Understanding Self Harm: Exploring the Impact and Coping Strategies

 
Understanding
Self Harm
 
Gloucestershire Self Harm Helpline
 
 
Alice Brixey
 
W
h
a
t
 
i
s
 
S
e
l
f
 
H
a
r
m
?
 
www.rethink.org
 
In pairs, discuss what you feel self harm is
 
W
h
a
t
 
i
s
 
S
e
l
f
 
H
a
r
m
?
 
www.rethink.org
 
Self harm is an umbrella term for behaviours that can cause
injury or danger to oneself.
 
W
h
a
t
 
i
s
 
S
e
l
f
 
H
a
r
m
?
 
www.rethink.org
 
There’s 
no single definition 
of self harm
 
- Self injury is when somebody 
 
intentionally
 
  damages or injures their body
 
- “Tissue damage to relieve tension”
 
Self harm is a behaviour – it is not a mental illness.
However, it could be a symptom of mental illness
 
It is a sign of 
extreme distress 
 - 
An internal scream
 
Self harm is a 
way of coping
 with emotional pain,
distressing memories, or overwhelming situations
and experiences.
 
W
h
a
t
 
i
s
 
S
e
l
f
 
H
a
r
m
?
 
www.rethink.org
 
After a difficult day, how do you cope?
 
W
h
a
t
 
i
s
 
S
e
l
f
 
H
a
r
m
?
 
www.rethink.org
 
Smoking
Alcohol
Over-Exercising
Eating
 
Life-threatening
behaviours, e.g.
overdosing
 
Self harm is a 
spectrum
 
H
o
w
 
D
o
e
s
 
S
e
l
f
 
H
a
r
m
 
A
f
f
e
c
t
 
Y
o
u
?
 
www.rethink.org
 
The number of 
children
 (aged 10-14) who had been
treated after deliberate self harm 
increased by 70%
in the past two years.
 
The number of teenagers (aged 15-19) treated
increased by 23% in this period.
 
Health and Social Care Information Centre, 2014
 
H
o
w
 
D
o
e
s
 
S
e
l
f
 
H
a
r
m
 
A
f
f
e
c
t
 
Y
o
u
?
 
www.rethink.org
 
Young Minds
1 in 12 
young people
have self harmed
Last year, 
38,000 young
people
 were admitted
to hospital because of
their injuries.
Inpatient
 admissions due to
young people self-harming
increased by 68 per cent in
the last 10 years.
W
h
a
t
 
i
s
 
t
h
e
 
T
r
u
e
 
E
x
t
e
n
t
 
o
f
 
S
e
l
f
H
a
r
m
?
www.rethink.org
The number of people who have self
harmed but not sought help....
?
We don’t know the true extent of self harm, as
some people don’t have/seek the support
 
H
o
w
 
D
o
e
s
 
S
e
l
f
 
H
a
r
m
 
A
f
f
e
c
t
 
Y
o
u
?
 
www.rethink.org
 
Self-harm is the 
number one issue that young people are
concerned about among their peers 
in a list including gangs,
bullying, drug use and binge drinking.
 
Self-harm is the one issue that all groups (young people,
parents and professionals) 
feel least comfortable approaching
with young people.
 
Teachers feel helpless and unsure about what to say to a
young person who is self-harming.
 
 
Talking Self Harm
, Cello Group
There is little open communication about self harm
S
e
l
f
 
H
a
r
m
 
F
a
c
t
s
www.rethink.org
1. 
People who self
harm are just 
attention
seeking
2. 
People who self
harm have a
personality disorder
4. 
Self harm is a 
failed
suicide attempt
3. 
If self harm does not
require stitches or
hospital treatment,
then it is 
not serious
Fact:
 
Self harm is often a very private
thing, and people can go to great
lengths to cover it up.
Fact:
 
Self harm is a behaviour, not an
illness, though self harm can manifest as
a part of a mental illness.
Fact:
 
Injuries rarely equate to the
intense emotional distress an individual
feels.  All self harm should be taken
seriously
Fact:
 
Self harm is often a way of
keeping oneself alive.
 
