And how do you see the future?

Well, guardedly positive. I, and particularly with the middle daughter, I am aware that there is definitely always going to be a chink in the armour and it’s a weak point. Everybody has a weak point. Everybody has an Achilles’ heel and I think she still needs work on self-esteem. Shes still doing work on her self-esteem.

I’m not sure. I’m not sure. I I’ve got to try and stop asking her if shes all right because I don’t think that’s terribly useful and terribly helpful but I can’t help myself doing it and I’ve apologised to her. I said, you know, You must understand that I feel very vulnerable. Shes, at the moment, working in another country, which makes me feel doubly vulnerable but you’ve got to trust. You’ve, shes got to go her way and shes just got to know that she can come back if she needs to with no threat of criticism or condemnation to a behaviour that, actually, some people, they never did drugs that. You know, some people have different crutches.

This this maybe, unless she can deal with it better, it may be something that she resorts to. I hope shes building up an armoury and that’s the way weve looked at it for her, building up an armoury of things that she can do rather than harm herself. So yeah, guardedly positive I think is how I’d see the future.

When she first was seen by PCAMHS [Primary care Child and Adolescent Mental Health Service], she was referred to them by the GP. There was a little delay. I remember being incredibly anxious during the time when I knew she was cutting herself and before she was seeing anyone. It was it was a time for me when it was it was a very anxious time because we weren’t talking about anything.

We weren’t talking about her behaviour at all but I knew that she was doing it and she was seen by PCAMHS. They have an assessment session and then six sessions and she, during the time that she was being seen by PCAMHS, she cut herself, to our knowledge, two or three times but then in the last three the last three weeks, therefore, the last three sessions, she didn’t cut herself at all. So when it came to time for her review from PCAMHS they said, you know, We think this behaviour has stopped. Weve managed to talk about it and stop this behaviour. And I felt very unhappy about it because I knew that [my daughter] was still very unhappy. I keep saying that.

Yes, say, My daughter.

Yeah, I knew she was very unhappy and I felt that all that had, it was a sticking plaster on on what was going on. It was it was not.

The root of the problem had not come out. But they seemed happy and they said, If you have any more problems go back to your GP.

And, while she was in the adolescent inpatient unit, she still managed to cut herself. They knew that she was a self-harm risk and they allowed her scissors because she was doing cross-stitch and she did a lot of cross-stitch at that time to try and relax and to distract and they allowed her scissors and she cut herself. Not very badly but, when she first went in she was on twenty four hour watch, so we went from being on twenty four hour watch with somebody outside her room to being allowed a pair of scissors and I was deeply, deeply angry about that. Because, obviously I was looking for someone to blame and I thought I could have done a better job quite honestly. At the very least, I wouldn’t have allowed her a pair of scissors.

I think, when she was very ill, I think it was very helpful to have a situation where we could see the family therapist without her and we actually, probably could have done with more of that. We saw them with her as well but certainly my husband found those sessions very, very valuable because he was he was angry and I was making him sit on that anger because I didn’t want him reflecting it back to her. So I was containing it very much and he needed somewhere where he could express that anger safely and I think that that was very, very useful to him that that environment.

And also her younger sister, similarly, she, it was particularly useful with the anger because the anger, I was terrified always of it being reflected back to my daughter and affecting her adversely so I was very, I felt like I was spent my whole time containing this anger from both of them and there was somewhere they could let it out there, which was very useful.

Within the wider circle of friends I have to say, if I’m honest with myself, there is an element of shame because it’s like I, it’s almost like a weakness. Why could I not help her more? Why did she have to do that? Why could I not?

And I’m sure they wouldn’t think that but that’s how I think they would think. So yeah, close circle of friends, yes, but not very many.

So both of us went, my husband and I and her and then began a very long and very horrible night at the hospital. Because shed told me fairly quickly that there was a delay before they could take blood tests or anything because she told me within probably half an hour of taking them. So we went up and they put her in a bed. At this point, she was, her eating disorder was probably at its worst. She was terribly thin. Her heart rate was terribly low. The monitor kept going off and all they kept doing was coming in and turning it off.

