Ep. 59 – Michelle Mitchell – Self Harm: Why Teens Do It & What Parents Can Do To Help

Please note this week’s family360 episode is called Self Harm: Why Teens Do It And What Parents Can Do To Help. The following conversation is highly informative but should not replace a conversation with a doctor or licensed professional and is not suitable for all audiences.

Rachel Cram – Well, Michelle, it is so good to be with you again for a second interview. I don’t know of a better person to turn to with my questions on this topic, so thank you for gifting me with your time and your expertise.

Michelle Mitchell – Your podcast is one of my absolute faves. I listened to Ann-Louise Lockhart the other day, and the Four Horsemen. That interview Rachel, it was brilliant, and I’ve been recommending that to families because I just think it’s a wonderful interview with so much good quality information in it.

Rachel Cram – Oh, thank you! And thanks for listening while you were on holiday! That means a lot to us! I loved that conversation with Ann-Louise as well. It’s such a privilege to be about to air these important topics and, that is absolutely how I feel about this topic today as well. Self-harm. Why kids do it and what parents can do to help. I’m eager to share your wisdom on this Michelle.

Michelle Mitchell – We’re going to have a great conversation. This is a big topic, isn’t it?

Rachel Cram – It is a big topic, especially in the light of the times we’re in right now, which are uncertain, as we talked about with Ann-Louise Lockhart.

Your book on self-harm, I have to say, was fantastic, which seems a bit funny to say on the topic. But so many stories, so much practical information, an encouraging read. You did a great job.

Michelle Mitchell – I love. I love to hear that you can tell me that any time.

Rachel Cram – You did a great job.

Michelle Mitchell – I really spent a lot of time trying to get that balance between the research and honoring the weightiness of this topic, but also making it really hope-filled, because I know that when parents are in the depths of this issue with their children, they can feel like they’re drowning in it. And the truth is, there really is hope. Tomorrow can be so different with the practical tools to cope today. And I think when parents have the right tools, it can really open the door to new ways of thinking about things. And I wanted that book to represent that for families. I wanted them to feel like they were walking into my office and being able to grab my hands and really walk through that.

Rachel Cram – That is exactly what it felt like, and I think that is really what any reader would pick up. You want to feel like you’re sitting and talking with somebody who really cares about you because it’s scary.

Michelle Mitchell – So scary.

Rachel Cram – To find your child is experiencing self-harm, that they’re participating in that, or even as a parent that’s worried about it to come in the future, you want to feel like you’re sitting with somebody who really cares about you and has hope.

Michelle Michell – That’s right because our instinct as parents is to protect our kids. Whenever they find out kids are self-harming, it’s very hard for parents to get their heads around and understand. It’s usually a shock Rachel, and it’s that shock that I’ve been so privileged to be able to sit with families in, and actually say to them, “You know what you do and what you say right now really matters, so let’s work out the best way forward with this because you are just so critical in your young person’s journey right now.”

Rachel Cram – Well, and you do relay quite a few stories and in those stories, you hear that you’re talking to parents who do care very deeply and who have been actively involved in the life of their child. So I think that helps parents to know it’s a common experience. And it’s not indicative of your parenting, necessarily.

Michelle Mitchell – No, that’s right. So many parents feel so alone in this. One beautiful mom said this, she said, “Some days I feel like standing on my doorstep and screaming for help and other days I feel like slamming the door shut and locking myself out from the world.”

And I feel like it’s that real contradictory, ‘I need help, but I want to just handle this all in-house because it’s so overwhelming.’ I feel like it’s that contradiction that parents really struggle with.

Rachel Cram – OK, well, maybe before we go much further, it would be helpful if you just even want to define, what do you mean by self-harm?

Michelle Mitchell – Yeah, definitely. It’s when someone deliberately hurts themselves to express or cope or control emotional pain, and I think typically we think about it as cutting or burning. But the reality is, it’s that intention that drives self-harm, not the behavior itself. And it’s that intention that we want to stay really connected to.

Rachel Cram – So, our focus as parents is not best served so much on what they are doing, but why they are doing it.

Michelle Mitchell – Yeah, that’s right.

Rachel Cram – Ok, that’s a good starting place. You’re using the phrase ‘young people,’ again and again, so is self-harm usually something that occurs during adolescence? Is that the demographic where it’s most relevant?

Michelle Mitchell – Yeah, it’s typically initiated in those middle school years. That time, Rachel, where kids have big, overwhelming giant emotions. They have less impulse control and they really lack a tolerance for emotional pain. And the really positive note is for most young people, it doesn’t serve them longer than about 18 months. So that’s a lot of hope for families in itself. They tend to grow through it and find different ways of coping with things that are going to serve them better as they get older.