W
h
y
 
D
o
 
Y
o
u
n
g
 
P
e
o
p
l
e
 
S
e
l
f
 
H
a
r
m
?
 
www.rethink.org
 
Everyone has their own reasons for self harming
 
Family Factors:
 
Unreasonable expectations
 
Neglect/ Abuse
 
Poor relationships
 
Individual Factors:
 
Mental Health Issues
 
Low Self-Esteem
 
Impulsivity
 
Social Factors:
          Difficulty making relationships
          Bullying/ peer rejection
 
Other Factors:
 
Trauma
 
Relationship Breakups
 
Pressure/ Change
 
T
h
e
 
S
e
l
f
 
H
a
r
m
 
C
y
c
l
e
 
www.rethink.org
 
N
e
g
a
t
i
v
e
 
E
m
o
t
i
o
n
s
 
(Sadness, Anger, Despair)
 
T
e
n
s
i
o
n
 
(Inability to control emotions, maybe
using disassociation to cope)
 
S
e
l
f
-
H
a
r
m
 
Cutting, Burning, Etc.
 
P
o
s
i
t
i
v
e
 
E
f
f
e
c
t
s
 
(Endorphins released, tension
and negative feelings dispelled
for a short period of time)
 
N
e
g
a
t
i
v
e
 
E
f
f
e
c
t
s
 
(Shame, guilt over self-harm act)
 
What have
you done,
you silly girl?
 
Mum cries
when I try to
talk to her
 
How could
you do this
to me?
 
You’ve had
everything
given you your
whole life,
what’s wrong
with you?
 
You’re
always trying
to get
attention.
 
Why have
you been so
selfish?
 
T
h
e
 
S
e
l
f
 
H
a
r
m
 
C
y
c
l
e
 
www.rethink.org
 
N
e
g
a
t
i
v
e
 
E
m
o
t
i
o
n
s
 
(Sadness, Anger, Despair)
 
T
e
n
s
i
o
n
 
(Inability to control emotions, maybe
using disassociation to cope)
 
S
e
l
f
-
H
a
r
m
 
Cutting, Burning, Etc.
 
P
o
s
i
t
i
v
e
 
E
f
f
e
c
t
s
 
(Endorphins released, tension
and negative feelings dispelled
for a short period of time)
 
N
e
g
a
t
i
v
e
 
E
f
f
e
c
t
s
 
(Shame, guilt over self-harm act)
 
Taking
control
 
Reduction
in tension
 
Distraction
from
problems
 
Form of
escape
 
Ways to
communicate
inner pain
 
Care
eliciting
 
Self
Punishment
 
Outlet for
anger
 
Peer Group
 
F
u
n
c
t
i
o
n
s
 
o
f
 
S
e
l
f
 
H
a
r
m
 
www.rethink.org
Release
Self Loathing
Self-Punishment
Distraction
Coming back
to Reality
Sacrifice
Control
Numbing
Communication
Self-Care
Coping
Cleansing
Calming
 
M
e
a
n
s
 
o
f
 
S
e
l
f
 
H
a
r
m
i
n
g
 
www.rethink.org
 
P
r
a
c
t
i
c
a
l
 
S
u
p
p
o
r
t
 
www.rethink.org
 
S
i
g
n
s
 
s
o
m
e
o
n
e
 
m
a
y
 
b
e
 
s
e
l
f
h
a
r
m
i
n
g
 
www.rethink.org
Physical injuries that are observed more
than once, and that appear too ordered to
be accidental
Disappearing at emotional times
Loose/ baggy clothes
Low mood, negative self-talk
Isolation, not wanting to engage
 
