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Self harm - with Karina from 42nd Street
Karina from the organisation 42nd Street joined us in live chat to answer your questions on coping with self harm. Find out about when to seek treatment, how to tell a teacher or tutor and how to support a friend who is harming themselves.
Ella-Mae: I have a question. Is it possible to stop self harming forever?
Karina: Hi Ella-Mae, thanks for your question. Each person is an individual. Some may stop self-harming for years and then find they need to use it as a way of coping with a difficult situation that's arisen. Others may find they never need to do it again because they've found another coping strategy.
Ella-Mae: I haven't done the worst type of self harm in a while but the urges are so strong. I'm hoping I can stop all self harm.
Karina: It's really positive that you're feeling you want to find another way to manage your urges to harm.
Ella-Mae: Yes, because I went too far last time which is dangerous. Thanks for your help.
Karina: Try to remember that when the urges come, you can think about what's happened in the past and what worked and do your best to continue to do those things.
Ella-Mae: OK, thank you very much.
Karina: It's important to know your limitations and know when you need to get help if you feel something is too dangerous. This could mean talking to someone, or going to the hospital to get medical intervention.
Ella-Mae: I'd get help if the nurses at A&E were nicer.
Fostress: We've got some info and a video here about going to A&E which might help a bit Ella.
Ella-Mae: Thanks Fostress.
ballpointpen: Some nurses at A&E aren't too bad but, yeah, some are awful.
Karina: We understand many A&E staff need more training on caring for young people who self harm. Remember you certainly have the right to receive fair and respectful treatment, as is shown in the video, and you have the right to complain if you don't receive that.
Ella-Mae: I didn't know that. I thought in hospitals you deserved it because it's self inflicted.
Fostress: That's definitely not true Ella. Maybe have a look at the video later as that has more info on going to A&E for self harm.
Broken-Angel: Hi. I was just wondering about burns. How do you know if you need to go to A&E? I know with you should go with deep cuts, but I've never been sure when burns need medical treatment?
Karina: Thanks for your question Broken-Angel. It's quite difficult to gauge how far you can go without seeking professional treatment. With a minor burn you can run it under cold water for a long time and that can help. It's not necessarily about what the burn looks like but, how it feels. So, if you're in unbearable pain, then you need to listen to that and go and get it seen to. It's also about how a burn heals. If it's not healing well then that's also a reason to get treatment.
Broken-Angel: How are you supposed to dress burns?
Fostress: TheSite has a first aid article on burns which might be useful.
Broken-Angel: Thank you Fostress, I'll have a look.
Karina: I'm afraid I can't give you accurate [treatment] advice around burns, so hopefully that link will help. I can offer much more information about emotional support than I can medical intervention. It's really good you're asking about these things though Broken-Angel.
Fostress: NHS Choices also has some information that might be useful too.
ShyBoy: I found out someone very close to me was self-harming. She said she didn't do it often, that it was a one off and I should forget about it. I tried to be non-judgemental and said if she wanted to talk to me, she could. She really appreciated that and gave me a hug. Since then, she's never mentioned anything about it to me and I have no idea if she still self harms. Should I just keep my nose out of her business? Or should I ask her about it?
ballpointpen: I wouldn't ask her.
Karina: For some people, self-harm may be a one-off. There are others who continue but want to keep it private. This could be because they feel they're managing it and are in control. It would be good if you can trust your friend. It's good that you were aware of it this time but, chances are, she will seek you out if she needs your support again. It sounds like you've been really supportive until now, so just let her know you're there if she needs you. Does that make sense?
ballpointpen: In my experience, if people want to talk they will approach you. I felt like people were interrogating me, or didn't believe me, when I said I'd stopped. It's about trust I suppose.
Karina: Yep, that's a good insight ballpointpen.
Broken-Angel: ShyBoy, ask her more about her emotions not just the self harm. Ask how she feels, instead of asking if she's hurt herself.
