Jane S
Age at interview: 54
Brief Outline: Jane’s daughter began cutting herself at the age of 15, while she was having treatment for an eating disorder. She hasn’t cut for the last 4 years.
Background: Jane is 54, married with three children. She is director of a charity. Ethnic background: White British.
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Jane’s daughter began cutting herself when she was in hospital being treated for an eating disorder. Looking back, Jane thinks that some of her previous behaviour was also self-harming. Jane found out about the cutting when the nurses on the ward moved her daughter closer to the nurses’ station so that they could supervise her more closely after they discovered self-inflicted scratches on her arms.
Jane and her husband were shocked and upset to discover that their daughter was self-harming. Initially they thought it would stop naturally and they didn’t talk about it much as they were focused on the next stage of treatment for her eating disorder. She continued to cut throughout the following period of inpatient treatment, despite a zero tolerance policy on the unit. During her first months back at home she also took an overdose of paracetamol, and continued to cut for another 3 years. The impact on the family was profound. ‘We were a normal happy family’, Jane said, ‘and it spoiled everything’. Jane herself suffered a period of depression in response to the stress caused by her daughter’s self-harming.
Jane thinks that their GPs were not very helpful with self-harm, though they were helpful with Jane’s own depression. Accident & Emergency staff were not supportive or reassuring, and offered no psychological assessment or follow-up care. Jane felt quite alone throughout most of the four years her daughter was self-harming, partly because she didn’t feel able to talk to her friends after receiving some negative reactions from them. She confided mostly in her husband.
Jane’s daughter has not self-harmed for four years. Jane lives more from day to day than she used to and tries not to project anxieties onto the future. She hopes that her daughter would allow her to help if she ‘relapsed’ and started self-harming again.
Jane thinks that health care professionals could help families of young people who self-harm by providing information and advice. Nobody pointed her to any sources of information. She also feels that negative attitudes should be challenged by education and training so that people who self-harm are ‘seen as a person, not just an annoying case.’
Jane’s message to other parents is to be hopeful that your child can come through self-harm. She recommends finding out as much as you can about self-harm, to try and have a good relationship and keep talking. ‘You will probably get it wrong sometimes’, she says, ‘but don’t despair: you can get it back. Self-harm is not something you can ignore and hope it will go away. You have to get involved.’
Jane and her husband were shocked and upset to discover that their daughter was self-harming. Initially they thought it would stop naturally and they didn’t talk about it much as they were focused on the next stage of treatment for her eating disorder. She continued to cut throughout the following period of inpatient treatment, despite a zero tolerance policy on the unit. During her first months back at home she also took an overdose of paracetamol, and continued to cut for another 3 years. The impact on the family was profound. ‘We were a normal happy family’, Jane said, ‘and it spoiled everything’. Jane herself suffered a period of depression in response to the stress caused by her daughter’s self-harming.
Jane thinks that their GPs were not very helpful with self-harm, though they were helpful with Jane’s own depression. Accident & Emergency staff were not supportive or reassuring, and offered no psychological assessment or follow-up care. Jane felt quite alone throughout most of the four years her daughter was self-harming, partly because she didn’t feel able to talk to her friends after receiving some negative reactions from them. She confided mostly in her husband.
Jane’s daughter has not self-harmed for four years. Jane lives more from day to day than she used to and tries not to project anxieties onto the future. She hopes that her daughter would allow her to help if she ‘relapsed’ and started self-harming again.
Jane thinks that health care professionals could help families of young people who self-harm by providing information and advice. Nobody pointed her to any sources of information. She also feels that negative attitudes should be challenged by education and training so that people who self-harm are ‘seen as a person, not just an annoying case.’
Jane’s message to other parents is to be hopeful that your child can come through self-harm. She recommends finding out as much as you can about self-harm, to try and have a good relationship and keep talking. ‘You will probably get it wrong sometimes’, she says, ‘but don’t despair: you can get it back. Self-harm is not something you can ignore and hope it will go away. You have to get involved.’
Jane S describes her daughter’s cutting as a way of dealing with emotions she couldn’t put into words, including feeling she had let herself or other people down.
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Jane S describes her daughter’s cutting as a way of dealing with emotions she couldn’t put into words, including feeling she had let herself or other people down.
