I would definitely say to have hope that you can come through this and that your child can come through this and that’s really backed up by research. I also think very strongly that unless families can help the individual with the problem, that where else are they going to go. Where else are they going to go and get help? And that if this is a problem that’s escalating in our country, then parents and other family members, other carers are an invaluable resource that the NHS should recognise and use. And that by involving parents or carers and by listening to what they say and by working together that we could make a big difference to the numbers of children who do this.

But, you know, for, for other parents I would say, yeah, have hope. Find out more. Try and encourage a dialogue, you know, and a good relationship. Teenagers are very difficult, we all know that. We don’t have to be saints and you will get it wrong sometimes. I would say to them, you know, don’t despair if it all goes badly wrong and you think you’ve lost it and you, you know, they’re not speaking to you and you’re not speaking to them and theres a terrible, you know, barrier between you. You can get it back, you know. You have to be resilient. We are pretty tough I think parents on the whole and enduring and have, you know, continue to have the love and respect for your child and to and to keep hold of the fact that they are a person, not just a, and I actually hate the term, self-harmer’ because I think that makes someone just a case. And also it rather means that they’re going to do it long term and I don’t think it has to be long term. So yeah, and if you’re the sort of person who really needs to do a lot of reading to come to terms with it like me then I think do so. But it’s not something that you can ignore. It’s not something that you can hope will just go away on its own. I think you have to get involved.

I think theres lots of ways that healthcare professionals can, can help families. Is that what you mean, families? I think leaflets with some of the facts. No, I think leaflets with some advice for parents, which would include some facts, but also some hints and suggestions ; to get the feedback from parents like me to be able to put into a leaflet so that you’re speaking the same language to another parent, rather than it coming just from, from a rather clinical aspect.

I think there needs to be help directories and resources, web resources, organisations that, that would help parents on there. I, I was never given any address of any organisation when I first came across self-harm and that would have been really useful and I’d like to have seen that at CAMHS as well. It’s also important to me that hospital staff, and I realise the dilemma having done some research now, that hospital staff feel torn because they’ll often see the same person back repeatedly self-harming and it’s hard. I’ve now had some counselling training so I know what it’s like to help and counsel someone who doesn’t seem to be moving forward. So I really see it from their point of view but they, a lot of people I think are switched off and negative about those who self-harm and I think that attitude must change.

That’s an interesting one, the future. I probably try to live more day to day than I ever used to. I’m incredibly thankful that weve got to where weve got to now. Weve got our lives back and were all happy again, you know, most of the time [laughs]. I try not to project any anxieties that I have had or I could have now onto the future because I think doing a what if?’ is actually pointless. I think, though, one has to be aware of vulnerable times. I think that’s really important that you watch out for your children as you would probably most parents would watch out for them and know that there are going to be times in their lives, maybe their relationship, you know, with a boyfriend or a girlfriend breaks down, you know theres going to be some fall out or granny dies or whatever it is or they become made redundant.

So and be there to, you know, offer support, not to, we can’t push our, as we, you know, as our children get older we can’t force ourselves on them to help. If they want our help and you’ve got a relationship where they, do come to you then that’s a real blessing and thankfully, our children do want to come to us when things go wrong. So when you’ve had mental health issues including self-harming, you’re, you’re going to be on the lookout I suppose, even more so for the impact of those events and what that could mean. And I don’t think I don’t, I think my daughter has come so far that she won’t want to throw that away. That’s my hope for her and talking to her, I believe that’s the case.

Could she relapse? She might, couldn’t she? You know, I’m it wouldn’t completely rock me but I’d be pretty determined to help her through that as well if she would allow me. But, you know, shes allowed me before, when shes been an adult, so I don’t see why she wouldn’t again. And I have to remind her of all the good things in her life and I still have to do that when perhaps depression sets in again, I just remind her how far shes come and all the good things shes got ahead of, you know, ahead, the opportunities and how, you know, what a risk it would be to slip back and to lose that again and she doesn’t want to either so that that’s how I see it.

She managed three years at university without self-harming. I can’t say that maybe she never self-harmed but maybe just once or twice in the whole of the three years.

So that’s pretty good and I think you have to take a long longish term view of this. You can’t rush them to stop it immediately, which is what you’d like to do or I wanted to do in the beginning. You can’t despair of them and turn your back on them. I think you have to find a way together to talk about things, to find out their triggers for it to try and reduce it, to take a longer term view and to keep, you know, hopeful and supporting them until they no longer need it.