No Harm Done, 
Young Minds
 
T
h
e
 
F
i
r
s
t
 
C
o
n
v
e
r
s
a
t
i
o
n
 
www.rethink.org
It can be 
difficult
 to
find out someone is self
harming
You may feel 
angry,
shocked, not know what
to do, upset...
These reactions are 
normal
All evidence suggests 
having somebody to talk to
is the most important aspect of recovery
 
T
h
e
 
F
i
r
s
t
 
C
o
n
v
e
r
s
a
t
i
o
n
 
www.rethink.org
Show you
care
Don’t 
blame
them
Don’t 
judge
 or
make
assumptions
Don’t just tell
them to 
stop
Be 
Supportive
& 
Empathic
Stay 
calm
Reassure
them
Recognise it is a way of 
coping
Take it
seriously
Listen
properly
 
H
o
w
 
t
o
 
H
e
l
p
 
www.rethink.org
Know your Safeguarding Policies
Encourage a young person to seek medical
support, 
e.g. from a GP, NHS Direct
Know 
relevant services and agencies
Make sure 
you
 get support too
Don’t promise to 
keep a secret
 – know
confidentiality policies
 
H
o
w
 
t
o
 
H
e
l
p
 
-
 
T
h
e
m
 
www.rethink.org
Explore
Coping
Strategies
Signpost to
organisations,
give
information/
factsheets
Take time to
listen to them
Remember,
not all
websites are
appropriate
Treat them
normally
Be
comfortable
exploring
reasons why
 
C
o
p
i
n
g
 
S
t
r
a
t
e
g
i
e
s
 
www.rethink.org
 
C
o
p
i
n
g
 
S
t
r
a
t
e
g
i
e
s
 
www.rethink.org
 
C
o
p
i
n
g
 
S
t
r
a
t
e
g
i
e
s
 
www.rethink.org
Release
Self
Punishment
Control
These methods won’t work for everyone, it is trial and error.
 
H
o
w
 
t
o
 
h
e
l
p
 
i
f
 
t
h
e
y
r
e
 
n
o
t
r
e
a
d
y
 
www.rethink.org
 
No Harm Done, 
Young Minds
 
Our Service
 
G
l
o
u
c
e
s
t
e
r
s
h
i
r
e
 
S
e
l
f
 
H
a
r
m
 
H
e
l
p
l
i
n
e
 
www.rethink.org
 
We aim to improve the lives of people affected by
self harm, including friends, family, carers or
professionals supporting the person self harming.
 
To provide 
confidential support 
to
people in Gloucestershire who self harm
 
Use 
a Recovery-oriented 
approach,
enabling people to build a 
meaningful
quality of life (as defined by themselves).
 
Provide 
emotional support
, a 
non-
judgemental space to share
, and
signposting for users.
 
Provide a service that 
empowers
those that use it, and reduces stigma
 
Reduce
, and 
prevent
, callers’ self
harming behaviour and intent to self
harm
 
The helpline is open 
7 days 
a week, 
365
days 
a year.  Offers a 
phone, text 
and
web chat.
 
Every night, 5-10pm
Call 0808 801 0606
Text 07537  410 022
 
Questions?
 
Gloucestershire Self-Harm Helpline
 
 
Alice Brixey
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Self-harm, a complex behavior not limited to mental illness, is a way individuals cope with distress. The behavior ranges from smoking to life-threatening actions like overdosing. It affects a significant number of young people, with a notable increase in treatment for deliberate self-harm cases. Despite this, the true extent remains unknown, as many do not seek help. Coping mechanisms and support are crucial in addressing this concerning issue.


