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Ruth

Age at interview: 40
Brief Outline: Ruth’s eldest daughter began cutting herself during a long period of absence from school between the ages of 12 and 13. She no longer hides her cutting, which Ruth describes as ‘horrifying.’
Background: Ruth, age 40, is a post-graduate student, married with two children. Ethnic background: White Scottish.

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Ruth first noticed that her daughter, Sylvia (not her real name), who was 15 years old at the time of interview, had been cutting herself when Sylvia was 13. She had got drunk with a friend and both were admitted to hospital. Disinhibition led her to show the scars she had been hiding up to that point. Sylvia wouldn’t talk to her mum about the reasons for her self-cutting but Ruth relates it to a long painful illness which kept Sylvia off school for almost 18 months from the age of 12 (eventually diagnosed, tentatively, as abdominal migraine). During that time Sylvia spent a lot of time on her own and became depressed. She was under the care of a pain team, including a psychologist. Ruth had no idea that Sylvia was harming herself during this time. 

Sylvia’s cutting increased after she was sexually assaulted, just after she returned to school at the age of 14. The shopkeeper was prosecuted and convicted, but, on one of the few occasions Syliva has talked to Ruth about her feelings and the reasons for her self-harm (‘to express myself’) she revealed that this assault left her feeling completely worthless. Ruth says that this incident had a devastating impact on Sylvia. Ruth describes her as an attractive, outgoing, bright girl who has recently done well in her English standard grade exam despite her long absence from school.  Since the assault Sylvia cuts deeper and no longer tries to hide her cutting or her scars. Ruth describes her horrified response to seeing blood running down Sylvia’s arms from fresh, deep cuts. Since the sexual assault Sylvia has received weekly counselling from the Child and Adolescent Mental Health Service (CAMHS) but, Ruth says, her self-harming gets worse and worse.

The only person Sylvia continues to hide her scars from is her birth-father. She has also embargoed Ruth from talking to him about it. Both her birth-father and her stepfather seem to Ruth, who has researched self-harm, to have simplistic views about it, which she says is divisive and makes her feel alone in her thinking about it.

School hasn’t been helpful, in Ruth’s view, concentrating their concerns on Sylvia’s absences rather than on her health needs. Ruth feels excluded to some extent from CAMHS but understands that they can’t talk to her about Sylvia. She does occasionally see one of the psychologists herself and is able to talk about her own feelings and responses to Sylvia’s cutting. CAMHS staff suggested at one point that they have a joint session with Ruth and Sylvia, but Sylvia flatly refused. Ruth has received helpful information and support from a mental health charity.
Ruth has learned that self-harm is not just a ‘teenage thing’ and is concerned that there might not be a time when Sylvia is likely to stop. At the same time she is optimistic for her future, hoping that she will go to university and, experiencing a different kind of life, will decide to stop self-harming.
 

After Ruth’s daughter was sexually abused by a stranger her self-harming got much worse

After Ruth’s daughter was sexually abused by a stranger her self-harming got much worse

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And then in June of last year she had just got back to school, she had got back to school, with a staged c-, return, and she’d been back to school probably about a week and she, something dreadful happened to her. She was sexually assaulted. And that’s when it just completely kicked off, you know, in a big way. She was sexually assaulted, and it went to court and everything. She had to give evidence in court, because he pled guilty up until she, he pled not guilty up until she gave her evidence and then he pled guilty then. So the good thing about that was that he was actually dealt with and, you know, he was punished and everything, but not in a way that I thought was enough. But she was very brave and dealt with it really well and gave evidence against him. 

But that incident, you know, that one incident of, of being sexually assaulted, it was good that she was believed and it was good that it was proved in court and everything like that, but it had a massive effect on her. So up until that point she had been depressed, she had had some self-harming, some sort of rebelling kind of thing, but nothing outrageous, you know. And that just tipped her completely over the edge. And she just, I didn’t know what to do with her at all and it just got worse and worse. And she, was seeing a team at CAMHS, children and adolescent mental health services, who deal with sexual assault. And so she was seeing all the right people, and she still sees them more than a year later, she still goes there once a week.
 

