About self-harm: a guide for young people

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A booklet for young people produced by Mind and Barnardo's

Copyright note: professionals are not permitted to print off copies for distribution to colleagues or clients. For more information see Mind's copyright guidelines.

This booklet can also be viewed as a non-printable pdf file and purchased from the Mind shop.

Why you self-harm and how to seek help
Do you self-harm?
What is self-harm?
Why do people harm themselves?
How does self-harming help?
Why doesn't it always hurt when I self-harm?
Who is most likely to self-harm?
Truth and lies
The Government says…
Moving forward
Friends and family – how you can help
Further information

Why you self-harm and how to seek help

'I no longer self-harm, but it's been a long struggle to try to work through emotions that once felt overwhelming in their power.'

Do you self-harm?

If you do, this booklet is for you. It has been written to help you understand why you self-harm and what you and others can do to help.

You may harm yourself once or twice when you have a really hard time – and never do it again. For many young people though, self-harm is a way of coping with problems on a monthly, weekly, or even daily basis.

A reminder of the past may make you want to self-harm. Or it could be something happening unexpectedly. Sometimes, ordinary life is just so difficult that self-harming is the only way to cope with it.

Whatever the reason, there are ways to help you – some of you can manage on your own; or you may need someone to help you. The most important thing to remember is that if you want to stop self-harming, there is help available.

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What is self-harm?

Self-harm is a way of expressing very deep distress that you can't put into words or even thoughts. It's been described as 'an inner scream'. After harming, you may feel better able to cope with life again – for a while.

Self-harm includes:

• injuring or poisoning yourself by scratching, cutting or burning your skin
• hitting yourself against objects
• taking a drug overdose
• swallowing or putting other things inside yourself.

'I hate myself and everything that's happened to me. My razor blade is my friend. It helps me get through each day.'

When you feel painful feelings like rage, sadness, emptiness, grief, self-hatred, fear, loneliness and guilt – they may overwhelm you and self-harming may help you cope.

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Why do people harm themselves?

If you self-harm, it is likely that you are having or have had very difficult or painful experiences as a child or young adult. These can make you feel hopeless and unloved – especially if you have no one to confide in. These experiences may include:

• separation from someone you love
• being bullied, assaulted or isolated
• being put under pressure
• homelessness
• going into care, hospital or other institutions
• neglect
• physical violence, emotional abuse or sexual abuse.

If you have been betrayed or abused by someone you trusted, you may blame yourself for what happened. You may also have buried or blocked out these painful feelings to try and help you get on with life.

As you've got older, you may have started self-harming to punish yourself and to try and keep your memories buried inside.

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How does self-harming help?

Self-harming can:

• help release emotional pain
• distract you from the emotional pain
• help you show somebody else how you are feeling
• bring you comfort

It can also be a way of punishing yourself or of trying to gain some control over your life.

Self-harming can be a cry for help – especially when young people first hurt themselves.

Generally, young people who self-harm try to conceal what they are doing rather than draw attention to it, as they feel ashamed, afraid, or worried about how other people will react.

It's worth remembering that most people behave self-destructively at times – even if they don't realise it – to avoid being alone with their thoughts and feelings. They may smoke, eat or drink too much, or work extra hard at school or college.

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Why doesn't it always hurt when I self-harm?

You may not feel pain when you self-harm. It's a bit like the way people often feel numb during abuse or trauma. If something very painful or traumatic has happened to you, you may end up feeling quite detached from your feelings and your body.

Some people self-harm to separate themselves from what has happened to them. In this way, they can convince themselves that they aren't vulnerable. Others injure themselves to make them feel something and know that they are real and alive.

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Who is most likely to self-harm?

Young women are most likely to self-harm, although the number of young men who self-harm is on the increase. Other factors that make self-harm more likely include:

• mental health problems
• being faced with a number of major life problems at the same time, such as being homeless, being a single parent, being in financial difficulty or living in stressful circumstances
• using street drugs or alcohol

Recent research suggests that one in 10 (10 per cent) of 15 and 16-year-olds has self-harmed, usually by cutting themselves. The most common reason is 'to find relief from a terrible situation'. Young people often feel under great pressure from their families, their school and their peers. Many young people report having friends who also self-harm.