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Say a bit more about the carrying on.
Yeah.
In what form and how long, how much longer?
I’m just trying to work out how old she was then. Well, we had another, that was probably sixteen and we had another three years. We had another three years of cutting really, whenever things just got on top of her and she just felt she couldn’t cope or she felt angry about herself really not the world. When she was you know, beside herself with emotions that she couldn’t really put into words or she problems that she couldn’t solve, feelings of failure in herself. We always boosted her, as we do all our children, you know, they’re the most important things in our lives but it didn’t seem to matter to her. And so whenever she felt she’d let herself down or other people that’s what she would do to take it out on herself, you know.
Jane S could understand her daughter’s self-cutting. She explained “it works, doesn’t it, for people who harm themselves? It releases endorphins.”
Jane S could understand her daughter’s self-cutting. She explained “it works, doesn’t it, for people who harm themselves? It releases endorphins.”
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Jane S’s daughter was in hospital with an eating disorder. When a nurse told Jane that her daughter had scratched herself Jane thought it was an accident.
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Jane S’s daughter was in hospital with an eating disorder. When a nurse told Jane that her daughter had scratched herself Jane thought it was an accident.
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So it didn’t really sink in
So the next five months we were kind of oblivious I suppose because we didn’t, she wasn’t living at home and then it was just sort of, obviously, it was something we had to kind of deal with, when she got back, when we realised that it was still going on and it was going on even worse than before with the cutting. I can’t remember how I first discovered it once more, when she was home, to be honest but she and I do have a really good relationship so it was it was something that I could, after a while, after a short while, you know, raise with her and just say to her, you know, “What what’s going on because I’ve now noticed that, you know, there are some marks on your arms, the inside of your arms.”
Jane S’s daughter explained how she felt and why she self-harmed. Jane shared her own feelings with her daughter to help her understand her side of things.
Jane S’s daughter explained how she felt and why she self-harmed. Jane shared her own feelings with her daughter to help her understand her side of things.
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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 she’s suitably sensitive and intelligent enough to and caring enough to be able to see it from my side as well.
Jane S found information about self-harm from several different sources. This helped her understand and support her daughter.
Jane S found information about self-harm from several different sources. This helped her understand and support her daughter.
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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.
People’s shocked reactions made Jane S reluctant to talk about self-harm.
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People’s shocked reactions made Jane S reluctant to talk about self-harm.
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Keeping secrets was ‘terrible’ for Jane S and made it harder for her to get support.
Keeping secrets was ‘terrible’ for Jane S and made it harder for her to get support.
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Jane S was annoyed when her husband couldn’t understand their daughter
Jane S was annoyed when her husband couldn’t understand their daughter
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Jane S felt terrible that her daughter hadn’t felt able to come to her when her wounds were infected because she thought Jane wouldn’t understand.
Jane S felt terrible that her daughter hadn’t felt able to come to her when her wounds were infected because she thought Jane wouldn’t understand.
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Jane S was treated for a ‘reactive period of depression’ which she thought was a response to an incredibly stressful time.
Jane S was treated for a ‘reactive period of depression’ which she thought was a response to an incredibly stressful time.
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Jane S sometimes felt ‘trapped and emotionally blackmailed’ by her daughter.
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Jane S sometimes felt ‘trapped and emotionally blackmailed’ by her daughter.
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And I felt, therefore, rather trapped and emotionally blackmailed. And there were times when she’d say, ‘Well, right then,’ you know, ‘Well, you know what’s gonna happen. You know what I’m gonna do now.’ And, and I used to get very cross with her and I said, I would actually say to her, ‘Don’t do that to me,’ you know, ‘that is just not on.’ So, usually she’d, we’d apologise, one of us would apologise first and we’d try and calm it down. But that, I think, is a horrible aspect of it, the feeling that you’re treading on eggshells and that you can’t really ever let off steam and say how you’re feeling when you’re trying to support somebody because it could lead them to, to hurt themselves further. And, of course, you know, I was petrified that she would harm and cut herself deeply and that, you know, it wouldn’t, the next time, just be an infection, it could be something really serious, you know, she might even lose her life.
Jane S felt that lack of understanding led her other daughters to believe their sister was being selfish and could easily stop her behaviour.