For Ruth’s daughter, self-harm was a way of expressing pain.

For Ruth’s daughter, self-harm was a way of expressing pain.

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She definitely sees it as a way of expressing her pain. She sees it as a way of counteracting emotional, deep emotional pain and replacing it with physical pain. And I can see how that, that would be the case. I can understand that. And I’d certainly understand it if it was somebody else’s kid. I could, I could say, “Oh, well, that’s, you know, that’s how it is.” It’s just, it’s just awful when it’s your own child. She dresses in, I mean I think she always looks really nice usually, actually. You know, I don’t disapprove at all of the way that she chooses to dress and her hair and her make-up and everything. And she’s a really, I know I’m obviously biased, but she’s an attractive girl and she’s got a wonderful personality and she’s bright and everything. And I think that that’s a separate issue to this altogether, I really do. And, and, it was certainly, it was her words, it was her, it was her choice of phrase to say that that was how she expressed herself, as if it went along with everything else about her appearance and her tastes.
 

Ruth was ‘at her wits’ end’ before she found support through a local mental health charity.

Ruth was ‘at her wits’ end’ before she found support through a local mental health charity.

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I think that I was completely at my wits’ end when I came here to Penumbra. Absolutely in the wilderness in terms of information or, you know, how I felt myself and about how disturbing the whole thing was. And I think that speaking to [name of counsellor] who was able to make me feel a lot better about all of it. And she gave me, she gave me information to take away and read myself and, and pointed me in the right direction in terms of websites and everything, but it was really helpful information. That was a turning point for me, because I had never heard of [mental health charity]. And so now there’s a parents’ support group here. So that’s a really, and, and to hear another parent’s perspective is really very helpful indeed, when they describe things that you might have felt yourself but not thought were a legitimate way to, to feel. So very helpful. So this is a really good organisation for parents.

Being given information is one thing, but then doing something with that information is another. So I’m just kind of interested in that bit in the middle there. You took that information away from here and you managed to do something with that information inside yourself to give you a different approach and a different attitude. Can you say anything about that?

It opened my eyes to how widespread this is. I didn’t know so many people did it, I didn’t know so many various types of people did it, and different ages, and indeed that, what physi-, physiologically what happens. It all makes a lot more sense to me now. To actually see that written down and, and to process that and not just to wring your hands and say, you know, “My child is completely lost.” You know, there is research and help and people who understand about it. That they are there. I had barely heard of self-harm, barely heard about it. And if anyone had asked me, I probably would have thought that it was attention seeking, you know, that it was like, it was rebelling behaviour. So my understanding of it has increased.v
 

Ruth thinks her husband’s attitude to her daughter’s self-harm is too simplistic, but he makes an effort to talk to her and be supportive.

Ruth thinks her husband’s attitude to her daughter’s self-harm is too simplistic, but he makes an effort to talk to her and be supportive.

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My husband absolutely loves her and he is exactly like a father to her because, we’ve been together since she was 2. And he feels very frustrated as well that he can’t do anything. But I think he looks at it too simplistically. He often says, you know, “Why does she do this? It’s just attention seeking,” you know. He d-, he doesn’t mean to sort of  belittle her feelings, but he really does think that she just needs a bit of a shake or a bit of a talking-to and, and  that would sort her out. And it’s a modern cultural thing that because she likes certain types of music or likes to dress in a certain way that that goes along with it, and it’s just all nonsense that she should get over. Which is divisive that he thinks that, because it makes me feel quite alone in my thinking, you know, because I don’t see it like that. But he is supportive and he tries to talk, he does, he makes a big effort to try and talk to her about it. He doesn’t just sort of ignore that it’s going on, but he does see it in a very simplistic sort of way. 
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