F.E.A.S.T's Around The Dinner Table forum

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hopeful
I am new to the forum. My D 17 was dx'ed with AN in early Oct. and was hospitalized for one week then sent home with FBT. She back on her % weight last week. Unfortunately she started cutting three weeks ago as she got close to WR. I suspected that and asked her, but she denied it compLetely. I asked her pediatrician to check her body and she confirmed cutting. But since my D requested confidentiality. We continue to pretend we don't know. She is seeing two therapists, one for FBT and one for CBT. They are both working to teach her new tools. She continues to cut everyday. What should we do as parents to help? I am scared and frustrated. Thank you for listening. We hope to hear advice from you.
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mjkz
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What should we do as parents to help? I am scared and frustrated.


I think self harm is one of the hardest things to deal with.  I chose to face it head on.  I told my daughter I knew she was cutting and went through the house when she was at school to hide all the sharps.  I told her that I wanted to know when she cut so that we could make sure she got the medical care she needed and that I wanted her to let me help in any way I could whether that was sitting with until the urge passed or distracting her, etc.  I don't think you can really face something like that if you are all pretending it isn't happening.
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hopeful
Thank you both. My H and I just had sit down discussion with our D and she again denied it up and down. We agreed to her pediatrician that we will not talk about this in reference to her exam finding. Don't know what to do next. I know D is afraid that we are going to tak away her privacy and start to sleep with her....

She had an initial psychiatist evaluation last week and the doctor felt that she doesn't need medication yet and will see her again in two weeks. Our D is angry easily but improve a lot since two weeks ago but the cutting continues.
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Sotired
The problem with ignoring self harming as I see it is that because kids cut with anything they find, there is a risk of infection.when my d was cutting I tried to minimise what she could cut with-we put away razors, scissors,anything with glass,she used a nit comb,pins,a dream catcher,if it had a blade or a pin she used it.
We didn't talk about it a lot but I tried to be with her as close to 24/7as I could.when the cuts were bad-we had one suicide attempt after two 'practice runs' we took her to get stitched up.
After the suicide attempt and a stay in the secure unit at our CFU, I went through her room and removed everything but the bed and drawers.these were checked every night for months before she was allowed in her room to sleep.during the day she wasn't allowed in her room unsupervised.
All the sharps were put in a locked room and all meds were put in a lockbox that only h and I had keys to.
And she is right to dread you sleeping in her room, cause I would certainly be doing that-particularly on bad mood days.
If your d is suicidal make sure you have access to a crisis line and a mental health unit.section her if you have to.i am not saying she is -just that it's wise to prepare a just in case plan.i can tell you that the urge to self harm can dissipate over time.but in the here and now stay as calm as you can-hard I know-take her to a&e when you need to because sometimes they need antibiotics,and have a crisis plan made.
I also took d to get false nails put on as they can't scratch the same with false nails.
I hope something in this helps,
Sotired42
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Foodsupport_AUS
There is some advice in the Hall of Fame with other threads about self injury. It seems that one of the tricky parts for you dealing with this is her denial that it is happening. What had made you suspect it? Did you find blood or stained blades? When my daughter was self harming I was careful to initially approach it with concern and no blame. Like Sotired I did remove most things from her reach that she could cut with, although for some time it did continue as she seemed to be able to find implements in thin air. Talking about alternatives to self injury, asking her to talk to you or anyone else before self injury can help to break the cycle, recognising that self injury is an expression of something else in most cases. Ironically for my D it was the realisation that she scars badly and would have marked permanent scarring that allowed her to try to resist the urges to self injure. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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hopeful
Thank you for sharing your experience. How do we get her to open up to us? She is getting help from her therapists but we don't know how helpful it really is since she continues to cut daily. Forcing her to talk has not helped. We are back to square one. We don't even know if we should remove her blades as we were told that she will find other tools and may make things worse.
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mjkz
I wouldn't ask her if she is cutting to be honest.  I'd say that I know she is and that you are there to help.  She can deny it but with my daughter all I had to say was show me your arms (or wherever she is cutting) and she broke down in tears.  You don't have to mention the pediatrician. Something made you suspect already and I would just stick to that.

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We don't even know if we should remove her blades as we were told that she will find other tools and may make things worse.


I think this is bad advice IMHO.  Removing her blades puts one step in between her and cutting. Yes she may find other tools but the thing about cutting is if the person can sit through the urge, it does go away (like purging) so the trick is to put as much time between the urge and the action as possible.

Sotired is right about infection.  I've known people who cut to get septic and need skin grafts from ignoring infections.  You also need to know if she needs to get sutures if she cuts too deep, etc.
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ooKoo
I found the self-harming more distressing than anything else (and believe me, there was plenty of everything else to deal with!).