Jane S felt that lack of understanding led her other daughters to believe their sister was being selfish and could easily stop her behaviour.
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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.
Everyone in Jane S’s family was affected by the 'strain and stress'.
Everyone in Jane S’s family was affected by the 'strain and stress'.
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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. She’d 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.
Jane S’s daughter felt she had been ‘dismissed’ by the GP and Jane felt ‘shut out of the process’.
Jane S’s daughter felt she had been ‘dismissed’ by the GP and Jane felt ‘shut out of the process’.
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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. She’s 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.
Jane S felt judged when her daughter was in Accident and Emergency. No psychiatric follow-up was offered.
Jane S felt judged when her daughter was in Accident and Emergency. No psychiatric follow-up was offered.
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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.
Medication helped reduce stress for Jane S’s daughter but when she felt ‘normal’ she sometimes didn’t take it. She had problems getting prescriptions.
Medication helped reduce stress for Jane S’s daughter but when she felt ‘normal’ she sometimes didn’t take it. She had problems getting prescriptions.
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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, she’s 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, she’s 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 she’s 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 she’s on her medication, she’s lively, she’s bubbly, she’s 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 she’s 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 she’s 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 she’s nearly twenty three, she’s 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.
Jane S sometimes felt ‘trapped and emotionally blackmailed’ by her daughter.
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Jane S sometimes felt ‘trapped and emotionally blackmailed’ by her daughter.
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And I felt, therefore, rather trapped and emotionally blackmailed. And there were times when she’d say, ‘Well, right then,’ you know, ‘Well, you know what’s gonna happen. You know what I’m gonna do now.’ And, and I used to get very cross with her and I said, I would actually say to her, ‘Don’t do that to me,’ you know, ‘that is just not on.’ So, usually she’d, we’d apologise, one of us would apologise first and we’d try and calm it down. But that, I think, is a horrible aspect of it, the feeling that you’re treading on eggshells and that you can’t really ever let off steam and say how you’re feeling when you’re trying to support somebody because it could lead them to, to hurt themselves further. And, of course, you know, I was petrified that she would harm and cut herself deeply and that, you know, it wouldn’t, the next time, just be an infection, it could be something really serious, you know, she might even lose her life.
Jane S had a plan to identify patterns connected with her daughter’s self-harm and help her to deal with problems.
Jane S had a plan to identify patterns connected with her daughter’s self-harm and help her to deal with problems.
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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 she’d 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.
Jane S talks about her book ‘The Parent’s Guide to Self-Harm: What Parents Need to Know’.
Jane S talks about her book ‘The Parent’s Guide to Self-Harm: What Parents Need to Know’.
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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.
Medication helped Jane S’s daughter keep stable.
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Medication helped Jane S’s daughter keep stable.
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Jane S’s daughter had several different strategies to use instead of self-harming.
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Jane S’s daughter had several different strategies to use instead of self-harming.
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She’d been offered some of the techniques like pinging her, you know, wrist with an elastic band or holding on to ice cubes and things like that but, frankly, for her, she found those just really patronising and they just negated her feelings. So that wasn’t going to work at all but there were other things, talking to her friends, you know, and going on Facebook and playing music, relaxing, having a bath. Particularly for her, she found going to sleep, when it all mounted, you know, mounted up for her and she’d got herself into a right paddy about whatever it was and her emotions were starting to just go out of control, she realised that the best thing for her was to go to sleep. And so that was something, obviously, we could suggest to her when we saw her getting, you know, getting in a terrible state.
Jane S realises you have to take a long-term view and support young people until they no longer need to self-harm.
Jane S realises you have to take a long-term view and support young people until they no longer need to self-harm.
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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.
Jane S talks about the future and her hopes for her daughter.
Jane S talks about the future and her hopes for her daughter.
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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, she’s allowed me before, when she’s 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 she’s come and all the good things she’s 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.
Jane S thinks parents should be given more information and advice, and that negative attitudes towards people who self-harm should change.
Jane S thinks parents should be given more information and advice, and that negative attitudes towards people who self-harm should change.
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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.
Jane S advises other parents to have hope, find out more, be resilient and continue to love and respect your child.
Jane S advises other parents to have hope, find out more, be resilient and continue to love and respect your child.
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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 there’s 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.