Rachel Cram – OK, well then let’s talk about what we do as parents to get through those 18 months, two years until that stage of life has passed to get them safely through it.

Michelle Mitchell – There’s a lot of holding the fort and there’s a lot of nurturing the gap, and that’s what I’ve been all about in my career is helping parents do those things.

Rachel Cram – Now, when you say it’s 18 months, I think as a parent, I think I would start to wonder if it’s associated with a mental health disorder, which of course might extend beyond that 18 months of self-harming. Is there a correlation between experimenting with self-harm and mental illness?

Michelle Mitchell – There definitely is. The highest correlation with self-harm is actually anxiety, depression, impulsivity; they’re struggling. And when that’s combined with stressful life events and family instability, that’s what makes young people more susceptible. And that’s not putting the peer group into the equation because that can have such a big impact as well.

I think what’s important to know is that as we move through life, our capacity to self-care and also the emotional regulation strategies that we use, do change and grow with us. So this is not a permanent fixture. But, it’s always so important to offer young people professional support when they are self-harming, because underlying is often a state of poor mental health that they’re really struggling with.

Rachel Cram – Hmm. Now I know that I’ve been hearing through our Center for Disease Control that self-harm has really been on the rise in recent years, and I’m imagining part of that is pandemic related. What are you hearing and what’s your understanding of why that is happening?

Michelle Mitchell – Research really commonly tells us that about 10 percent of young people experiment with self-harm. And for some of them, that’s a one off incident, two times, three times. This is not always something that grows into a habit for young people. But during COVID, the latest stats coming out are around about 27 per cent of young people have attempted self-harm. And so we’ve got to remember that this research is done through GP’s in hospitals. This is done when young people come and present for help. And we know that about 70 percent of young people are not coming and presenting for help when they self-harm. So those stats are likely to be a lot bigger.

Rachel Cram – That’s alarming

Michelle Mitchell – It is.

Rachel Cram – you know, as a parent listening to that. Now you just use the word habit. How does self-harming become a habit?

Michelle Mitchell – There’s this transition that can happen with self-harm between it being something that young people experiment with, that they try out, and then moving into a phase where it becomes something that becomes their primary strategy to help them cope with those emotions. And that obviously evolves over time. And it can bring quite an aggressive distraction or an aggressive stop to really overwhelming emotions. And it can release those endorphins just like the pain of, I guess, a big mountain climb, it can release those endorphins afterwards that put kids feeling high. And then it can bring that low and that crash, which is just as addictive for young people.

So it really is this cycle or this pattern that they get very used to quite quickly because it involves all their senses. And if we can come into young people’s lives when it’s just in those early days, it is actually relatively easy to move.

Rachel Cram – So with that intervention in the early days, be one of the distinctives between it being something they’re just experimenting with and something that becomes a habit.

Michelle Mitchell – Yeah, definitely. And we can help them choose better coping strategies and we can help them talk out some of what they’re feeling. Stress plus something equals relief for all of us Rachel.

Rachel Cram – Yes. I remember this from your book. What do you mean by all of us? Because I think this equation brings the ‘normality’ (if that’s the right word?) of why kids self-harm, into perspective.

Michelle Mitchell – Yeah, you know, there’s the tub of ice cream in the freezer, the packet of Tim Tams, you know, and in that moment of feeling overwhelmed, and maybe that impulse control is lacking in us as well. As I explained that to parents, they kind of go, “Oh, I get that,”

But it’s usually this combination of things that has a tipping point that leads young people to have a go at self-harm and see if it can be something that actually works for them.

Rachel Cram – You’re saying stress plus something equals relief. So to prevent self-harm from becoming a habit, or to break the habit, as a parent or professional, you’re trying to help identify self-harm as an ‘unhelpful something’ and then introduce a ‘healthy something’ for them to experiment with instead, as the new plus to coping with their stress?

Michelle Michell – That’s right. And I’ve often built a coping kit with young people so when emotions are high, they have somewhere directly to go that has a range of strategies for them to use during those times.

Rachel Cram – So, health resources.

Michelle Mitchell – Yes, because whenever their challenges exceed their resources for coping, that’s when young people come undone.

Musical interlude #1

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Rachel Cram – Well, I would love you to spend a few minutes giving us a list of those coping strategies, but just before we do that, in your book, you talk about administrators asking you to come into schools to talk on self-harm and you say that you don’t want to come in and talk about self-harm because in a way, it’s almost contagious.