I told my D that I knew she was doing it and that I would help to stop it.  I searched her room frequently and removed all blades, pencil sharpeners, compass (matchs equipment), knives, pizza slicers, mirrors, toothpicks.... anything that could be used.  If I found a blade, I would remove it, without discussion with her.  She scratched her arm with her fingernails, but this stopped after false nails were applied. 

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I know D is afraid that we are going to tak away her privacy and start to sleep with her....
Quite often, the biggest fear is what they need the most. By saying that your daughter fears this could be her way of asking you to do it.  I slept in the same room as my D for months, to stop SH, purging or exercise happening at night.  My D didn't like the cutting and wanted it to stop.  Just a thought.  ED does not come with a rational mind, unfortunately.

My D used cutting as an outlet for Anxiety.  She has been on medication now since March 2016 (just over a year after AN diagnosis) and has completely stopped all SH.  Has medication been discussed as an option for your D now that she back on her weight percentile (well done to you for getting her there, by the way!).  Not saying that your D has to take medication.  But it can, for some, be a very useful tool in the box.

As MJKZ, there is a risk of infection.  Maybe that is how you could open up a discussion about it - from a medical perspective.  Supply her with ointment and/or bandages and explain the risk of infection to her.  This keeps the discussion on a practical level and removes the emotional element.  Again, just a thought.

Good luck x


UK - South East

19 yo D

Dx AN Feb 2015 (Aged 15). Pre-existing low self-esteen and high anxiety. 

2015: 3 x medical hospital admissions. 1 month in IP which she self discharged from [eek].
2016: 3 x hospital admissions. 
2017: CAMHS CBT. WR, dropped out of 2 different colleges and started an apprenticeship.  Started having grand mal seizures and was diagnosed with epilepsy in Nov 2017. Sacked from job because of this.  Tribunal ensued.
2018 - doing a Psychology degree through Open University and working in retail to pay her way in life. Relapses with eating disorder in June 18 and Nov 18 😢. 

On particularly rough days when I am sure I can't possibly endure, I like to remind myself that my track record for getting through bad days so far is 100% and that's pretty good. [Author Unknown]
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hopeful
Dear all.

Thank you!  I think my daughter feels anxious easily.  She has very mild/usual teenager worry and very mild OCD that he psychiatrist wouldn't describe it as true OCD from her assessment before ED.  But now she rides the emotional roller coaster up and down all the time.  @ooKoo, what kind of medication your D is on that you find it helpful?  She is at school full time and surrounding by cutters.  She used to talk about how bad she felt when she realized some of her friends cut.  Is cutting part of ED?  I know every kid is different.  We hope to hear your story or a roadmap/things that we can do to intervene this successfully.  So far she denied it and her psychiatrist doesn't want to start medication.  She is seeing two therapist and continue to cut.   
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mjkz
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I know D is afraid that we are going to tak away her privacy and start to sleep with her....


Well I think that points to when she cuts then, at night or when she is alone in her room.  Privacy is great thing for healthy people but not your daughter at this point if you really want to intervene with the cutting.  I locked up every sharp in the house, searched her room and slept with my daughter for months to stop the cutting.

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She is seeing two therapist and continue to cut.


People cut for all kinds of reasons and you really don't need to know why to stop the behavior.  Insight does not always lead to action.  It is a lot like the eating disorder.  You don't need to know why she quit eating in order to stop her from losing weight and start eating again.  You need to deal with what you are seeing and that is the cutting.  You could wait years for her to discover why she is doing it with her therapists and she could still be cutting.

I think too she is trying to normalize it by saying she is surrounded by cutters at school.  Even if that is true, it is still not normal and not something she should be doing to cope.  If you really want to stop it, you will have to be actively part of stopping the habit.  Pretending you don't know and having her see two therapists isn't getting you very far and even medication won't necessarily stop the behavior.  She needs help to stop and the best help she has right now is you and your husband.
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Torie
Oh yes, it's awful when they start cutting.  Really, really hard to come to terms with that one ... I don't know why so many here have had to deal with that (raises hand), but it seems that many do.

I agree with the others that she needs you to step up the supervision especially at night.  I slept with my d for quite some time and did my best to help her spend time with her mentally healthy friends - unfortunately, the troubled ones seem to attract one another like magnets, but she always did have a few untroubled ones (or at least differently troubled) in the mix.

Her t suggested that when she had the urge to cut, she rub an ice cube on that spot.  Or draw a line there with a red marker.  My d said those things didn't help, but maybe they help others.