Ah ha. In order to, to fill the gap and perhaps join the dots between the services and parents and carers and encouraged by my daughter, I have to say, I wrote a book for parents, the Parent’s Guide to Self-Harm, which I’m pleased to say was the first, or is the first book by a parent writing for other parents and including the insight and narratives of other parents.

So it’s not a book about my own experience with my daughter. It’s not my story. It’s a book that gives practical suggestions and takes the reader through from discovering self-harm to understanding self-harm, right the way through getting professional help and support through recovery to managing vulnerable times and overcoming and it has a first aid chart as well and lots of references to other organisations from where parents and carers can get help. And I think also I’m hoping that it’ll be of real use to medical staff and other interested carers, such as, you know, counsellors and other, other people in caring roles.

The plan we had was certainly one of consultation and working together so that she agreed and promised to tell me every time, we wed identified that there was a build-up and we tried to see if there was a pattern, you know, for when it first, when it when it started to rise, if you like, in amount, if there were any reasons and difficulties that that caused it.

So we identified, you know, a number of issues, if you like, that gave rise to the self-harming such as being overloaded at work, with work, I know, having bad results on something, I know it sounds quite petty but actually, for her that was hugely important. So learning to be able to deal with, in her eyes, failure, dealing with the inappropriate comments of other people was something she found very hard to deal with. Not only criticism but, you know, crass comments from other people and those would be the kind of issues that might you know, start her on this build-up towards harming. So there was that, which I think was very important, therefore, kind of helping her to solve her problems and to take small chunks of the problem into manageable parts and to keep her calm.

It was pretty much twenty four hour, seven work I have to say and my husband found it all really very difficult. So you know, and my other children found it very difficult as well, which perhaps, you know, you’d like to talk about later. But recognising, her recognising the build-up and coming to me and saying that she felt you know, all wound up and it was possible, you know, that she might self-harm. Getting her out of her bedroom, getting her away from being on her own with her own thoughts and being, you know, depressed really was something. I mean sometimes shed run out of medication and that was another hurdle we had to cross but certainly talking about it and finding, you know, somewhere else to be.

We also found, for instance, that it was worse for her when she was very tired so last thing at night, she was far more prone to self-harm, therefore, you know, if we could manage to get her to take a bath and, you know, spend some time with us and then to go to bed at a reasonable hour having gone through the worries for the next day and had a plan then that was better.

The strain and stress on the whole family and on the principal, you know, carers and your, you know, emotions, your heart is kind of overwhelmed and almost broken really because you can’t imagine why the person you love, who you think so highly of, could feel so badly about themselves and, as shed say, want to die. And to hear her say that, when actually shes had really good support and lots of opportunities, you know, it just doesn’t seem to fit and you, you know, you, you question, you question yourself really, you question the part that you might have played, your family, you doubt and you say to yourself, you know, Why us? Why me? Why her? And I suppose it’s pointless doing that over and over again. You can’t forever stay at that level because you’d never move on but you, you do feel like that to begin with anyway or we did anyway, you know, we did.

And, you know, not being able to fathom it and then I got a bit annoyed because my husband was still saying, Well, I just don’t understand it, sort of when I’d moved on and that then creates a rift between the two of you because I’m saying to him, Well, why don’t you understand it because I understand it better now? Have you talked to her? Why don’t you talk to her? Shouldn’t you be talking to her? And I think it did create a bit of a barrier in their relationship.

So you’re, you’re trying to do so many things all at once. You’re trying to keep your own family going, see to your other children, be interested in them and they have, you know, happenings. They have sports events or they have a birthday and life goes on doesn’t it, you know, and yet you’ve got this horrible hole where, you know, the person you thought you had in my older daughter wasn’t really there. Shed been replaced by somebody who had all these terrible emotional and mental health problems and we were seeing a, you know, all these different psychologists, psychiatrists and nurses, the whole, you know, that whole area of life that we never kind of thought about really or even known about. That was suddenly our life and it spoilt everything. It really did and every day that I’d wake up the first thing I’d think was, Oh no, it’s true. This is my life again, you know.