If you self-harm, you are much more likely to feel depressed and anxious. You may feel angry and blame yourself for everything that is wrong in your life – even though it is not your fault. Many people who self-harm find it hard to talk about their problems and feel unable to ask friends, parents or other adults for the help they need. See 'Moving forward'.

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Truth and lies

Lie – Some healthcare professionals think people who self-harm don't feel pain and so don't need painkillers to stitch wounds.

Of course you feel pain. If you need medical treatment, make sure healthcare staff follow the Government's guidelines on self-harm.

Lie – Young people who self-harm have mental health problems.

Just because someone self-harms, it does not mean they have a mental health problem. Often, self-harming is the only way they can cope with the trauma of what has happened to them. However, it is true that some people who have mental health problems do self-harm.

Lie – Young people who self-harm want to commit suicide.

Self-harm is a way of coping with inner pain. It is a release, so that the young person concerned can control their pain and go on living. Self harmers generally do not want to die and do not risk their lives by their behaviour. Those that do die, often did not intend to commit suicide. They were just so overwhelmed with pain that they wanted to wipe out their feelings at that moment in time. In extreme circumstances though, life can get too much for a young person – when they have to cope with acutely painful feelings and memories and not enough support is available. That is why it is so important to seek help.

Lie – People who self-harm are just seeking attention.

Because it can be hard to understand, healthcare professionals, friends and relatives sometimes think people who self-harm are manipulative or are seeking attention. However self-harm is often the only way some young people can express their pain, even though this can be very upsetting for those around them.
See 'Friends and family'.

The Government says…
if you need to go to hospital, you should be offered a 'full assessment of your physical, psychological and social needs, by a professional who has been trained in the treatment of people who harm themselves, in an atmosphere of respect and understanding'.

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Moving forward

STEP 1 – Open up
Try to talk about your feelings with an adult you trust. It could be a friend, a friend's parent, a teacher, a youth worker – anyone you know and like. Even though you may feel you are alone, there are others who can understand your pain and help you. If you don't feel you can talk to anyone you know, check out the helpline numbers and websites at the back of this booklet.

STEP 2 – Like yourself
Remember you are not to blame for how you feel. It's not your fault. Make lists of your feelings and write positive statements about yourself and the world around you. If you can't think of any, ask friends to write things they like about you. Keep these in a safe place and look at them often. Make a recording of your own voice saying something positive or reading your favourite stories or poems.

Try to find ways to make your life less stressful. Give yourself occasional treats, eat healthily, get plenty of sleep and try and get a bit more active by going for a walk, a swim or a bike ride. Physical activity is known to help lift low moods.

STEP 3 – Make contact
Keep the telephone numbers of friends or local and national helplines where you can find them easily, in case you need to talk to somebody in a crisis. See 'Further information'.

STEP 4 – Get mad
Think about your anger and what you want to do with it. If you weren't busy being angry with yourself, who would you really be angry with? Write a list of people who have caused you to feel like this. Remind yourself you deserve good things in life, not punishment for what others have done to you.

Line up a set of cushions – each one representing a person who has caused you pain. Tell them how they hurt you and that you don't deserve punishment. Kicking or hitting cushions is good. Try to do this with someone else, if possible, so that the experience is shared and you do not hurt yourself!

STEP 5 – Art attack
Try something creative – it is a powerful weapon against despair. You might want to make something – try clay modelling or painting. Some people draw on themselves using bright body colours. Or you might just want to listen to some music or do some drawing.

STEP 6 – Keep safe
If you feel the need to self-harm, focus on staying within safe limits. A supportive GP will give you good advice on minimising harm and caring for your injuries as well as help you to find further help.

STEP 7 – Professional help
If your experiences are so painful, you may seriously doubt whether you can deal with them in any way, other than by self-harming. If possible, talk to your GP and be as honest as you can. It may be very difficult for you, but do try. Your GP is the first port of call to help you get the professional support you need. They should refer you to a professional person, who should have the training to listen to you and help you manage your feelings in a different way. This person may be a counsellor, psychologist or psychotherapist – whoever is considered best.

