Self-Harm: Youth Edition
I’m probably not all that different from you. I like spending time with friends. I have a pretty nice family, though we have the usual disagreements. School is a constant pressure, but that’s nothing new. I’m not the most popular, but at least I have a few good friends. I spend most of my time being quiet and just being there. And I have a secret… I feel so numb at times that I hurt myself. I’m not proud of this, but when I’m alone I have a hard time resisting the urge. Every time I do it, I feel guilty and ashamed.
I don’t want everyone to know about this, because it would be another reason why people would dislike me. If my parents found out, they would probably freak out and tell me to stop seeking negative attention. My friends know I do it and promised to keep it as a secret. I know they’re worried. I wish I never started doing this, but I have a hard time stopping. I really don’t know what to do...
Self-harm (or “self-injurious behaviour”) is when you hurt yourself on purpose. People often think it’s a kind of suicide attempt, but it’s not. Self-harm is actually how some people try to cope with unbearable feelings or overwhelming situations. If you’re self-harming, you’re actually trying hard to handle things. Even so, some people who self-harm think about suicide sometimes.
Many people believe that self-harm behaviour is a way to get attention. For most people who self harm, this isn’t true. Those who self-harm usually try to keep this a secret. And because it’s mostly a ‘secret’ activity, researchers have a hard time working out exactly how often it happens. A number of studies show that anywhere between 1-14% of youth self-harm. Most of these youth start between 13 to 15 years of age. Earlier research suggested girls harmed themselves a lot more often than guys. We’re now finding out that there isn’t as big a difference between guys and girls. Self harm behaviour usually peaks between the ages of 16 and 25.
People may self harm for many reasons:
- Deal with stress
- Get relief from painful or distressing feelings;
- Deal with feelings of numbness;
- Communicate pain or distress to others;
- Gain a sense of control;
- Punish themselves or express anger toward themselves;
- Reduce anxiety.
Self-harm is not about "getting attention", but rather is a sign of needing help.
Having stresses and concerns are quite natural, but self harm is an unhealthy way to handle these challenges. Self harm behaviours can be a bit like addictions, because the intensity and frequency can increase with time if not treated early.
Unhealthy coping such as self-harm behaviours tend to appear when people experience a series of unpleasant experiences and are overwhelmed by their thoughts and feelings.
1. At risk person
Self harm happens more often in people who have:
- Family members who have self harmed;
- Lived through negative or very difficult experiences (like abuse or trauma);
- Have or have had a mental health problem;
- Few supports or healthy coping skills.
2. Stressful event or situation
People that self-harm are often triggered by a stress such as:
- Peers stresses, such as peer pressure, conflicts with friends, bullying, teasing
- School stresses such as schoolwork, problems learning, teachers
- Family stresses such as problems with parent's divorce/separation, transitions, or conflicts with parents or siblings
Difficult feelings such as feeling numb, empty, angry, anxious, depressed
When overwhelmed by one's stresses, a person may try to cope by using self-harm...
Unfortunately, while self-harm might give temporary relief, it can cause other problems and create a vicious and destructive cycle that can be difficult to stop.
The good news, is that there are always other ways to cope such as:
Telling a parent
Calling a friend for support
Going to work out
Listening to music
Writing in a journal
Distraction strategies, by doing something else
Coping thoughts such as telling yourself that things will get better, or that there are people that care and worry about you
If you find that you are self-harming, it can be easy to feel down on yourself, but don't despair... The truth is that if you are reading this, then you are doing something to manage your feelings and are trying to cope. You can learn new ways to handle things... Keep reading!
The good news is that there are many ways to manage, reduce and eventually stop self-harming:
Tell a trusted family member. It might be your mom, dad, aunt or uncle or even an older sibling. Maybe you've already told an adult and it wasn't helpful, or maybe you're worried about telling an adult because you're worried they won't understand. Here are some things to say that might make it easier:
Bring up the topic, "Can we talk sometime? There's something really important I need to talk to you about..."
Tell how you've been feeling: "I've been feeling really overwhelmed lately. Some of the stresses that I'm going through include _______."
Ask for support: "I could really use your support with this."
Let the other person know what type of support you want, which usually is someone to listen: "The most important thing that I need is for someone to listen. Its hard for me to open up if I'm feeling lectured, criticized or judged..."
Tell a teacher or guidance counselor, or a health professional such your family doctor or paediatrician. They can help you by referring you to a professional such as a counselor/therapist if necessary. They can help you find ways to deal with your stresses, and find alternatives to cutting (if that is what you want).
Common strategies include:
Pin point stresses and situations that ‘trigger’ self-harm behaviour
- What made me upset?
- Did anything ‘trigger’ me?
- Am I feeling anxious, depressed, numb or angry?
- When do I tend to harm myself?
- What am I typically thinking of?
- How does my thinking affect the way I feel?
- What am I missing?
- What would I like to see change?
- Did I try anything else to cope with my stress?
- What can I do differently next time?
Change unhealthy thoughts
What you think really influences how you feel. We tend to remember the negative things in life and forget the nice things: like positive experiences, relationships or our accomplishments. This negative ‘mental filter’ fills up with negativity and blocks out the good things we hear, or do or experience. We also get in the habit of ‘mind reading’, where we assume that others are thinking bad things about us. We end up jumping to conclusions and responding to situations with almost automatic negative thoughts. You can change the way you think about things, but it takes practice.
Become more aware of negative (and unhelpful) thinking and challenge your negative thinking by asking yourself:
- Is this a helpful thought for me to have?
- What would be a more helpful thought to have?
Then spend some time thinking of other possible explanations for a situation or someone’s reaction...
- Maybe they are upset about something else?
- Maybe this has nothing to do with me?
