Like many youths, Jane, was anxious to find relief from her emotional pain. The 14-year old girl struggled with self-harm for about a year. Overwhelmed by academic stress and feelings of helplessness, she inflicted pain on herself using scissors and fingernails. On top of exhibiting symptoms of depression (low mood, excessive guilt and hopelessness), Jane often felt emotionally numb and cutting allowed her to feel.
Self-harm has been on the rise and it is especially prevalent among youths. According to a study conducted by YouGov in 2019, it was revealed that nearly a quarter (23%) of Singaporeans have engaged in self-harm. 36% of those individuals fell under the age group of 18-24.1 The average age of youths who engage in self-harm is also getting younger, with some as young as 14 years old.2
It is important to know that self-harm is more than a learned trend or a youth subculture. Youths resort to the non-suicidal, intentional act of injuring themselves for various reasons. The most common reason is to cope with their emotional distress and pain. Some youths inflict pain on themselves because of emotional numbness, whereas some may do so as a cry for help. There are various methods of self-harm and the list is not exhaustive. Some common methods include cutting, scratching, abusing medication, ingesting toxic substances, and hitting oneself. Often, these actions are perceived as attention-seeking, manipulative, or an attempt to follow a certain trend. These youths are also frequently labelled as a bad influence. These misconceptions are perpetuated by the lack of understanding and proper education about self-harm behaviours.
As a result, these individuals experience judgement and shame. They may choose to isolate themselves and not seek help at all. Without proper support and help, they continue to experience emotional disequilibrium, which further exacerbates their pain. Being in a perpetual state of pain and distress can result in the development of mental conditions such as depression and anxiety, and even lead to suicide. Those who have engaged in self-harm for a while, it might be initially difficult to give it up completely, especially if it is their only “effective” coping mechanism. Hence, some may feel that they are “addicted” to self-harm.
Without proper support and help, they continue to experience emotional disequilibrium, which further exacerbates their pain.
Struggling with self-harm does not mean that one is suicidal. Although it may seem contradictory, individuals engage in self-harm to cope with their emotions and to stay alive.
The following are signs of self-harm that you can look out for:
- Unexplained scars and wounds, especially at the wrist area
- Wearing long sleeves, even during warm weather
- Isolating from others
- Possession of sharp objects or items that could hurt them
- High irritability and impulsivity
Underlying psychological issues can contribute to self-harm behaviours. Yet, these behaviours do not necessarily indicate mental health issues. It does suggest serious emotional distress and delaying help or treatment may worsen one’s condition.
Self-harm is not only difficult for the affected individuals but their loved ones too. Many may face questions about these individuals. Family members may also tend to feel anxious, overwhelmed, or upset at the start. To support these affected individuals, family members should only engage them while in a calm emotional state. This is to prevent them from feeling more distressed about seeking help.
Support is important to those who are struggling with self-harm issues. Therapy or counselling can help with addressing the underlying issues contributing to self-harm behaviours. It can also teach them adaptable and healthier ways of coping with stress.
Jane was referred to Upper Room, a 12-month mental health intervention program, for counselling support. As part of the program, she attended 8 sessions of peer-support group work to equip her with skills such mindfulness, distress tolerance and emotional regulation. Through counselling, underlying factors contributing to her emotional pain were identified and addressed. In addition, Jane also became more aware of her emotional vulnerabilities and learned to manage them before escalating to a breaking point. Healthier alternatives in managing her distress were explored as well. As of now, Jane no longer self-harms and can cope with distress more effectively.
Self-harm is a serious issue and is not to be treated lightly. Here are some dos and don’ts to support individuals with self-harm issues:
- Be emotionally present with them. Try to engage them in open conversations about self-harm as these behaviours often happen in secrecy.
- Encourage them to seek professional help, especially when there are signs and symptoms of mental illness.
- Do not rush them into disclosing their self-harm issues with you if they are not comfortable. Be gentle and patient in your approach.
- Do not give them ultimatums or expect them to fully give up on self-harm, especially when they do not have other adaptive coping methods yet.
- Refrain from making judgements or assuming their motivations behind self-harm. Find ways to empathise with their emotional distress. Validation helps them to feel supported and it would increase their motivation to seek help.
- Do not promise to keep their harm/safety issues a secret.
Alternative ways to self-harm:
- Squeezing ice cubes in your hand till you feel an aching sensation
- Rubbing ice cubes on your wrists
- Progressive muscle relaxation
- Paced breathing exercises
If you or your loved ones are dealing with self-harm, you do not need to struggle with this on your own. To find out more about our services and support, speak to one of our counsellors at TOUCHline (1800 377 2252).
This article is contributed by TOUCH Integrated Family Group.
1 YouGov. (25 June 2019). “A third of Singaporeans have experienced suicidal thoughts.”
2 The Straits Times, Singapore. (28 Dec 2015). “Rising trend of self-harm among the young.”