Why children self-harm and what parents need to look out for

Self-harm is a subject parents are understandably reluctant to discuss with their children, but the sad truth is that it is all too common among teenagers.

Self-harm is a taboo subject, not just among friends but culturally, too. Although there are no official figures on the number of young people who injure themselves in the Emirates, Clare Smart, an adolescent counsellor at Lifeworks Dubai (www.counsellingdubai.com), estimates from clinical experience that there are as many cases in Dubai as there are in other parts of the world. According to the World Health Organisation, 20 per cent of teenagers self-harm worldwide.

It is particularly difficult to gauge how many people are self-harming, since parents and teenagers alike fear talking to their doctor because under UAE law self-harmers can be fined and/or jailed for attempted suicide, despite the fact that most people who self-harm are not trying to kill themselves. In August, a runaway teenage boy slashed his wrists at a Dubai police station but denied an attempted suicide charge, saying he did not mean to end his life. "I hated myself then because of my problems with my family so I cut myself with a blade. I wasn't aware of what I was doing," he said. The boy is receiving treatment at Rashid Hospital.

Adolescence is a trying time for both young people and their parents and it is frequently when self-harming begins. "When certain teenagers feel pressure, are lonely, or conflict with a parent or authority figure, they resort to self-harming to cope with the emotional pain," explains Dr Roghy McCarthy, a clinical psychologist at the Counselling & Development Clinic, Jumeirah (www.drmccarthypsychologyclinic.com). Adolescence is also a time when a person may be exposed to self-harm through peers or the media.

What parents should look out for

It is important parents are aware of the signs that their child might be injuring themselves.

"Those who self-harm generally try to keep it a secret and cover any proof with clothing, which makes it difficult to detect self-harm injuries," explains Dr Raymond Hamden, a clinical and forensic psychologist at the Human Relations Institute, Dubai (www.hridubai.com). "However, there are red flags you can look out for. These include: unexplained scars or wounds from cuts, bruises or burns. These types of injuries are usually found on the wrists, arms, thighs and chest." Hamden advises parents to be aware of clothes, bedding and tissues that may carry blood stains. Sometimes parents are alerted by the school when physical marks are seen during PE lessons or by the school nurse.

How a parent should respond

If you discover your child is using self-harm to cope with emotional problems it can come as a great shock.

The first reaction that a young person has when they admit that they have self-harmed is really important. "While you may be feeling shocked, disgusted, scared, upset and angry, it is advisable to try to keep calm when talking to your child," says Smart. "Remind your child that you love them and that they can talk to you about this if they feel ready, then allow them to talk while you simply listen." Don't ask them to make any promises about stopping self-harm or issue ultimatums or threats of any sort. Instead, try to empathise and encourage them to see a counsellor who can help.

Case study

Clare Smart explains how she helped a teenager who was self-harming

"Gill [not her real name] was 14 years old when her mum brought her for counselling. The school had informed Gill's mum of a Tumblr blog that Gill had been keeping. When her mum looked at it she was shocked at the graphic images of cutting posted by her daughter.

"Gill was initially reluctant to come for counselling but her mum insisted after she noticed some blood-soaked tissues in the bathroom. Gill had broken down and told her mum that she had been cutting her stomach using scissors for the past six months.

"During regular counselling sessions we identified the reasons behind Gill's self-harm and unhappiness. The problem began when she had gained some weight and had been picked on at school. Gill's sister had also recently left home for university and her mum and dad had been having marital problems. Gill had felt increasingly isolated and had started to cut as a way of stopping the emotional upset that she felt.

"The sessions helped Gill to find new ways of coping with the negative thoughts that she was experiencing, she started to socialise more with her friends and joined a netball team, which gave her a mental and physical boost. Gill also closed her Tumblr and started to keep a written diary to get her feelings down. Her self-esteem improved and the cutting stopped as she developed alternative coping strategies to overcome the urge to cut.

"Gill also worked out how to let her mum know if she was feeling unhappy by sending her a BBM of a sad face. Her mum knew to respond to this by giving Gill a hug and being available to listen to her."