Self-Harm: A Teacher's perspective on the way forward
I have my fair share of scars but have never cut or burned myself on purpose. I did once punch a wall in utter frustration, following an argument with my girlfriend at the time. I can remember staring at my collapsed knuckle and the blood oozing down my trembling hand; I felt a curious mix of fascination and relief. The pain came later, but for a minute or two the mental chaos fell away and I found myself in a still, quiet and peaceful place. This is the closest I have come to being able to understand 'self harm' - the strategic use of physical pain to temporarily relieve mental anguish.
When I was at school I don't remember my peers hurting themselves as a coping mechanism. It certainly wasn't something that we talked about but then, perhaps it was going on in toilets and behind closed doors. The most insidious thing about self harm is the conspiracy of silence and shame that accompanies it. The wounds that young people inflict on themselves are rarely a cry for help or a means to gain attention - more often than not the injuries are hidden from view. In my experience as a teacher, it is rare to see direct proof that one of my students is hurting themselves. Instead I've learned to look for other tell tale signs.
Often self-harmers will wear long-sleeved tops, irrespective of the weather. They will avoid shared changing rooms and might excuse themselves from sports lessons all together. Usually myself or my colleagues will pick up on a dip in grades, withdrawal from friendship groups or neglect in personal hygiene - the cuts and burns will only come to light once they've begin receiving support.
It's hard to know how many of our sons and daughters are cutting, burning or poisoning themselves (swallowing toxic substances accounts for 88% of all self-harm admissions to Accident & Emergency centres in the UK) but it seems that the numbers are growing. Girls are far more likely to hurt themselves, although even this statistic has to be treated with some reservation - it could just be that boys are less likely to seek help and, like me, use their fists, rather than razor blades or lighters. One article I read recently in The Guardian cites an 80% increase in self harm cases over the last 10 years, while the Huffington Post claims that 1 in 4 young women (16-24) have self harmed at some point. I don't suppose any of these figures are anything more than a conservative best guesses.
What I do know is that I have come across more cases of self harm in the last 5 years than in the previous 20 years of classroom practice. This will be, in part, because as a pastoral leader I have more direct involvement in helping young people when they are struggling to cope, but nonetheless, I no longer think of self harm as an aberration so much as a regular feature of the modern educational landscape. I wish this were not the case but if we are to address the issue, the first thing we have to do is name it and take away the shame and taboo associated with it. Children are resourceful and adaptive by nature. If more of them are wounding themselves to make it through their teens, it is because that behaviour serves a very real need. We must start there.
Too often I hear adults dismiss self harm as a sign of weakness. They complain that young people who cut themselves are indulged 'snowflakes' who need to toughen up and realise how good their generation have got it. Alternatively, their expressions speak of a mix of disgust and confusion - they quickly push the issue into a mental box file marked 'the kids these days'. It is so easy to do - I chuckled at a meme on social media just a few weeks back which depicted young soldiers storming the beaches of Normandy on D-Day, juxtaposed with a millennial cowering in his allocated 'safe space' on campus. Pigeonholing kids this way salves our conscience and means that we can absolve ourselves. The issue is theirs - not ours.
As a professional educator, it is very uncomfortable to choose not to look away - to take my duty of care seriously enough to look beneath the surface. As teachers and parents, we have to acknowledge that we are 'muggles' when it comes to the mental health of our children. There is the world we know - the displays of student work in classrooms, the hard-won exam certificates and the sports trophies...and then there is the darker realm of dementors and ever-shifting staircases that means we can never really know what young people are having to cope with. I had it easy - I did not feel undue pressure to excel in school, I had no social media mesmerising me with images of the perfect life I should be experiencing and I had a family that was intact and full of love. In short, I had a childhood and grew up at my own pace.
The evidence shows that self-harming children are struggling to find their place in the world. They may have been sexually abused, bullied or have grown up in broken or toxic families. They almost certainly experience unprecedented pressure to conform to impossible standards of body image, lifestyle and academic success. They feel lost, afraid and are ill-equipped to manage the sense of overwhelm they experience during pinch points in their life. In the UK, where self-harm seems to be growing faster than anywhere else in Europe, 25% of all those who are referred to CAMHS (Child & Adolescent Mental Health Services) will be turned away without any alternative means of support - they simply don't have the funding or resources to cope with the demands for help. When the world of adults has no answers, kids will self-soothe, even if their methods leave scars. We, as a society, have to do better.
Because self-harm serves a positive function, it is not enough to simply discourage those who cut or burn themselves to get through their day. It is tempting to judge and discourage - to stick a draconian band-aid over the wounds and convince ourselves that we have fixed the problem. This would be a terrible mistake. If we take away their means to find relief, without addressing the underlying causes of that person's pain, the pressure may build and when it becomes too much, as it will, the fall out may be extreme by comparison. The relationship between self-harm and suicidal ideation is well-documented - if we mishandle the support we offer to young people who are self-harming, we may make things far worse. While it can be distressing to see self-inflicted wounds, they are rarely life-threatening.
Instead, we might begin by acknowledging the strength of character and positive intention behind their current behaviour. If you baulked at that last sentence, ask yourself how easy you would find it to drag a blade repeatedly across your skin, cutting deeply enough to produce the endorphin-release that comes from a significant experience of pain. Or try holding your forearm over a naked flame for a few seconds - self-harming kids are not without character or courage! Only once we respect their effort to find relief, can we guide them towards more constructive surrogate behaviours.
For some, a sharp sting from an elastic band on the wrist can produce similar effects to a burn. For others, holding tight to an ice cube containing red food colouring can simulate the discomfort of a cut. As the ice melts, the dripping red water can mimic the blood trail which often comes to take on metaphorical significance, as if their inner pain flows away at the same time. Strategies like this may take a while to transition to and, in the meantime, parents or the school nurse can help by checking and dressing existing wounds to avoid infection and maintain an open dialogue. At the same time, that person can begin to put the support system in place to unpack the blocks and sources of pain that have led to self-harm in the first place. Self-harm should always be thought of as a life preserver, rather than a long-term way of coping with being lost at sea.
The chances are you know someone who is self-harming. Perhaps you have fresh scars yourself. I would encourage you to join me in making this a topic which no longer carries guilt or shame. There are plenty of people in our society who are in pain. Some turn to alcohol or medication, some find solace in violence or they numb themselves with addictive online activities. Self-harming is just another path up the mountain we are all trying to scale - each of us is trying to climb above the cloud line so we can get some perspective on our lives and find a little relief. Just because the damage caused is visible does not mean those who self-harm are more screwed up than the rest of us!
Perhaps it would be a healthier response to neither condone nor condemn self-harm - instead let's try bearing witness, let's honour the wounds rather than cover them up. After all, those who have cut or burned themselves choose to live rather than run away, they choose pain over numbness or surrender. That seems, to me, to be a great starting point for healing to take place.
Andy Fisher is the creator of Tests of Life - an educational project designed to help students, parents and teachers navigate the 'hidden curriculum'. He is an English teacher and PSHE co-ordinator, based on the east coast of the UK and uses his blog, podcast and digital products to spread the word that schools should be preparing young people for the tests of life, and not just for a life of tests!