Our other children were so scared often that they’d come in, you know, to our room and either sleep at the bottom of the bed and our little one would, you know, try and snuggle in between us. It affected them badly like that. So then you’d have to make allowances for them. You’d be ringing up school teachers and having meetings because somebody was falling behind with their workload or they were crying or, you know, having a spat with another pupil and you’d have to go in and see to that. And then you’ve got obviously, hospital visiting in between and then, as I say, the kind of normal stuff of life that just then becomes much much harder because you’re just so worn out really.

And she continues on that anti-anxiety and anti-depressant

Yes.

medication?

Yes, she does, yeah, yeah. I think she needs to, you know, I think she needs it actually. Sometimes, it’s very interesting, shes a very intelligent person so I wonder why it is that she runs out or forgets to order and she said something very interesting, first of all she said, Well, mum, it’s because I feel well when I’m on them, I feel normal, therefore, I don’t think I need them.

And when she when she stops taking them, the, after a couple of days, shes so noticeably changed, she can’t even remember who she is or how to write her name. I’ve actually stood with her in the surgery, when shes an adult after all and my surgery is very good and I’ve actually, had to coax her into knowing how to write her name because she just completely goes to pieces. If you met her when shes on her medication, shes lively, shes bubbly, shes just normal but a very interesting thing she said was that, she said, I’m not sure whether sometimes I purposely don’t order my medication because it’s another form of self-harming.

So she hasn’t stopped then?

Well, yes, she has stopped and on the whole, she does order her pills [laughs] but there are times when, you know, her emotional health isn’t so good and she wobbles. But I think the fact that shes identified that is a, is a very positive thing.

So that’s all been very interesting and what’s happened is that the medication has put her on an even keel so it stops those, you know, that that stress. And I notice, I know now when shes forgotten her pills either forgotten to take them or she hasn’t, you know, had a repeat prescription, which I think by the way, is extremely hard, a hard process nowadays. But I notice it because she becomes much more introspective and I can, I recognise the signs in her and I ask her. And, you know, because shes nearly twenty three, shes not a kid and I have to be respectful but I have to respectfully also kind of look out for her.

But the whole process of getting medication is just so hard and, you know, you a) you can’t just ring up and ask for a prescription, a repeat prescription in our surgery anyway. You have to have a review constantly and they’re always looking to cut down her dosage and sort of wean her off, when actually I don’t think and she doesn’t think that that’s a good idea. Some doctors can be very hard on her for taking them and, in fact, one pharmacist, when she was at uni, called her name and handed over her prescription and then wouldn’t let go of the package and looked at her and tutted and said, You shouldn’t be on these. Which she found really upsetting to be told off and she vowed never to go back to that pharmacy to get her pills again. And I thought that was unnecessary, actually.

And the whole, I suppose, and this sounds mean, but the whole fact that here we go again, where, you know, it’s hard enough, life is hard enough without now having to go, you know, and sit in A and E and you know, have to, to talk about this to medics, who might be annoyed with her for wasting their time. And, and, you know, we did get that. We did get that feeling very much so, actually. They, they weren’t, I mean we were, obviously, wanting her to be seen immediately and there was a bit of a laissez faire attitude when we got to, to A and E. It was just like, Well, go and sit there and wait kind of thing, which alarmed me, and then there was the, the look, you know, that look of, Oh, you know, it’s one of those teenagers. And, and a judgment I suppose of us as parents and our family and, even though it wasn’t said. I think we were sensitive to what they might have, they might have been thinking. Perhaps we were over-analysing it but it was there was no kindness or reassurance or no. And there was actually very little follow-up. The GP did realise because they did tell, you know, it did go on the notes but nobody actually asked us afterwards. My GP didn’t either. I suppose they would wait for us to go in and say, Do you know what happened last night? But we, we didn’t need to so there was no follow-up.

No, no offer of psychological assessment, while she was in?

No. No. She didn’t have any psychological help with the self-harming, officially, whatsoever.