Noticing the ‘good things’ in your life is important, and it also takes practice. Take some time every day to remember some positive things in your day. Each day, think about the things in your life that you’re grateful for. Practice gratitude for small things: a delicious muffin, the feeling of sun on your face, seeing a lovely bird, a kind smile, the feeling of your cat’s fur, a compliment, having a friend....)
Manage your emotions
Emotions can range from being pleasant to unbearable. We need to be able to experience our emotions, but we also need to be able to manage them. It’s hard to make good decisions if emotions take over. We can learn to handle sadness, worry and anger, without letting these feelings control us. There are things you can do to make yourself feel a little better. When you are feeling sad, anxious, stressed or angry, try things that will distract or relax you:
- Arts and crafts
- Exercise (walking outside, yoga, any physical activity you enjoy)
- Playing or listening to music
- Watching a funny movie
- Taking a bath or singin in the shower
- Deep breathing
- Hanging our with friends (and not talking about the things stressing you)
- Cleaning your room
- Journal writing
Note that not all these strategies will work for everyone. Try a few to see which ones work for you!
Improve problem solving skills
You really can develop skills to give you more control over situations and improve things. It’s always easier to handle things if you break them down into smaller bits first. You might find this a helpful way to work through a problem in a positive way. Don’t be afraid to ask for help. Writing things down may also help you to organize your thoughts a little better. Please see our ‘Mental Health and Mental Illness’ fact sheet for youth for more detail on problem solving techniques.
Define the problem. What’s bothering you? Does something need to change? This has to be something that is
important to you. If it isn’t, you’re not likely to put any real energy into solving it. Be as clear as you can.
Set a goal. What would you like things to be like? Having a goal in mind will really help you get there, but make sure your goal is realistic. You may not be able to get an A+ in math. But you could go from a failing grade to a ‘C’. Keep track of your progress. When you meet your goal, you can build on your success by setting other goals.
Brainsorm options. Think of all the possible ways to make things better. Be sure to think about:
- Things you might need to learn or practice
- Things you may need to change
- Actions you can take
- People who can support you or help to solve the problem
Make a plan. Write out what you’re going to do to meet your goal. It will help to be as realistic and specific as possible. Remember that change doesn’t happen overnight. Change usually happens in smaller steps, over time. Think about how you’ll handle mistakes and setbacks. This is where you try to focus on the stuff you will do, instead of the outcome. If you goal is to improve your grades, break things down into manageable actions like:
- Go to class everyday
- Spend ___ hours each night on homework
- Limit screen time to ___ hours a day
Get started and follow through. Keep track of the actions you’re taking. This can help you see the progress you’re making. Plan some little ‘rewards’ for yourself, for sticking to your plan. It’s OK to make mistakes-everyone slides a bit when trying to make a change. Learn from it, and move on.
Reflect. Think about what’s working and what’s not working. Be sure to pay attention to the things that may be getting better. Ask yourself:
- Is your goal realistic?
- What part of the plan am I having trouble with?
Do you need:
- More time?
- More support?
- A different plan?
Communicate effectively. Learning to communicate more effectively can help you solve problems and have better relationships. Speaking up can also help you reach out when things hurt so much that you need to take it out on yourself. For things to get better, you’ll need to share your struggles with others, and ask for help. You can do this face to face, but you can also write a letter. Being a good communicator will help you get your needs met. When talking about anything that’s bothering you, try ‘DEAR’, below. It will help you share what’s on your mind and help you to solve problems.
Describe the current situation. Try to stick to the facts.
E.g. “This semester has been pretty rough.”
Express- your feelings and opinions about the situation by using "I" messages. Using “I-messages” is the best way to get your points across, and can prevent the other person from reacting defensively. “I” messages are ways of expressing yourself, that begin with “I”. They are a respectful way to get your point across, without threatening others.
E.g. “I feel overloaded and overwhelmed by all of this school work. I get stressed when you compare me to my brother."
Ask for what you want or need.
E.g. “I was hoping I could get some help to prepare for this next test.” / "I was hoping you could just listen to how I feel; I don't want any advice, but just someone to listen." "I was wondering if you could stop comparing me to my brother."
Reinforce by telling the person how they can help you. Help them feel good ahead of time for supporting you.
E.g. “I know how busy you are, and I really appreciate your help.”
Well, my worst fear happened. My friend told the guidance counsellor at school. I have to admit, I was pretty upset and felt betrayed at first. But now I look back at it and I see that my friend was actually being a good friend to me. I met with the school counsellor who told me I wasn’t alone and it wasn’t my fault. She helped me understand my stresses, my feelings and my thoughts. I learned some new things to help me me get through the rough times.
She also helped me talk with my parents. They were upset at first, but it wasn’t the end of the world. They really wanted to help, and it was a relief to have more people to talk to about things. They helped me practice the things I was learning. It wasn’t always easy, and I would still hurt myself sometimes. However, as things progressed, the time between each relapse became longer and longer until the day I realized that I had plenty of other tools to help me deal with the tough times. Things aren’t perfect but for the first time in a very long time I can say I feel happy and hopeful about the future.
Reviewed by the Mental Health Information Committee at the Children’s Hospital of Eastern Ontario (CHEO). Thanks to YouthNet’s Youth Advisory Committee (YAC-CHEO) for reviewing and providing feedback to this fact sheet!
Under a Creative Commons License. You are free to share, copy and distribute this work as in its entirety, with no alterations. This work may not be used for commercial purposes. Contact the Mental Health Information Committee at the Children's Hospital of Eastern Ontario (CHEO) if you would like to adapt these for your community!
Information in this fact sheet may or may not apply to you. Your health care provider is the best source of information about your health.
Date of Last Revision: Oct 28, 2016