We removed the sharps and did our best to keep her within sight.  I think it's probably one of those things that the more you do it, the more you feel like doing it.  Just my opinion based on nothing but gut instinct.

Please remember that we're with you in spirit.  It does get better. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Penny31
We've found the cutting to be the hardest thing to stop. What we've learned is that someone determined to cut will find something sharp, somehow, even if you think you've locked everything away, and will go to great lengths to smuggle sharps into hospital after a period of home leave. It seems to be highly addictive behaviour. Our D, who is normally respective of privacy, went through my husband's drawers, found a screwdriver he'd hidden and used it to remove the blades from her younger brothers' pencil sharpeners, then smuggled them into hospital in the lining of her clothes. We're hoping it will get better eventually, but for now we're just thankful on the days she seems to have resisted the urge. Unfortunately there seems to be a bit of a self-harm epidemic among teenagers, so the behaviour has become almost normalised for that generation. 
14 year-old D diagnosed with AN in March 2016. Episodes of self-harming, anxiety, severe depression. Waiting for a CAMHS assessment to see if there's an additional diagnosis. 
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mjkz
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Unfortunately there seems to be a bit of a self-harm epidemic among teenagers, so the behaviour has become almost normalised for that generation.


I am going to sound like a broken record but there is NOTHING normal about anyone cutting him/herself.
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Penny31
I agree, there's nothing normal about it. What I meant by 'normalised' is that the teenagers themselves see it as normal, and that makes it all the more difficult to address. 
14 year-old D diagnosed with AN in March 2016. Episodes of self-harming, anxiety, severe depression. Waiting for a CAMHS assessment to see if there's an additional diagnosis. 
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hopeful
Thank you for the great advice.

I know my D is quite anxious and angry during refeeding. I believe she developed very unhealthy way of coping via cutting. She asked if she can use some medications to help her. We had a psych evaluation at Stanford and they didn't want to give her anything. We want to hear from you. She was a happy kid before ED with some usual teenager anxiety before exams, but nothing too much that she couldn't handle.
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EDAction
My D occasionally self harmed, but it increased as she got close to WR.  It got to the point where she looked at me during one terrible time and said "do something!".  I had her evaluated for anxiety meds 2 days later and she started on fluoxetine.  It definitely helped reduce her anxiety level and the instances of self harm decreased.  We'll never know how much of that is due to brain healing and how much is due to the meds, but I'd bet it's some of each.

In our situation D had a longstanding relationship w/T and T had suggested looking into anxiety meds earlier, but we (parents) resisted.  MD prescribed.
DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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Francie
Hi Hopeful,
I'm sorry for what you're going through. Our d has had some self harm, too. What has helped her with that is DBT (Dialectical Behavior Therapy).

Our d was admitted to the hospital after a suicide attempt and a self-harm incident. She was referred to a DBT clinic for adolescents, and now is in a DBT program for adults (she is 19). The DBT T suggested I go to a Family Connections workshop where I could learn skills to deal with my D and it was helpful in reducing stress.

If you search this forum you will find other people who have discussed the effectiveness of DBT for self harm and suicidality.

all best to you!
 

Francie

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hertsmum
Hi Hopeful
Our d self-harmed regularly, but refused to talk about it with me and the only time she would ever acknowledge it was when the cuts were deep or infected and I had to take her to A&E.  A doctor advised me not to talk to her about self-harm as he explained she would have felt very ashamed of herself and discussing it could make it worse.  I went to a talk by a child psychiatrist fairly recently who was a supposed expert in self-harm, and it was clear to us that she had no idea why kids self-harm or how to deal with it.  Out of desperation I tried bribing my d to stop - dreadful thing to do I know! - giving her £1 for each day she didn't cut herself.  It seemed to work for a week or so.  She is left with dreadful scars on several parts of her body which are very upsetting to look at, but they'll fade in time.  I wish I'd been more rigorous when it was at its peak about searching her room regularly, as I did when she was in hospital and I was shocked and sickened at finding pieces of broken glass, sharp stones and several blades from pencil sharpeners buried deep in drawers and jewellery boxes.  Although I probably couldn't have stopped her I could definitely have made it more difficult, and perhaps made her think twice by taking away the temptation.  

My d's self-harm seemed to go away when ED reared its ugly head.  Now, after much treatment both at home and in IP, her ED seems to be under control and I'm hoping not to see the return of self-harm.  She is very anxious and is on a high dose of sertraline (200mg) that I think that may be helping.  I've looked into DBT but cannot seem find it (I'm in London, UK).

Best wishes xxx
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