We went to the doctors quite a bit and they weren’t very helpful. I have the most fantastic doctor’s surgery but and they’re very helpful with lots of other, you know, issues but on this one they were completely stumped, to be honest. They photocopied some things from the internet for her. I went and had a chat with my doctor, who I knew was going to be seeing her, because she was still quite young. She was only sixteen. I know she had rights of confidentiality so I thought, Well, I won’t. I’m not trying to ask for information. I’m going to give information. Which I thought I’d done quite successfully but unfortunately, they wanted just to talk to her and kind of shut me out of the process really and I can see why but I didn’t think it was very helpful. I needed support and I also needed to inform them of things that I thought would be really important for them to know. One of the doctors at the surgery actually said to me, Is she a nice teenager? As if only sort of, you know, horrible teenagers self-harmed and I found that really distressing actually.

So, equally, she found it very distressing that she had given her just a lot of photocopies about anger and anger management and, as she said, you know, she wasn’t angry. Shes not an angry person. She wasn’t self-harming out of anger. She was, it was far more complex than that and she felt she was dismissed really.

I suppose they both, if they were being critical, they would have thought, and they did feel, that she was being selfish. They did think that she could stop it. They had less of an understanding than I managed to get by reading up on the subject and listening to my daughter. They didn’t have that opportunity, if you like, or they didn’t take that opportunity. So they just did what many a parent, I suppose, does and I did in the early days which was just to expect that somebody could sort of snap out of it or pull themselves together or whatever one says about any kind of mental health problem, sadly. That the onus was on the person to stop it and that it was selfish of them to be so self-absorbed and doing this that had an effect, clear effect on everybody. So, they would sometimes be very protective of me and say to her, you know, Can’t you see what this is doing to Mum?’ which I didn’t want them to say, because I thought it was unfair, but also because I was petrified that it might lead her then to go off and self-harm which, of course, it did in the earlier days.

So, it’s a bit of, if you’re not careful it’s a family battlefield, really of the other children, you know, her siblings feeling a bit, maybe, neglected and left out sometimes. You have to work doubly hard to you know, keep everyone happy and it’s exhausting, it really is, absolutely exhausting.

He [her doctor] suggested antidepressants, which I was dead against because I said to him, I’m not, this isn’t this isn’t a clinical depression. This is a reactive period of depression, which will pass. I am responding to an incredibly stressful time, which I full believe will be over at some time.” So I also thought that it would be really detrimental to my daughter, who was about to go on anti-depressants herself, for then me to be almost copying her and I didn’t want any sort of fallout from that. So I didn’t think it was right for me. Anyway, I’ve never taken pills at all. I have to really seriously talk to myself to even take a headache pill so I said, no, to that and my doctor was really very firm with me and said, Well, you’re not leaving my surgery unless you sign up for counselling, free counselling or anti-depressants. And he said, And you have said no to both so let’s sit here until you actually come up with one of them. [laughs]. So I said, Well, it’ll have to be the counselling then. Which I had already thought would be useless in my head. I was very negative about it and, actually, it was marvellous. It really was. It was it was just what I needed at the time and, although the lady wasn’t particularly experienced with self-harming or eating disorders, she had a lot of other skills and she got me to prioritise, to relax, to give myself time and permission to kind of grieve. There was really important and really good stuff that I learnt from her and so I had two free sessions of six from the NHS and I’m really grateful to it, grateful to them for it.

So looking for, you know, signs of wound problems and having a relationship where, you know, my daughter, for instance, with the, a horrible infection that she had at the time didn’t feel she could come and talk to me about it. She told a counsellor, who she was seeing for the eating disorder, who actually booked a doctor’s appointment for her and my daughter went on her own and I felt really terrible about that. I felt that if I’d been perhaps more understanding at that time, she would have been able to say to me, you know, Mum, this doesn’t look right. This wound hurts and it’s angry, you know, and starting to fill with pus. And she felt, obviously, that she couldn’t tell me that. She couldn’t show me and it wasn’t just because I’d have been upset. It was because, at that time, she didn’t think that I would understand and that I might be angry with her and I think that was a key moment for me, realising that if I wasn’t able to try and put aside some of my emotions and really listen to her and help her in a structured way, I know that sounds very clinical, I don’t mean it like that but you know what I mean, then she would just ignore, you know, she would have to leave me out and she would have to go it alone and I couldn’t bear that.

And then I got a bit annoyed because my husband was still saying, Well, I just don’t understand it, sort of when I’d moved on and that then creates a rift between the two of you because I’m saying to him, Well, why don’t you understand it because I understand it better now? Have you talked to her? Why don’t you talk to her? Shouldn’t you be talking to her? And I think it did create a bit of a barrier in their relationship.