ShyBoy: I still talk to her about a lot of things. She just never mentions the self-harm so I guess she doesn't want to talk about that. I've never brought it up other than the time I saw it. I just worry about her. Yes that does make sense Karina, thank you.
Karina: Sounds like you're on the right track ShyBoy. Just keep doing what you're doing.
ShyBoy: Yeah, I wouldn't want to force her to talk about something that embarrasses or upsets her, so I've never brought it up.
ballpointpen: Which therapies are actually effective in helping with self harm? I've been a self harmer for over 10 years and I'm horribly scarred. I have children, and I'm pregnant, which obviously raises difficult questions. I'm not a bad parent and Im desperate to stop self harming, but sometimes it feels like something else takes over and I just can't help it.
Karina: Thanks for your question ballpointpen. First off, just because you self-harm doesn't make you a bad parent. In terms of therapy, different approaches work for different people. Counselling often works well with the people we support at 42nd Street, talking about ways of coping and distraction techniques.
You say you've been harming for ten years - have there been any periods where you've managed to stop or have had any therapies? Also, is your GP or midwife aware of your self-harm?
ballpointpen: I had CAT therapy which triggered off terrible PTSD, so wasn't effective at all. I had a short course of psychotherapy but, unfortunately I was a drug addict at the time and was always intoxicated, so the sessions were terminated. That was pre-children, I'm clean now. I generally don't self harm when I'm pregnant.
My GP is aware as I have spent some time in psychiatric hospitals and my midwife is aware there are mental health issues. My history was flagged up at my booking appointment.
Karina: Do you think you might be able to go back to psychotherapy at this point? Would that be an option? Any therapies can trigger flashbacks or nightmares at the start because emotions you've repressed through harming can come back. But, over time, the situation will improve and you will move forward.
ballpointpen: If psychotherapy would be beneficial then I can ask about it. I know the NHS is very stretched though so waiting lists are through the roof.
Karina: It's good that your GP is aware and it's important you continue to access the services that are locally available as this is how you can get ongoing support. It sounds like, at this point, you are ready to begin this kind of treatment. It may be quite painful at first, but it does have lots of potential.
ballpointpen: I wanted to get some support while still pregnant but there is no chance, sadly.
Karina: It might be helpful to check out some voluntary psychotherapy projects in the area to avoid waiting lists. Heres a link to the local advice finder. How old are you, if you don't mind me asking?
ballpointpen: I'm 24. Thank you for the link. I am nearing 25 though, so I don't think youth services will help me for much longer.
Karina: You might also have come across an online community called www.recoveryourlife.com - there will be lots of discussions about different treatments on it.
"We realise that sometimes a situation might feel so tough that self-harm is the only option. But by putting support mechanisms around you, you have every chance of moving forward."
ballpointpen: OK, thanks. I'll write that one down too.
Karina: Quite a few youth projects do go up to your 26th birthday and some local support groups are supportive to both young and older people.
We realise that sometimes a situation might feel so tough that self-harm is the only option. But by putting support mechanisms around you, you have every chance of taking forward other ways to avoid harm. It's so positive that you've been able to stop harming while pregnant. It will be good to remind yourself of how you've managed that, and what mechanisms you've put in place, that can help post pregnancy.
ballpointpen: Hopefully. Thank you for the advice!
Karina: Keep up the good work ballpointpen. We're really pleased you came to this chat.
Lizzie: I self harm and I slipped up two days ago. I think I'm going to tell my tutor in college but I don't know how to tell him or what to tell him.
Karina: Hi Lizzie, this is quite a common question. A good way to start is to perhaps write down what you'd like the tutor to know. You could either read it out to them or hand them the letter. It's also good to think about the reasons you'd like the tutor to know.
ballpointpen: I agree with handing them a letter. That's what I do when I have GP appointments and find it difficult to talk.