Michelle Mitchell – That’s right.

Rachel Cram – When you talk about self-harm, it can actually incite kids to do it.

Michelle Mitchell – That’s right, 30 percent of young people who try self-harm have heard about it from a friend or presentation at school, and it was obviously a presentation that was trying to deter them from it. But the reality is it’s putting it in front of them as something that young people do to cope or control pain. And if that’s the objective at the time, I can totally see why young people would want to pick that up. So I always come in and talk about self-care because we’re really about building up their resources for coping.

Rachel Cram – So talk about coping strategies and coping kits. I found this very helpful and practical in your book.

Michelle Mitchell – Absolutely. So a coping kit will help young people distract and then decide what to do. It’ll give them this little bit of a pause. And I always encourage young people to identify what’s going on and identify that kind of urge or that desire to harm or identify that internal dialog that’s not coping, and right then say to themselves, “You know what? I’m not going to act on that right now. I’m just going to delay for a minute.”

And for some young ones I’ve worked with we’ve literally put on a timer for half an hour. And during that half an hour, their task is to go to that coping kit. So a range of creative strategies can be really helpful there. It’s got to be personalized.

But there are some kinds of things that commonly young people tend to put in these coping kits, things like journals, beautiful pens. I mean, we want to bring out the big guns, the best glitter pens we can find, anything that’s going to give them some creative expression. Music, playlists, all their favorite songs, so they return to those songs during these times. Even having makeup or nail polish in there. Body Paint that’s very soothing on the senses. Bath gel. Hot chocolate in little packets. Anything that’s really comforting. Pajamas. Fluffy socks are another one. You can get socks with sensory bubbles or little spikes underneath the socks, and I find that young people find that really soothing.

I had a young man once, a Rubik’s Cube is what he had in his coping kit. A list of people that they know love them that they can turn to for a conversation. A picture of a beautiful place they’ve been to in the past.

They’re all things that communicate that life is worth living. And for so many young people, self-harm is actually a way to want to enjoy life more. So it’s a strategy to live rather than to die. And I think that’s really important for parents to know because it can be really scary when we think that our kids might want to harm themselves.

I’ve seen some young people actually write, “I love my grandma,” on the place where they normally self-harm because they know that grandma wants them to stop self-harming. Simple, emotional pulls for kids that can be really, really helpful.

Apps as well can be helpful and helplines, so if mom, if dad, if grandma is not around at the time and they really know that they need that support, that they have got somewhere that’s accessible that they can find.

‘Calm Harm’ is a great app.

Rachel Cram – Ok. Calm Harm, ok.

Michelle Mitchell – Yeah, I would always recommend that parents look at it first and use it first because it really is more for young people who are harming as a habit. But it is definitely a way that young people can track their progress and choose less harm.

Rachel Cram – I love that, that’s important to have that already in place for when the moments arrive. As you’re talking, I’m thinking that there are quite a few shows out, even on Netflix now. I’m thinking in particular, shows like 13 Reasons Why. Is that what it’s called?

Michelle Mitchell – Yeah, that’s right.

Rachel Cram – That I think have been designed as helpful tools for kids, but then I’m wondering if the research now is showing that they’re not actually that helpful. I wonder if, like you’re saying, it actually kicks up more of that. What do you think?

Michelle Michell – Yeah, it really depends, the place that that young person is at and the opportunity they’ve got to process. If their mental health is not strong at that time, I think that would be the absolute worst thing for them. It’s likely to trigger that off as an option for them.

But I have seen some families use that as a way to discuss self-harm and help them understand, possibly a friend that self-harms. I think the challenge is that half of young people who report self-harming, they’ve internet searched about self-harm or suicide related material before they’ve self-harmed. So we can’t deny the impact that seeing has on our feeling, our thinking, our behavior. That visual is incredibly powerful. And also young people are looking for opportunities where they feel like they belong and that their intensity makes sense. And that’s why it’s so important for us to really validate where they’re at as adults, and not shut down or push that intensity away because they’re looking for a community that that intensity belongs to. And when their sense of who they are is identifying with a coping strategy like self-harm, that can really form a habit very quickly.

Rachel Cram – You know, you’re talking about what they see, I also think of what they hear. I feel like I’m such an old person saying it this way, but a lot of the music kids are listening to these days, it does have a lot of self-harming, suicide, type of talk, I hate myself.

Michelle Mitchell – Very intense.

Rachel Cram – It’s very intense and I can see that being very therapeutic for the person who wrote it perhaps, but not necessarily for the person who’s listening to it, if it’s giving them ideas.