I remember thinking though with friends that there were some people I would have loved to have tried to share with but I dared not to just in case the reaction was dismissive or incredulous or, you know, critical. I felt I couldn’t take that risk and, therefore, I felt I was leading a double life because I’m a very open person normally, I like to support other people but equally, you know, if they say to me, What’s the matter? You don’t seem your normal self, or something, I would probably tell them, whereas I felt I couldn’t, I was hiding and living with this sort of terrible secret that was eating me up and I desperately wanted the help but I was trapped and couldn’t, felt that I couldn’t do so.

No one was helping us to look ahead. No one was helping us with strategies. I had to do some reading, you know, for myself and to begin with, I must admit, I didn’t. I looked to my GP and NHS Direct, you know, who I rang when things got really difficult with wounds and learning wound care. I’d been a teacher so I suppose I knew a fair bit about first aid but, you know, not, not huge amounts.

I personally think the, the information that I, I got for myself was really important. I, I believe that if you understand why somebody is doing what they’re doing it just gives you much more insight and it helps you to, it helps to give it some rationale, you know, apart from anything else. It also can help you feel not so alone because you might get, you know, narratives of other people. You know, so that you realise and you can pick up some hints and tips from them and just learning about it either from, you know, the website or from books was something I did. I have to say that nobody suggested that I did that and I think that would have been useful. I think, having, you know, downloads about anger management was completely off the mark and was a bit hurtful really.

I don’t think, and I’m sure my doctors wouldn’t mind my saying, I don’t think they really have much experience about self-harming and couldn’t offer anything. They couldn’t really support me with the issue. They supported me well on other, you know, other things and with me personally and with the panic attacks and all the other things but they didn’t really link it to, to why I was feeling like that. They just dealt with that but they didn’t link it and they didn’t give me any suggestions as to how I could improve things for my daughter, which of course, in turn, would have improved things for my health. Yeah, so I just, I researched if you like, and looked, you know, for myself.

Were there particular websites or particular books that you remember being helpful?

I looked at Mind. I found the Mind website very useful and books, I got a lot of books, actually. There wasn’t anything for parents, at the time, so I, I had to find things that clinicians had written, which some of it was a bit hard to stomach because it’s a bit impersonal and, obviously, self-harm and suicide comes kind of often lumped together and so that, that’s yeah, that’s a hard read for a parent, especially if people haven’t experienced it for themselves. They, they’re talking about cases and case studies and they’ve got a lot of, a wealth, obviously, of medical experience and knowledge and that’s very useful but the human side of it I think needs, needs to be told as well and understood.

I also found sites like Red Cross and St John’s Ambulance very, very helpful, for just checking up on the first aid side of things. I think that’s really important. I think you can’t, as a parent, just let a child tend to their own wounds and not be at all interested in that.

And, you know, when they’re fifteen, sixteen you actually don’t see them undressing so I hadn’t seen the marks on the top of her thighs or just underneath the pant line, where shed been hiding it, when shed been at the unit. I obviously didn’t see that but, when I had noticed them on her arms, I was able to talk to her about it and not kind of by then, not fly off the handle and get too emotional or angry. Of course, you just you just want to beg somebody to stop it but I was able to have a really nice chat with her and she did explain a little bit, well, she explained a lot to me about how she felt and why she did it.

I wasn’t able perhaps, to understand and I was also able to tell her how it felt from my perspective, actually, as a mum who cared for her, for her skin, if you like, ever since she was a baby that, you know, the mother’s instinct and the mother’s heart is to protect their child from harm. And shes suitably sensitive and intelligent enough to and caring enough to be able to see it from my side as well.

And for people who self-harm, well, that’s a generalisation, but certainly for my daughter, who self-harms, I realised that she couldn’t hold those emotions for any length of time initially, at all. She had to do something immediately to make herself feel better and it looks as if it’s a destructive thing against her own skin but actually, of course, kind of bizarrely it works, doesn’t it, for people who harm themselves? It releases endorphins. I learned the reasons why it was effective, even though I hated it and couldn’t condone it, with my, my, you know, my thinking and my understanding of it made some kind sense to it. And I found that when she realised that she was very poor at coping with her emotions at that instant and she started to hold the emotions for a little bit longer and I supported her and helped her to do that, we were making some progress.