June 23, 2021
Dealing with Distress
By Dr Kathy Weston
Reflect
It is currently World Wellbeing Week, so it is the perfect time to spotlight an issue that, sadly, is on the increase among both boys and girls; self-harm.
It is a topic that most of us likely never heard of when we were pupils at school. Now, it is a major talking point (yes, even in primary schools) and is increasingly on the radar for parents. For many of us, it is unthinkable that our children could hurt or injure themselves intentionally. It is unthinkable that they could ever want to end their lives. Yet, in recent weeks, I have spoken to several, very loving, parents, who have had to face these devastating facts. We can’t afford to stigmatise this topic. We mustn’t ignore it. Doing so is a bit like paying no attention to the flight attendant urging us to familiarise ourselves with the emergency equipment, designed to assist in the very worst scenario.
The stakes are high and the statistics speak for themselves. Worldwide, youth suicide is the second leading cause of death in young people aged 10-24 and the fourth leading cause of death in 5 to 14 year olds (Hughes, 2021). In the UK, data from the Millennium Cohort Study showed that 1 in 4 teens reported self-harming in the last 12 months and that about 7% of UK children have attempted suicide by the age of 17.
The risk of both self-harm and suicide dramatically increases in the teenage years (the steepest increase in risk for any age group) and whilst girls are more likely to attempt suicide, boys are more likely to die from a first attempt. Being LGBTQ puts young people at much higher risk of self-harm or suicide. We know that in America, LGBTQ youth seriously contemplate suicide at almost three times the rate of heterosexual youth. The impact of the pandemic is still being analysed and it remains a source of research discussion as to whether or not lockdown reduced or exacerbated self-harm rates in the young.
Motivate
First of all, if you are reading this and are concerned that your child has self-harmed, is self-harming or might be suffering from depression, do seek immediate advice from a medical professional. Do not be afraid to take this step.
If you can’t wait to see the GP, you can also head straight to A&E, where your child will be seen. Professor Ellen Townsend, a national expert on this issue has asserted that, ‘all acts of self-harm should be taken seriously‘. As tempting as it might be, try not to minimise or dismiss any acts of distress, or leave it to see if the situation improves.
There is very specific advice in terms of how to respond if/when you come across your child self-harming and, as parents, we should only access the highest quality information. As hard as it may seem, try to remain calm. Be as gentle and understanding as possible. Reassure your child that you are there for them and you will get through this together. Tell them that you might not understand, but you are willing to learn. Make sure they know that you are happy to listen or to facilitate the process of them talking to someone else. Remember that self-harm is a coping mechanism which is a symptom of an underlying problem. Getting angry or upset about the fact they have chosen to cope in this way, won’t help.
In addition to seeking professional support for your child, you can help by ensuring that family life is as stable and secure as possible and that your child has contact with people that make them feel good about themselves. Make sure that they have access to online material that is life-affirming and positive (rather than negative and dark), and to things that can help them to process their emotions (music, art, journaling, poetry, for example) as well as exercise, good nutrition, joy and unconditional love.
Support
Ultimately, I urge all parents to think about the theme of coping. What helps you to cope with life’s challenges? What habits do you wish to pass on to your children? Which maladaptive coping strategies are you prepared to ditch?
Proactive parents should routinely help their children to map out the things that make them cope better and feel joyous, optimistic, hopeful or enthused about life. Don’t wait to do this exercise! In terms of early intervention with tweens and teens (or suicide resilience), focus on the pillars of good mental health in family life; sleep, healthy diets, exercise, access to nature, spending time with loved ones, doing more of what we enjoy and having things to look forward to.
Be on the lookout for behavioural signs of distress in your child (e.g. increased irritability, insomnia, withdrawal from normal activities or loss of energy). Situational triggers might be experiencing loss, relationship conflict, being fearful of punishment or feelings of shame. Reiterate, as gently as possible, that there are many ‘emergency exits’; options, choices and pathways, ahead of ever injuring oneself, that can help us to cope throughout life. Discuss multiple coping strategies, across a range of scenarios. Talk about some of the reasons why young people don’t want to ask for help and try and unpick these with your child.
In times of distress (particularly for teens), it can be really difficult to think about what our options might be, so it is a good idea to think it all through, ahead of time. While your children are happy and relaxed, help them to articulate who they can turn to in times of trouble. Help-seeking is something we hope all our children will be practised at, as they move into young adulthood. We want them to be able to admit when they aren’t feeling so good and be able to locate, the support tools necessary to cope and adapt well, from the psychological toolbox that we have modelled and discussed with them over the course of their childhood.
Are you a Tooled Up member?
If your school is Tooled Up and you want to learn more about this topic, tune into my podcast with Professor Townsend and read the accompanying podcast notes. Check out our Self-Harm: Tips for Parents resource and download our list of organisations, apps and resources that you or your child can reach out to in times of need. To make sure that your child knows who to turn to when they need help, we encourage all parents to download our Who is There for Me activity to fill in together.
If you know that your child is already struggling with self-harm, it is important to have a clear safety plan in place. Keep your eye on the Tooled Up library as we will soon be publishing a template which can help struggling teens to think about who is there for them and consider their coping strategies. This should not be used as a replacement for clinical advice – always speak to a medical professional.