Karina: You say you slipped up two days ago? What is it that you'd like to tell your tutor about? And maybe what were the triggers around that?
Fostress: There's an article on TheSite about confiding in someone which might be helpful too Lizzie.
Lizzie: That's a good idea. I hadn't thought of that. I just wanted to tell my tutor in general that I self harm. What would happen after I told my tutor?
Karina: That's good to hear ballpointpen. It's helpful to know that it's an approach that has worked for others.
As I said Lizzie, it's important to know why you'd like the tutor to know. But it's also important to check out the confidentiality policy for your school/college so you know what will happen with the information. It will probably be shared with wider teaching staff and not just stay with that tutor.
Lizzie: The last time I told my other tutor she told my head of year, but nothing really came of it because I'm 18. Will they have to tell my parents?
Karina: No they won't, but other teaching staff will be made aware.
Fostress: We've got a good article on confidentiality that's worth a read Lizzie.
Lizzie: Thanks, I'll take a look at it.
Karina: Is there anything else you wanted to ask around that Lizzie?
Lizzie: I don't have any more questions. Thank you very much for your help.
HannahMarie: Hey, just a quick thing really. Im 13 and if I told my school that I self harm, would they have to tell my parents?
Karina: Again, it would very much depend on the policy of the school. From our experience, some schools will immediately have it in policy to safeguard by informing parents, but we can't answer that on behalf of your school.
HannahMarie: OK, thanks.
Broken-Angel: Hannah, they probably would, they told my parents. But it is useful because that way you can have a meeting with the school and your parents and talk it all through in a safe environment.
Karina: Is the reason you'd like to tell your teacher to get help? If so, there might be other projects in the area that can offer support without breaking confidentiality?
ballpointpen: How do you find out what your school's policy is? Can you just ask the head?
Karina: You can ask any of the teaching staff or the reception staff at the school. There may even be a policy on your schools website.
HannahMarie: I look after my mum so wouldn't want her to find out. If she did, then it could cause more stress to her which actually will make things harder for me. I'm hoping to tell school about looking after mum so I can get some help and wasn't sure whether to bring the self harm up or not.
ballpointpen: This is a difficult one and I suppose it depends on why you want to tell your teacher. For support within school? Or for outside support? I guess I would ask the year head or your trusted teacher about what they have to tell your parents. I'm a bit out of the loop with things like this.
Karina: Are you in touch with staff at a local young carers project? Perhaps they could help you with being in touch with the school?
HannahMarie: Not at the moment. I sent them an email recently but didn't get a reply so think I might phone up.
Broken-Angel: Hannah, I think you need to speak to someone. Maybe your GP or a trusted teacher?
Karina: We'd agree that it's important that you speak to a trusted adult as it's a lot for you to manage alone.
HannahMarie: Yeah, I'm hoping to talk to school about it more. Thank you.
Karina: Giving the local project a call is a good idea as it can speed up the process to make sure you get the care you need, as well as your mum.
noonoo: I have a question. Is it normal that I yearn for the sight of my own blood just to prove to myself that I still exist?
Karina: This isn't unusual. We've heard this from other young people who feel disconnected that seeing their own blood helps them to feel real
noonoo: That makes sense as I have diagnosed DID.
Karina: I see, so hopefully it's useful to hear that. Self-harm serves many functions for different people. It's good that you're able to identify one of the reasons why you do it. From there, you can identify other ways to feel alive.
noonoo: Yes, I also see myself and have alternate-personalities. I count things to help me cut off my emotions.
Karina: It's good you have an understanding of yourself and what you need to do.
ballpointpen: What is 42nd Street?
Fostress: 42nd Street is the organisation Karina works for ballpointpen.
Karina: We'd love to be able to offer some advice now with more time, but if you send us a question then we'd be really happy to help you with a considered, detailed response. We answer questions on self harm through askTheSite. We're based in Manchester, Salford and Trafford. We're a mental health project offering support to young people aged 13-25.