Just a quick bit of help for anyone who is dealing with any young person who self-harms…. Quality Training are brilliant for this course and many more.  I’ve attended quite a few of their courses. Also the web has mountains of alternatives to self harm…. remember that the person who self-harms is trying to express some feeling they have inside and they need to be allowed to express that feeling but just in a more productive and less harmful way to themselves or any others.  One good thing i have found works (not for everyone though) is having an elastic/hairband around the wrist and snapping it each time the young persons feels they want to self-harm.  Ice cubes can be used as well as a for of release instead of hurting themselves.

There are loads of different sites which give lists of alternatives to self harm. One thing to be really aware of is who is writing the sites, many sites are maintained by harmers or former harmers, which can mean the quality of content varies greatly. The most solid info I have found has been written by the larger more established organisations, http://www.siari.co.uk is a really good place to start with loads of links to other sites. The site is maintained by Jan Sutton who has written several good books on the subject and is very respected in the field. The is a page linking to lots of different alternatives that other sites have, which she has checked for content.

The thing to bear in mind with recommending alternatives is what type of alternative it is, an alternative to the harming action or an alternative way to express to emotions that they feel overwhelmed by. The latter will enable the young person to develop a portfolio of skills for coping with their emotions. The former can continue a dependance on the harming itself.

Also when recommending alternatives make sure you work through with the young person that the alternatives are aimed at weening them off harming and giving them other ways to cope while they develop the support and skills they need.

For example, I once told a young person about wearing an elastic band on her wrist and pinging it gently when she felt the need to harm. the next week I saw the girl and she proudly told me the elastic band really worked - and showed me her wrist covered in a massive purple bruise and cuts. She had been pinging the elastic band from as far away as she could stretch it, and found that tying knots in the band also helped.  She’d developed it into another way for her to self harm.

Self-harm is a sign of stress and is often caused by a different problem such as bullying or abuse. People might self-harm because it’s a way of releasing tension or anger. It’s a physical pain that they can deal with, rather than an emotional feeling that is hard to cope with. It is also a way of controlling something, especially if they feel that other parts of their life are out of control.

If people are not helped to stop self-harming, there is a risk that their urge to hurt themselves could grow into a stronger wish to end their lives.

I come at this issue from a slightly different point of view having had to deal with it in the past. It’s more psychology/sociology

The self harming action produces endorfins (http://en.wikipedia.org/wiki/Endorphin) which effectively mask other pains or, depending on your point of view, raise the mood level.  It is a chemical process and perhaps also placebo. If you look at a very basic understanding of drug addiction, an addiction occurs when there is a triangle of elements involved: the chemical addictive nature of the drug itself, the psychological disposition of the person to compulsive/addictive behaviour, the social grouping in which they spend most of their time.  Endorphins are very addictive and of course are easily available (they are in your body) so it is almost impossible to get away from them.  Breaking the cycle finding some replacement or other will almost never work by, although such things as exercise which is a much healthier way of endorfin release will both improve the self-harmer’s view of themselves, they will be fitter, and feel that they can cope with life better.  The removal or healthier expression of endorfin release should be accompanied however with removal of the other elements, or at least strategies for helping.  Psychologically addictive personality can be educated, if only to the extent to know that that is what you are like.  Look at some of the ways of helping with something like gambling I would suggest.  As for the social aspect, some anecdotal work suggests that a non-selfharmer who stays in a campus house with other self-harmers may themselves start to cut.  Finding different social groupings may help. 

None of these points though is more important than those that have already been mentioned - stress and self image for example which can often be the initial trigger - all have a role to play in this discussion.  I am no expert and what I know only comes from general discussions with professionals and their own opinions and trying to help my own young people.

I speak for a fair few people when I say that not everyone self harms because they are sad/upset/stressed/angry. Some people do it because they enjoy how it feels. I am myself someone who self harms and I love it.
Someone on the outside may think I do it for the attention, but they may do drugs or smoke because they like how it feels; this is exactly the same.
When my mum found out and I told her why I do it, she freaked out and didn’t speak to me for ages. I think that if people in general were more aware of the reasons as to why people do it, and that it can be quite common, people wouldn’t have such a hard time showing how they feel and find other means of overcoming difficult situations.
My opinion is, I think that getting people to stop self harming isn’t a good idea. If thats how they cope, its much better than smoking etc. However, in more extreme cases, help may be needed.
Some people don’t want help or don’t need help and I believe this is a serious issue that needs to be addressed.

[Look through someone else’s eyes]

Jess makes some great points, it’s always really important to think how the person may be feeling and how they may view the experiences they are having. For many young people self harm represents something that is stabilising for them and removing self harm from that equation can be very daunting. It is better to support the young person to understand their self harm and work with them to decide if they want to stop. If they don’t want to stop it is very unlikely you will be able to ‘make’ them stop and highly likely that you would break down any relationship you have with that young person in the process.

People always self harm for a reason, even if that reason is that they like the way it makes them feel. That feeling is linked to the chemicals released when someone harms, many describe it as giving them a sense of calm or release. Usually along the way there will have been an emotional trigger to the harming, but it can develop away from that and become something that offers comfort and reassurance and a feeling that people want to revisit. The question that needs to be asked is whether the self harm is a positive coping mechanism. It does act positively to help people cope, but just like smoking and drugs they cause detriment to health. As youth workers we seek to promote and encourage the development of healthy ways of coping, that positively impact the lives of young people we work with.

You put it better than I can :]

And yeah, I agree, there are other ways to cope and if people agree to try and chane their ways from self harm to more positive, less risky coping mechanisms, that would be great :]