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  1. Understanding Self Harm Gloucestershire Self Harm Helpline Alice Brixey

  2. What is Self Harm? In pairs, discuss what you feel self harm is www.rethink.org

  3. What is Self Harm? Self harm Unprotected Sex Drugs Self Injury Eating Alcohol Self harm is an umbrella term for behaviours that can cause injury or danger to oneself. www.rethink.org

  4. What is Self Harm? There sno single definition of self harm - Self injury is when somebody intentionally damages or injures their body - Tissue damage to relieve tension Self harm is a behaviour it is not a mental illness. However, it could be a symptom of mental illness It is a sign of extreme distress - An internal scream Self harm is a way of coping with emotional pain, distressing memories, or overwhelming situations and experiences. www.rethink.org

  5. What is Self Harm? After a difficult day, how do you cope? www.rethink.org

  6. What is Self Harm? Self harm is a spectrum Smoking Alcohol Over-Exercising Eating Life-threatening behaviours, e.g. overdosing www.rethink.org

  7. How Does Self Harm Affect You? The number of children (aged 10-14) who had been treated after deliberate self harm increased by 70% in the past two years. The number of teenagers (aged 15-19) treated increased by 23% in this period. Health and Social Care Information Centre, 2014 www.rethink.org

  8. How Does Self Harm Affect You? 1 in 12 young people have self harmed Inpatient admissions due to young people self-harming increased by 68 per cent in the last 10 years. Last year, 38,000 young people were admitted to hospital because of their injuries. Young Minds www.rethink.org

  9. What is the True Extent of Self Harm? The number of people who have self harmed but not sought help.... ? We don t know the true extent of self harm, as some people don t have/seek the support www.rethink.org

  10. How Does Self Harm Affect You? Self-harm is the number one issue that young people are concerned about among their peers in a list including gangs, bullying, drug use and binge drinking. Self-harm is the one issue that all groups (young people, parents and professionals) feel least comfortable approaching with young people. Teachers feel helpless and unsure about what to say to a young person who is self-harming. There is little open communication about self harm www.rethink.org Talking Self Harm, Cello Group

  11. Self Harm Facts MYTH 2. People who self harm have a suicide attempt require stitches or MYTH MYTH 4. Self harm is a failed 3. If self harm does not MYTH 1. People who self harm are just attention seeking personality disorder hospital treatment, then it is not serious Fact:Self harm is a behaviour, not an illness, though self harm can manifest as intense emotional distress an individual keeping oneself alive. Fact:Self harm is often a very private thing, and people can go to great lengths to cover it up. a part of a mental illness. feels. All self harm should be taken seriously Fact:Injuries rarely equate to the Fact:Self harm is often a way of www.rethink.org

  12. Why Do Young People Self Harm? Family Factors: Individual Factors: Unreasonable expectations Neglect/ Abuse Poor relationships Mental Health Issues Low Self-Esteem Impulsivity Social Factors: Difficulty making relationships Bullying/ peer rejection Other Factors: Trauma Relationship Breakups Pressure/ Change Everyone has their own reasons for self harming www.rethink.org

  13. The Self Harm Cycle Negative Emotions (Sadness, Anger, Despair) Why have you been so selfish? You re always trying to get attention. Tension (Inability to control emotions, maybe using disassociation to cope) You ve had everything given you your whole life, what s wrong with you? Self-Harm How could you do this to me? Cutting, Burning, Etc. Positive Effects (Endorphins released, tension and negative feelings dispelled for a short period of time) What have you done, you silly girl? Mum cries when I try to talk to her Negative Effects (Shame, guilt over self-harm act) www.rethink.org

  14. The Self Harm Cycle Self Punishment Negative Emotions (Sadness, Anger, Despair) Distraction from problems Care eliciting Tension (Inability to control emotions, maybe using disassociation to cope) Reduction in tension Ways to communicate inner pain Self-Harm Cutting, Burning, Etc. Taking control Positive Effects (Endorphins released, tension and negative feelings dispelled for a short period of time) Outlet for anger Form of escape Negative Effects (Shame, guilt over self-harm act) Peer Group www.rethink.org

  15. Functions of Self Harm Self Loathing Sacrifice Release Coping Distraction Self Harm Communication Calming Self-Punishment Control Coming back to Reality Self-Care Numbing Cleansing www.rethink.org