Michelle Mitchell – That’s right. And the other place that really concerns me is the gaming sites where that rage and that hate language is so common. I can’t help thinking that they would turn that inward at some point because they’re getting used to that language.

Rachel Cram – All this being said, I do think as parents, especially as our kids move through the tween years towards like 14, 15, it is increasingly difficult and unrealistic to control what our children are seeing or listening to. And so that’s where this self-help is so important I think.

Michelle Mitchell – I’d really like to pick up on that because sometimes when we accept that this is a part of a teenage journey or our teenager’s journey, what it allows us to do is to lean in with compassion and to open the door for learning opportunities. And when we don’t accept it and we don’t make room for it, we’re shutting the door for them to move through it and to learn from it.

And I even find that in schools, Rachel, I find that there’s a very anti self-harm kind of approach but because of that, young people don’t seek help and they don’t talk about the intensity of their feelings. And none of us want our kids to be in a dark place. But if they ever are, gosh, we want them to be able to come and lean on us.

Rachel Cram – Absolutely.

Musical Interlude #2

If you’d like to connect further with Michelle Mitchell’s writing and work, find links on her episode page at family360podcast.com. It’s all there waiting for you.

Rachel Cram – You know, when you’re talking about it being in school, something that kids perhaps don’t feel comfortable bringing up, I do know there’s a tendency of professionals and parents to sometimes look at self-harming behaviors as attention seeking behaviors and almost minimize it as that, like, “They’re just doing this to get attention.”

What do you say to that?

Michelle Mitchell – Yeah. There has been moments in my career where I’ve sometimes felt that inner frustration like, “Come on, get it together,” you know? And I found for myself that that’s actually a really dangerous way of thinking. If I start to see it as ‘attention-seeking behavior’, it doesn’t give me the chance to be helpful in the way that I need to be. When we’re thinking to ourselves, this is ‘attention seeking’, let’s just flip it and realize that it’s often a bid for connection. That right now, they need someone to sit with them with these intense feelings because they actually don’t feel like they can do it on their own.

Rachel Cram – So what are they needing?

Michelle Michell – They’re asking us to see them, to hear them, to accept where they’re at, to even show interest and really delight in who they are as a person and hold them in that space. Young people are wanting us to understand them. So consider and really respond to my needs. Help me organize my feelings, validate where I’m at, be really curious about what’s happening to me, protect me.

I don’t think we talk about this enough, this attachment seeking that kids have, “See my extreme distress right now and the different ways that I’m expressing it support me as I regulate it and help me be safe.”
And when parents show up as this big person in their kid’s life that is prepared to connect, understand and protect, that’s a really, really powerful space to work in.

Rachel Cram – And just because they might be physically just about as big as we are, it doesn’t mean that they don’t still need that same lean in and care. I think often with toddlers, we’ve come to the awareness that if they’re tantruming, or if they’re whining, it is a bid for more than attention, it’s a bid for attachment, and we step in rather than step back. But it’s the same when our kids are teens, and it’s easier to forget it then though I think.

Michelle Mitchell – Absolutely it’s exactly the same. And I love it when parents and their teenagers can get to this point where a teenager can actually really feel comfortable going to someone in her family and saying, “Hey, this is getting a bit much for me right now.”

And it’s so beautiful to hear 20 year olds reflect and talk about their parents who have showed up. And the memories that kids have of parents being that big person in their life. And being so grateful for that presence is just, you know, it’s beautiful.

Rachel Cram – Very beautiful and I’d love to dig more into this topic of how we show up as parents more in a minute if that’s ok.

Michelle Mitchell – Sure.

Rachel Cram – One of the really surprising variations of self-harm that you talked about in your book that I had never heard about before was digital self-harm, and perhaps one that’s even gaining more popularity because we’re in such a digital world right now, especially during lockdowns. Do you want to describe what that is?

Michelle Mitchell – Yeah, it’s when young people set up an anonymous or a fake profile and use that profile to bully themselves or to damage their reputation online.

So it’s kind of quite staggering, isn’t it? What’s more staggering is one of the research projects that interviewed five and a half thousand teens between 12 and 17. Six percent of them admitted to doing this.

Rachel Cram – Wow.

Michelle Mitchell – That’s a lot

Rachel Cram – That would admit.

Michelle Mitchell – Yeah, that would admit. And that means that if they’ve had a hard day at school, they can actually go home, bully themselves. And then it immediately gives them an indication of who’s on their side and who’s not.

Rachel Cram – By how people respond to what is their anonymous bullying of themselves.

