Mind Matters with Kyle MacDonald: Self-harming a cry of distress

Self-harming is scary, especially when a person is young.

A friend of my 12-year-old daughter has started self-harming by cutting and scratching herself, and has shown my daughter - and then she told me. Should I do something? Should I tell her parents? Help please.

Scary stuff for any parent, and even more so at this age - sadly we know that the age at which people commence self-harm has been getting younger, and we also know that children and young people are experiencing higher levels of distress and mental health struggles, in part due to Covid-19, but it was a trend that had commenced well before the pandemic.

I believe there is a responsibility to do something, given her age. But the first thing I would want to do is to validate and affirm your daughter for coming to you. She is also too young to be holding on to information like this and she should be commended for sharing it and in doing so seeking out help for her friend.

As to your question, telling her parents- whilst certainly an option - it depends largely on your relationship with them, and your read on what kind of relationship she has with her family. She may be telling her friend - your daughter - because she feels she can't talk to her parents, and if so it would be good to respect that, and understand why.

Generally, when people reach out - unless the risk of immediate harm is acute - then the best plan is to talk with them about what help they might like - yes even when they are 12.

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Self harm is scary, and especially when the person is so young. But it doesn't necessarily mean they are at increased risk of suicide. Of course, there is always the risk that the person may accidentally cut harder or deeper and unintentionally themselves serious harm.

However self-harm isn't suicide, nor is it a manipulative "cry for help". It is a way of managing overwhelming distress and emotional pain, and people do it because it works - at least in the short term. The physiological response to pain and harm is so good at grabbing our attention at a basic physical level it tends to get rid of, at least for a while, other distress. However the price paid is one of shame, regret and of course physical harm and frequently lifelong scars.

It's also true that in the longer term if people come to rely on harmful ways of managing distress they don't learn other, more effective tools.

Back to your question. We can safely assume she is distressed, and has some things going on in her life she doesn't know how to handle.

I'd invite her over and have a gentle, non-blaming, concerned conversation. Let her know you are aware of her recent self harm and you're concerned, and want to help - and importantly won't do or say anything to anyone without her okay. But that it's also important that she tell someone, so she can get some support and help with whatever is going on for her.

Lay out the options for her. Is there a school counsellor, or a teacher she feels comfortable talking to? Would she benefit from calling a helpline as a first point of call? Or would she like you to talk to her parents on her behalf?

If she refuses to seek out help, you will need to intervene with or without her permission, so you should tell her that. But that is the option of last resort, ideally, she can be supported to make that choice herself.

Because it's okay to know you need help, and at the same time - especially at her age - not know what help looks like. And even though it's hard we should certainly trust young people to know what help they DON'T want.