It was just a thoroughly unpleasant time. We were then transferred to what was called then the clinical decision unit. She was seventeen at the time I think. It think she was seventeen so she was young to be on what was really an adult ward and they were still waiting, they’d taken the bloods and then they were waiting for the blood results to come and she just curled up on her side, faced away from me and I don’t I don’t know if she slept or not. I don’t think she was asleep because there was so much noise going on. There was a woman with very, very bad dementia in the bed opposite and she was ranting and raving. They had to put the bed sides up and it went on for about two hours. I was sitting in the chair beside her. I was never offered a drink. I was never offered anything. Of course, my husband had gone home to deal with my other daughter so I just sat feeling not entirely welcome. Feeling not really part of the equation at all, I have to say. It it was, I felt we were in the wrong place. I felt she was too young to be in that environment, very distressing, this woman with dementia.

And, eventually, I went to the nurses and said, Look, I don’t want to be a pain but either weve got to be moved or shes got to be moved because it’s very upsetting. And, in fact, then the doctors came along and sedated her and it was it was all right but it was, I felt that we were in the wrong place then. I couldn’t understand why we weren’t on a ward for young people. I wasn’t it wasn’t entirely made clear to me what was happening. I had to keep asking what was happening and I felt I was being a pest.

And [my daughter] was just disengaged with the whole thing. She was lying on her side, facing away from me, completely just disengaged with everything. And that night, I’m talking a lot about that night because it was very, it’s, it was the lowest, I think the lowest of the low really. But then they said we needed to wait for an assessment. It was the weekend as well so we needed to wait for an assessment and we waited and we waited. I don’t think she cared where she was. I don’t think she didn’t really care. She didn’t really care about much so I waited and I waited and a lovely, lovely charge nurse came on the ward, when everybody was having breakfast and, of course, she didn’t want any because she was full of her eating disorder and definitely, that was not on the cards. No attempt was made to encourage her or to help her or to find anything she maybe could have eaten that, people with eating disorders have very strict rules with themselves about what they will allow themselves to eat and when and nobody came and said, Would you try this or would you try a yoghurt or whatever? But this lovely charge nurse came on and he sat on the bed and he had time to talk to her. He, well, he made time. He made time to talk to her and me and he was just gently, he was the first person that had actually talked to us about something that wasn’t medical. He was, he was not a psychiatrist. He was a nurse and he said, it, you know, did she think there was anything she could have done to alert me that that was how rough she was feeling? And because, I don’t know whether it was because he was somebody shed not seen before or whether it was his manner, she talked to him and she said, that she was in a such a bad place, she couldn’t talk about it and he said, he was once looking after a little boy who felt very sad and very low sometimes and he couldn’t tell his mum. He was much younger, this little boy apparently and what they had was a special teddy and when he wanted to tell his mum that he was feeling rubbish, he would appear holding the teddy and she knew not to ask questions, not to try and discover what it was, but just to distract, to sit, to cuddle, to put the telly on, to do something. And he said, Do you think you, you and your mum could work out some kind of way that she, you could tell her so that she knows not to ask. You don’t want to talk about it but just that you’re feeling really rough. And we didn’t then but subsequently, we talked about that same thing and we worked out that if she sent me a blank text, I knew that she was feeling rubbish.

She didn’t need to say anything in the text, but a blank text and I knew that she needed some company or that she needed a cuddle or she needed distracting and it worked. That one lovely charge nurse, who was not a psychiatrist, he was not a psychiatric nurse, he gave us something that for the rest of the time that she was ill actually worked.

I think that, basically, was what her self-harm behaviour was about. It was she hated herself. She thoroughly hated herself and the only way she could find of expressing that was to deface herself, if you like.

So that’s it really. That’s her story, my story.

When it first started and was there any particular trigger to it do you think or how had she heard, I mean how would it become part of her thing that she could do?

It’s very difficult to say and I never really asked her. I never really asked her what started, at the very beginning, what started that behaviour, why. Her older sister, who also had an eating disorder and was also very depressed, said to me a long time later that she tried cutting herself. I don’t quite know what that means but that it didn’t do it for her. Those were her words. She said, I tried it but it didn’t do anything for me. So she didn’t get any of the positive reinforcement that clearly the other one was getting. My other daughter was was getting something from it, some stress release or some expression of anger or something she was getting from it. My youngest daughter also cut herself a little bit. She was aware of her older sister and whether there was some kind of, I’m feeling angry. It obviously worked for her. I don’t know. I don’t know what it was with her but the behaviour stopped much quicker. It never became entrenched in the way that my middle daughter’s behaviour became very clearly a way of her coping with distress and it didn’t with the other two. But I don’t know what started it.

Well, I can’t exactly remember when I first knew that she was self-harming actually because it it’s quite a secretive behaviour and I think it was happening for a long time before we knew.

Yes.