Together you need to address what happened to you in the past and how you can cope with life now. If your GP is unhelpful, you have the right to change your doctor. Look in your local Yellow Pages or visit www.yell.com for a full list of GPs in your area.

If your self-harming is severe, you may be referred to psychiatric services for further assessment, treatment and support. In an emergency, you may be taken into hospital. While there, tell an adult you trust about how you feel and get them to speak up on your behalf. In time, most people do move forward and are able to grieve over past events and work through the fear and confusion surrounding them. With plenty of support, you will learn to cope with the pain, anger and rage, which need to surface.

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Friends and family – how you can help

If someone you love or care about self-harms, it can be very difficult to cope with your own feelings. You may feel shock, anger, guilt, grief and helplessness. You may be very afraid of what might happen.

1. Don't ignore what's happening.
Pay attention to the young person's injuries. In this way, you can show that the young person and their body is worth caring about. Don't make a big deal of the injuries, though. It's important that you appreciate how difficult things are for the young person concerned and that this is their only way of coping.

2. Tell the young person that you want to understand how they are feeling and want to help.
Gently encourage them to examine their feelings. Ask them why they self-harm. At first, they may find it difficult to talk or you may find that what they have to say is difficult to hear. If it feels too much for you, help them to find someone else to talk to.

3. Be honest about your own feelings, but try not to be critical or blame the young person.
Try not to make them feel guilty either or treat them as if they have mental health problems. This will help them feel accepted and cared for.

4. Be positive. Keep emphasising all the positive aspects of the young person's life to help develop and support their sense of self-worth.

5. Be realistic. Don't expect the young person to stop self-harming, just because you want them to. People who self-harm are trying to resist feeling the full weight of their emotions. They have learnt to protect themselves by self-harming over a long period of time and this cannot be overcome easily. It takes time for people to learn that their feelings won't destroy them.

6. Don't take over.
While you want the young person to stop self-harming, you can't solve their problems for them. In the end, everyone has to draw on their own strengths and find their own ways of healing.

7. Remember – although you may feel helpless – you are not.
You can make a lot of difference by showing you care.

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Further information

Barnardo's
Information and some support services for children and young people who self-harm.
Tel: 020 8550 8822
www.barnardos.org.uk

Basement project
Support groups in Wales for those who were abused as children and people who self-harm.
Tel: 01873 856524
www.basementproject.co.uk

ChildLine
A confidential 24-hour helpline for children and young people.
Tel: 0800 11 11
www.childline.org.uk

Crisis Recovery Unit
Dower House, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX
A national, specialist service for people aged 17 and over, who persistently self-harm. Includes in and out-patient treatment.
Tel: 020 3228 4414
www.slam.nhs.uk/services

Hearing Voices Network
Information and support for people who hear voices and those who support them.
Tel: 0845 122 8641
www.hearing-voices.org

LifeSIGNS
Raises awareness and provides information on self-harm.
www.lifesigns.org.uk

National Self-Harm Network
A survivor-led organisation supporting those who self-harm.
www.nshn.co.uk

NSPCC
Free 24-hour line for abused children, families and survivors.
Child protection helpline: 0808 800 5000
www.nspcc.org.uk

Penumbra
One of the main organisations in Scotland concerned with self-harm, particularly amongst 16 to 25 year olds.
Tel: 0131 226 3661
www.penumbra.org.uk

RU-OK.com
Website for young people who self-harm to use on their own or with an adult.
www.ru-ok.com

Samaritans
Confidential, non-judgemental helpline offering support 24 hours a day.
Tel: 08457 90 90 90 Minicom: 08457 90 91 92
Email: jo@samaritans.org 
www.samaritans.org.uk

YoungMinds
Provides information and campaigns to improve mental health of all children and young people.
Parents' information service: 0800 018 2138
www.youngminds.org.uk

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'Self-harm involves all of us on some level. We may all punish, distract or numb ourselves, as a way of dealing with difficult feelings or situations.'

All rights reserved. No part of this publication may be reproduced, stored on a retrieval system or transmitted in any form or by any means without permission of the publisher. © Barnardo's / Mind 2007