Is self-harm addictive?

36% of young people aged 16-24 in the UK have self-harmed at some point in their lives, this statistic was taken from the most recent survey carried out by SelfharmUK, The Mix and Young Minds for Self-harm awareness day (01.03.18). This means that the amount of professionals dealing with disclosures of self-harm has soared in the last 5 years. In this article I want to give you some helpful tips around how to manage self-harm disclosures. But before that, I want you to think about self-harm and how you approach it, is it something you always see as a mental health problem? Do you think all young people who self-harm need an intervention from Child and Adolescent Mental Health Services? (CAMHS) Could self-harm be as a result of something other than poor mental health? Is self-harm addictive? When we start to broaden our thinking around this complex and difficult subject, it can dramatically change the way we work with the young people we are supporting.

Self-harm is highly addictive and can be a coping mechanism for many different things, sometimes it may be due to clinical depression, but sometimes it can also be because of persistent bullying. If a young person disclosed to you that they were using cocaine to cope, you wouldn’t automatically assume that they had a mental health condition. You would most likely talk to them about why drugs have become an unhelpful coping strategy. Next time you are working with a young person who is harming, try and think of it in the same way as other addictive behaviours. Then, rather than focusing on the harm itself, try and help the young person to open up about why they began harming and how it helps them deal with challenging and difficult situations. If a young person does disclose to you, here is some ways in which you can help;

Listen

It sounds so simple, but really listening is not about prescribing a list of things for someone to do to feel better, it is about hearing what they are saying and sometimes acknowledging that it is tough. I had a young person share with me once that he didn’t feel listened to by me, he said as soon as he had finished speaking, I was ready to give him advice. This taught me more about working with young people than my 3 year degree, there in that moment I realised I had to truly learn how to listen.

Examine the Risk

Self-injury is a very risky coping mechanism, and needs to be thoroughly and robustly risk assessed. The first thing to do is to speak to someone in your organisation who is more senior than you, it is always helpful to discuss risk with someone else. Remember, that the most important component in risk assessment is knowing the young person really well alongside efficient record keeping. The only way we can effectively identify and assess risk is if we know what risk was posed the last time we met that young person. It is vitally important to keep accurate notes after sessions with young people.

Move the conversation on

Try not to end on a difficult note, and if you can move the conversation on before the session ends that is really helpful. Be sure to think about how you help the young person feel ready for the next part of their day. It is really important that they feel positive and safe in all they have told you before the session ends. As well as understanding what will happen next.