About RTÉ Television
The Afternoon Show
The Afternoon ShowRTÉ One, Weekdays, 4.00pm

Family Matters with Grainne Ryan; How Do I Know If My Child Is Self Harming?

Wednesday, 8 October 2008

A recent European study found that Self Harm is a widespread problem which is usually hidden among adolescents. The study found that the problem was more widespread amongst females and the most common reason given was "to get relief from a terrible state of mind" and "to die".

Today with the help of parenting expert Grainne Ryan we're looking at how to spot these signs. In Ireland alone in 2006 there were self harm cases involving children as young as 5 and the number of kids self harming progressed to 1500 + as it hit the 15 - 19 age bracket.

Grainne Ryan - Parenting Coach
Presenter of Baby on Board Series 2. Grainne is a public health nurse and midwife and mother of three children. Areas of interest child development, parenting issues, adolescent development and post natal depression and works as a public health nurse in Ennis Co. Clare.

Stats - 2006 - Self harm in kids
5 - 9 years, 5 cases, (all male)
10 - 14 years, 49 cases (male) 187 cases (female)
15 - 19 years, 579 cases (male) 1033 (female)

It's important to remember that these were cases that presented themselves to hospitals. Many self harm cases go unreported to the hospitals.

What is self-harm?
Self harm is when someone deliberately hurts, cuts or injuries him/herself. For some people, self-harm is seen as a way of coping with stress or painful feelings. It is an act of survival. This behaviour does not indicate an intention to die, rather on intention to live. This is their way of coping. However, self-harm is progressive and left without proper intervention, suicidal intention may develop. Young people and teens are more at risk of self-harming than the rest of the population.

Self-harm injuries occur when someone hurts themselves by: cutting, punching, scratching or tearing at skin, burning, bruising, pulling out hair, driving dangerously or abusing drugs or alcohol.

Why would a child feel the need to self harm?
Young people who self-harm have often had very difficult or painful experiences or relationships. These may include:

. Bullying or discrimination
. Losing someone close to them such as a parent, brother, sister or friend
. Lack of love and affection or neglect by parents or carers
. Physical or sexual abuse
. A serious illness that affects the way they feel about themselves.

Other young people may start to self-harm as a way of dealing with the problems and pressures of everyday life. Pressure can come from family, school and peer groups to conform or to perform well (for example in getting good exam results). Young people can be made to feel angry, frustrated or bad about themselves if they cannot live up to other people's expectations.
Young people who self-harm may have low self-esteem. For some this is linked to poor body image, eating disorders, or drug misuse. Understanding why young people self-harm involves knowing as much as possible about their lives and lifestyles.

Peer pressures may occasionally be the most important reason for self-harm .Young people may find themselves among friends or other groups who self-harm and may be encouraged or pressurised to do the same.

What type of physical behaviour should parents expect to notice?
Remember that self-harm is not attention seeking, the injuries are often hidden from other people and the person probably feels guilty or ashamed

Physical signs include
. Continuing cuts, scratches or bruises that never seem to heal properly.
. Unexplained scars or cuts on top of scars
. Wearing long sleeves and or covers their legs even in warm weather.
. Other problems such as eating disorders, drug or alcohol abuse

What type of emotional behaviour should parents expect to notice?
Emotional behaviour may be difficult to notice because teenager moodiness is a normal part of adolescent development. It is important to distinguish between "normal" typical adolescent moodiness, caused by hormonal changes and brain growth spurts. For example, it is common for girls to become moody, edgy, an anxious just before and during menstruation, and maybe longer, if she suffers from hormonal problems. If grouchy behaviour seems to have a pattern or cycle, it is likely the symptoms are linked to hormonal changes. One hallmark of concerning emotional behaviour is the tendency to become isolated - to stop talking to family, and to stop spending time with friends.

What steps would you recommend in approaching the subject?
It may not be easy to accept the fact that someone you care about self-harms or to understand why they do it. There are things you can do to help, such as;

. Listening
. Offering to go with them to tell someone
. Offering to tell someone for them
. Encouraging them to get professional help
. Finding information for them
. Offering to go with them to an appointment with a health professional or counsellor.
Educate yourself. Find out as much information as you can, and talk to a professional about what you can do to support your child.
. Be supportive without reinforcing the behaviour. Let your child know that you are there if he or she wants to talk. Make the initial approach, but don't push your child to disclose information. Be aware that if your child finds it easier to talk to someone other than yourself, that is her choice. She is not rejecting you. Take comfort from the fact that she is talking to someone and beginning to deal with the problem.
. Take care of yourself. Recognise that this is a difficult situation, and you need time to adjust and make sure you are taking care of your own needs as well as the person you care about. Everyone has to make their own choices, you can't make choices for your child - you can only help them to find ways to make better choices.

If you want to support someone:
. Remember that they are extremely distressed and that self-harm may be the only way they have of communicating their feelings
. Allowing them to talk about how they feel is probably the most important thing you can do for them. Just feeling that someone is listening and that they are finally being heard can really help. Good listening is a skill. Always let the person finish what they are saying and, while they are talking, try not to be thinking of the next thing you are going to say
. Be clear and honest about your feelings. Explain that their behaviour upsets you but that you understand it helps them to cope
. Take them seriously and respect their feelings. Don't tease them or call them 'mad' or 'mental'
. Don't blame them for hurting themselves. Try to avoid being critical even if you feel shocked by what they are saying. This may make them feel even more alone and prevent them talking to anyone else
. Don't ask them to promise never to self-harm again. They may well do it again and then feel guilty about breaking their promises.

Who do you seek advice from at local level?
If you or someone you know is at risk of suicide or self-harm, you should immediately contact your local doctor or go to the A&E department of the nearest hospital.

If you self harm it is very important that you seek help and support. It might seem that nobody understands what you're going through or that you are alone but remember there is help available.

For people who self harm:
Who to talk to,
. The most important thing to do is tell someone about the self-harm.
. Talk to someone you trust (a family member or friend) and ask them to support you in finding help.
. Talk to your doctor, a school or college counselor or support services in the area where you live.

Why would a child self harm?
. Bullying or discrimination
. Losing someone close to them
. Lack of love and affection
. Physical or sexual abuse
. Illness affecting the way they feel about themselves

What steps would you recommend in approaching the subject?
. Listening
. Offering to go with them to tell someone
. Offering to tell someone for them
. Encouraging them to get professional help
. Finding information for them
. Offering to go with them to an appointment with a health professional or counsellor.

For More Information

Support Services:

Pieta House-Centre for the prevention of Self-Harm or Suicide

Pieta house offers a specialized treatment programme for people who have suicidal ideation or who participate in self-harming behaviours.

Samaritans Phone 1850609090

Childline Freephone 1800666666

Spunout: Ireland's National Youth Website. is a youth-led media initiative covering all aspects of youth info, health, lifestyle and activism

Teenline Ireland is a national, freephone helpline specifically for teenagers who may be feeling lonely, depressed or suicidal. ph: 1800 833 634
Helpline is open on Wednesdays 3pm - 6pm; Thursdays, Fridays and Saturdays 9pm - 12 midnight; and on Sundays from 8pm - 11pm.

Grainne Ryan