It was probably, I think, about a year after she started that it became obvious to us. She was then cutting herself and she was cutting the top of her thighs so we didn’t see it. She became quite secretive about getting dressed and undressed and, if we were on holiday, one year we were on holiday and I remember she we go to Cornwall where it’s cold and she put her wetsuit on very quickly. So she was, she was hiding it.

She wasn’t public with it at all and I honestly can’t remember. It wasn’t a light bulb moment. It wasn’t a moment of great discovery. It was something that became obvious and that I felt I needed to talk to her about and she refused first of all.

I think that was really the turning point of her harming behaviour, except then it started again. She was treated for her eating disorder. She slowly recovered from her eating disorder. We had some fantastic, fantastic help from the CAMHS team and gradually, she got over it and she finished at school and she went off to London and was very unhappy and the behaviour that I thought had stopped, started again. And she, this time round, didn’t tell me but that was because she felt like a failure. It wasn’t because she was embarrassed of it because she was, by then, cutting herself on her arm so it was it was clear and she, we went to see her in London and I didn’t know. She had a long sleeved cardigan on. I didn’t think anything about it. She was telling me how unhappy she was and that she felt she needed help and I just didn’t think to probe about was she harming herself?

The next time I saw her, shed got, in fact, no, I saw a photo of her that a friend had taken and I noticed on her wrists she had tubigrip and I thought, Uh oh, I don’t like the look of that. And, by this time, I’d learnt, I’d learnt a lot during the passage of these few years and it’s about picking your moment to bring things up. I didn’t jump in, which is what I would have done two years previously. I waited I waited until we were together. She was relaxed and I said, Are you cutting yourself? And she went, Yeah. And I said, Could you have not told me? And she went, No. And I think it was, well, I said, Why why could you not have told me? With all that weve been through, why could you not have told me that you were doing it again? She said, Because I’ve failed you.

How sad is that?How sad is that? And, of course, she hadn’t failed me. She hadn’t failed anyone. She was feeling rough and she reverted to the one way she knew of coping.

And how about your husband? How did he react?

A whole variety of emotions, as you would expect. Initially, completely and utterly shocked. Totally, I mean literal shock. The cutting made him very sad because, obviously, it was leaving scars and to him, it was his beautiful girl. The overdose made him incredibly, incredibly desperate that she should feel that desperate. Anger, definite, definite periods of anger, as weve all felt I think. Probably me less so. I think I’ve felt the least, in fact, I don’t think I’ve really felt angry, if I’m honest. I don’t think I’ve felt angry. He has felt periods of extreme anger on how it’s affected our lives but, then again, this is all wrapped up with the eating disorder, which actually in practical terms, affected our life much more because on a day to day basis an eating disorder affects your life tremendously. Self-harm probably less so. I think he feels incredibly protective of her now.

To his relationship with her I think. So yeah, and shock that he, he thinks hes produced these three beautiful girls and he can’t understand why they feel so awful, enough to not eat and to harm themselves. And it is hard to understand I think. I think it is hard to understand really, the behaviour.

So the effect of the self-harm, [sighs] it’s very difficult to say. Certainly, it’s made her younger sister, shes had periods of extreme anger, extreme anger both with how her sister was and why she felt that it was okay to behave that way.

And periods of extreme insecurity when she first moved away to London, the one that was left at home was saying, How do you know shes okay? How do you know shes going, is she going to be okay and shouldn’t you be ringing her every day? And a completely over the top reaction. Normally, I’m sure, when a sister, one goes to university it’s like, Yes, I I’m at home on my own and how great is that. But very insecure. I think, if there are any positives to come out of it, which I think you have to look for some kind of positive, we all communicate very much better than I think perhaps we would have done, considering were only, weve still got a teenager and were only just moving through the teenage years, which are notoriously difficult and notoriously turbulent, particularly, I think, I only know about girls, but particularly with girls very turbulent. And I think, coming through all of it theres, there has emerged a closeness, particularly oddly between the three siblings. They and maybe it would have happened anyway. How do you know? How do you know how they’d have ended up but they are very, very close now.

I think, if there are any positives to come out of it, which I think you have to look for some kind of positive, we all communicate very much better than I think perhaps we would have done, considering were only, weve still got a teenager and were only just moving through the teenage years, which are notoriously difficult and notoriously turbulent, particularly, I think, I only know about girls, but particularly with girls very turbulent. And I think, coming through all of it theres, there has emerged a closeness, particularly oddly between the three siblings. They and maybe it would have happened anyway. How do you know? How do you know how they’d have ended up but they are very, very close now.