  16. Means of Self Harming Type Means Cutting Most common method use any sharp object (i.e. razor/ scissors) Burning Flame/hot water/cigarette/bleach Using prescription medication or non-prescribed medication, or by ingesting liquids such as shampoo/bleach Overdosing From hair from eyebrows, eye lashes, scalp, arms, legs, pubic regions, often with tweezers or hands Hairpulling Scratching With brillo pads, nail brush, hands, etc Skin Picking Re-opening wounds/picking at imperfections Bone Breaking Causing damage to bones by using a hammer/other Restriction Using ligatures/ropes to restrict the flow of blood Insertion of Objects Inserting/swallowing razors Excessive Excessive use of alcohol &drugs, binge or restrictive eating. www.rethink.org

  17. Practical Support www.rethink.org

  18. Signs someone may be self harming Physical injuries that are observed more than once, and that appear too ordered to be accidental Disappearing at emotional times Loose/ baggy clothes Isolation, not wanting to engage Low mood, negative self-talk www.rethink.org No Harm Done, Young Minds

  19. The First Conversation You may feel angry, shocked, not know what to do, upset... It can be difficult to find out someone is self harming These reactions are normal All evidence suggests having somebody to talk to is the most important aspect of recovery www.rethink.org

  20. The First Conversation Don t judge or make assumptions Listen properly Don t blame them Show you care Don t just tell them to stop Stay calm Reassure them Take it seriously Be Supportive & Empathic Recognise it is a way of coping www.rethink.org

  21. How to Help Know your Safeguarding Policies Encourage a young person to seek medical support, e.g. from a GP, NHS Direct Know relevant services and agencies Don t promise to keep a secret know confidentiality policies Make sure you get support too www.rethink.org

  22. How to Help - Them Signpost to organisations, give information/ factsheets Explore Coping Strategies Take time to listen to them Remember, not all websites are appropriate Be Treat them normally comfortable exploring reasons why www.rethink.org

  23. Coping Strategies Coping strategies are used to manage immediate distress they do not allow somebody to deal with the underlying issues Asking somebody to stop self harming without finding alternative ways of coping can be very detrimental Coping strategies work best when matched to the function of somebody s self harm www.rethink.org

  24. Coping Strategies Function Coping Strategies Creativity, Writing, Talking, Exercise, Expressing emotions. Release Time limit, Rewarding yourself for not harming. Control Self Punishment Mimicking Self harm Expression of Emotions Calling help lines, Creativity, Talking, Positive thinking, socialising. Means of Staying Alive Making yourself safe, Mimicking self harm. Memory box, Medication/MH teams. Dissociation Self Loathing Be kind to oneself, Mimicking self harm. Grounding Mindfulness, Breathing, Relaxation. Be kind to oneself, Reasoning with yourself, Positive Thinking. Self Care www.rethink.org

  25. Coping Strategies Self Release Control Punishment Setting a time limit Hitting a pillow. Bite into a chilli These methods won t work for everyone, it is trial and error. www.rethink.org

  26. How to help if theyre not ready Is there someone else who may be able to have this conversation? Think of the young person and their support An informal environment or activity can help conversation flow Think about alternative ways of talking (e.g. text, helplines, etc) www.rethink.org No Harm Done, Young Minds

  27. Our Service

  28. Gloucestershire Self Harm Helpline We aim to improve the lives of people affected by self harm, including friends, family, carers or professionals supporting the person self harming. Provide emotional support, a non- judgemental space to share, and signposting for users. To provide confidential support to people in Gloucestershire who self harm The helpline is open 7 days a week, 365 days a year. Offers a phone, text and web chat. Provide a service that empowers those that use it, and reduces stigma Use a Recovery-oriented approach, enabling people to build a meaningful quality of life (as defined by themselves). Reduce, and prevent, callers self harming behaviour and intent to self harm www.rethink.org

  29. Every night, 5-10pm Call 0808 801 0606 Text 07537 410 022

  30. Questions? Gloucestershire Self-Harm Helpline Alice Brixey

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