The rise in self-harm points to something seriously askew in our priorities as a country
PARENTING INVOLVES an awful lot of stumbling along in the dark, hoping to God that you are doing something right. Every so often, parents are presented with situations that seem to confirm their worst fear: that they are actually doing everything wrong. As vividly illustrated by the two case studies written about by Sheila Wayman in the Healthplus supplement recently (August 11th, 2009), there is a particularly visceral feeling experienced by parents, like being punched hard in the stomach, when they discover that their child is harming him or herself.
Not unnaturally, most parents react with shame and panic, and become desperately worried about exacerbating the situation. The idea that a child would be so distressed that swallowing tablets or cutting oneself would constitute some kind of relief horrifies parents.
Levels of distress are clearly rising among young people, but that does not mean that parents are justified in shouldering all the blame. Young people resort to self-harm for complex reasons. For example, while it is more common in families where there are difficulties of one kind or another, it can also happen in so-called “good” families.
While no family is perfect, most families can learn to cope. Dr Keith Holmes, a consultant child psychiatrist in the Lucena Clinic, says that “the sign of a well-functioning family is not that bad stuff never happens, but that when it happens, it is dealt with well”.
Families who have kept the lines of communication open have an advantage when a crisis happens. Dr Holmes talks about how impressive it is that many families manage to get over the initial denial and sense of failure, and begin to do all that they can.
Even where things have gone awry, perhaps because of a messy and acrimonious breakdown, it is more than possible to help a child, if the parents can manage to retrieve enough of their relationship to make the welfare of the child a priority. Parents need to be parents more than ever, he says. They need to re-establish lines of communication, and healthy levels of discipline.
Many parents worry that something like cutting will lead to suicide attempts. Prof Carol Fitzpatrick of Children’s University Hospital, Temple Street, says it is important to realise that even though the risk of suicide is greater among people who self-harm, only a small minority will go on to die
by suicide. Some young people will have only a few incidents. Others will respond positively to parents’ willingness to listen and to help, and may not need further intervention.
However, if there are signs of deeper distress, or increasing isolation and depression, parents should seek help. Her advice to parents is to “trust your gut feeling”. Parents can go to their GP for a referral to child and adolescent mental health services for their child. It is a national scandal that so many of them will go on a waiting list for anything from six weeks to three years, depending on where they live.
A dedicated deliberate self-harm team was set up in Temple St some years ago, and while initially focused only on the young people, the need to provide support to parents soon became evident. The Space programme resulted. Initially only available on referral, a new course is available free to parents of children under 18, due to sponsorship by the ESB workers’ charity, Electric Aid.
The next course is being run in Wynn’s Hotel on Tuesdays, in October and November. It is important to register, as places are limited, by contacting Lorna Power, tel: 01-7166321 or e-mail Lorna.Power@cuh.ie.
The National Suicide Research Foundation suggests that the rise in unemployment may be a factor in the rise in self-harm among young men. Ironically, before the recession we blamed consumerism and conspicuous consumption instead.
Clearly, something deeper is going on. Why are people less able to deal with the challenges that life throws at them, or at least more likely to resort to self-harm as a deeply flawed way of trying to cope?
Ireland of the past was in many ways a dark and repressive place. However, we also have to face the fact that when we threw off the shackles of that time, we also inadvertently weakened societal constraints that helped to make self-harm and suicide much more rare.
While there is much greater openness in society, that same openness means that the idea of self-harm occurs to far more young people. It is one of the paradoxes of our age that we have never had so many means of communication, but more fundamental levels of communication, such as those between parents and children, have become much more difficult.
As Prof Kevin Malone of UCD has pointed out, many young people can live in a virtual cocoon, frantically interacting with peers, while parental influence is greatly diminished or even excluded. Behaviours such as cutting can even be become tacitly acceptable as a result.
Self-harm is not the only dysfunctional coping mechanism to which people resort. Our society has long had a problematic relationship with alcohol, while “workaholism” is often just a more acceptable way for adults to evade difficult emotions or situations.
Our young people’s distress is further evidence that something is seriously askew in our priorities as a country and a culture. It is an overt sign from our upcoming generation that all is not well, and perhaps we should pay more heed.