response you need? Is there another approach you would feel more comfortable with? Writing a letter to someone you trust may help you express what you want to say without worrying about the other person's immediate response. Think of a plan to look after yourself if they respond in a way which isn't what you'd hoped for. Remember the first person might not be able to help, so be prepared to try again. Unfortunately you may meet some people who respond in a way that makes you feel worse. Remember people who respond like this may be finding it hard to manage how they feel too - it's not your problem, so don't take it on. Perhaps you could try telling them they are not helping. If they don't listen, try and find someone else who will. It can take a lot of courage and determination to keep trying, but you will find the right person in the end. If your health or safety is at serious risk the person you tell might want to contact your parents or carer. You may need to speak to this person first about this and explain you want what you say to be confidential.

5 How do you get help? 'You've got to want to be able to do it, have the support of as many people as possible and bring it out in the open and not hide it from people'. We all need help and understanding from other people sometimes. It can be hard to recognise when you need to involve other people. Talking to someone might help you feel more able to cope. You might wish you could express feelings more safely, or want to find ways of keeping them under control. Try and talk to someone you like and trust. This could be a parent, carer, friend, teacher, school nurse, youth worker, school counsellor, social worker, doctor, relative or a helpline. You may find that counselling will help you as this will give you a safe space to talk to someone who is specially trained. This will help you to say how you really feel inside and the counsellor will work with you to help you find solutions and healthy coping strategies and to look at the reasons behind the self harming. This will give you a better understanding of your feelings and some support in working through anything which is troubling you. What can I do to help a friend who is self harming? It can be very puzzling why someone would hurt him or herself. The following can help your friend feel more supported and more likely to get help. Remember: Keep an open mind. Your friend will be concerned about what other people think and will have taken a risk by telling you. Show your friend that you care by making time to listen and take what they say seriously. Help them to find their own way of managing their problems, including worries that don't seem to be connected to self injury (they might not want to handle things in the same way as you would). Try to help them identify who can help (you could offer to go with them to tell someone or offer to tell someone for him or her). Carry on doing ordinary activities you do together. Don't tease them. Your support will be very valuable. Your feelings matter too Your friend might tell you that they are hurting themselves and ask you not to tell anyone. This can put you in a very difficult situation. It's natural to want to help someone but it's up to him or her whether they feel ready for further help.

6 It would be better if you could work out together who the best person to tell would be, but you might have to decide alone. You might have lots of feelings about your friend. These could include: Upset - because they are hurt. Worried - you're not sure how to help. Anger - that they could do something to hurt themselves or at whatever has made them feel so bad. Frustrated or helpless - because you don't know what to do. Wanting to take care of them all the time. Shocked - at the injury, or you didn't know they felt so bad. Confused - because you don't understand why. Resentful - that they hurt themselves even though you are trying to help. Guilty - for feeling you don't help them. Scared that your friend might damage him or herself seriously or even die. Responsible for how your friend is. Scared about involving someone else and scared if you don't. Remember: Look after yourself. This can be a lot to go through on your own and even people who are trained to work with people who self injure need support from other people. Try to carry on with your other activities and relationships. You don't have to be available for your friend all the time. If your friend hurts themselves it is not because of you. If you can show your friend that you can look after your own needs, it can help them begin to think that they can do the same. Some organisations which may be useful to you ChildLine: , Get Connected: , Free telephone and helpline finding young people help whatever the problem. Can connect a child or young person to any UK helpline where appropriate SupportLine: , - A confidential telephone helpline providing emotional support and befriending. SupportLine also keeps details of counsellors and organisations around the UK Youth2Youth: confidential , online and phone, run by young people School-Based Counselling Service

7 Useful websites - Site for self harmers, self esteem, etc - Includes information on self harm - Key information resource for young people who self harm, their families, friends, and professionals working with them

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