Michelle Mitchell – That’s right. So they either agree with the bully or they defend them and so it’s one way they can kind of work out who’s their friend and who isn’t. Again, it can be a bid of connection, a bid for attention, a bid to see my pain. Hear me, someone understand what’s going on.

Rachel Cram – Now, you’re talking about kids seeking attachment more than attention and I’m wondering, especially in situations like digital self-harm, do they usually want their parents or their friends to be aware that they’re self-harming? Or do they want to keep that hidden?

Michelle Mitchell – It’s quite a private experience for a lot of kids. If they drop like the cookie crumb trail of hints that something’s not going great in their life, they often want those cookies to lead them to the heart of the issue. So there’ll be some young people that are quite desperate for their parents to find out, and they are making lots of bids for connection.

But there will be other young people that feel really deeply ashamed about it, and they spend a lot of time afterwards trying to cover it up and hide the fact. And for those young people, when their parents do find out, that’s a very delicate, tender moment because they’ve been exposed and they feel very vulnerable.

Rachel Cram – Now, for a parent, when you do discover this, it brings up intense fear and your instinct is to jump in and protect your child. What’s the best way for a parent to respond to a child or teen who is self-harming?

Michelle Mitchell – OK, this is my space, Rachel, because so many parents contact me after they found a blade with blood on it in their daughter’s pencil case, or one of their daughter’s friends has anonymously texted the mum to tell her what’s happening, or the school calls them in and talks to them. And so it’s often a big shock for parents.

It’s so important that we are able to process our emotions away from a young person. And let’s unpack this a little bit because this is really important. I’d like to read you a few statements from parents from my book because I think this just shows the intensity of what parents go through at this time.

Patricia said this to me. “I felt sick to my stomach and then I just felt numb. I didn’t know what I had done wrong.” And so you can see parents internalizing, “What have I done wrong?” Or, “What’s happened to my child?” is another very, very common way of thinking.

“I was filled with every emotion you could think of it exactly the same time.” This is Cathy. “At first, I was worried. My thoughts went straight to picturing deep slices in her skin,” and her daughter was actually just really scratching her skin, so it was this catastrophizing what was going on and very fear-driven thinking, “And the horrible, emotional and mental place she must be in to do that to herself. I didn’t understand cutting. I didn’t understand why she was doing it or what she was trying to get out of it.”

And one more. This is Laura. “I suppose I just turned on myself. How could I have failed my daughter so much as a mum to let her get to a place of thinking self-harming was a way to solve problems? We knew we were losing our little girl to something, but we didn’t know what.”

And when we have these initial kind of reactions when we first hear about self-harm, they can come out in ways that are not helpful to our kids. And that’s why I always say to parents, if you can find a place to process your emotions before you have that first conversation, it’s ideal.

Book yourself in to see a psychologist, a close friend, somewhere you feel like you can just vent how you feel because all your emotions parents are absolutely as legitimate as your child’s are. And it’s really, really important that you give space and air to that.

What I see happening when parents don’t have that place to process, sometimes when they come to their child, they might say things like, “If you don’t stop right now you’re going to end up in hospital or something worse,” or “You’re going to throw your life away.”

And we say very big things when what we really want to say to our kids is, “I’m just so deeply concerned for you right now that I want to show up in the most helpful ways possible, and I want to do everything I can to support you.” And that’s really at the essence of what we want to say.

Rachel Cram – It is. Those previous statements, the not so helpful ones, are understandably said in fear.

Michelle Mitchell – Right.

Rachel Cram – And what does that do to the conversation?

Michelle Mitchell – It gets clouded in emotion.

Rachel Cram – Ok.

Michelle Mitchell – What I don’t want parents to do is come to conversations with this stiff upper lip like, you know, like they’ve got it all together, and that their emotions are all positive about it and it’s all going to be OK. Or with that sense of distance from their kids that they can’t be real and honest about what they’re feeling. It is okay to be human in this. There’s no perfect thing to do. And what’s more important is that your child feels your heart. And in fact, when we hide that heart from kids, I think that can really bring a disconnect there in itself.

Rachel Cram – But maybe don’t start crying in front of them, like, is that the kind of intensity you’re suggesting you hold off?

Michelle Michell – You know what, if a parent cried in front of their child, there would be nothing in me that would want to say that was inappropriate. In fact, that might be the most appropriate thing for them to do at that moment. Kids want to really connect with our heart, and I think when they see that we care, it’s important. What’s more important? On top of that is actually bringing helpful language around those tears.

Rachel Cram – OK, so can we call that your first point? Process your emotions away from your young person first, or at least enough to come into the conversation with comments and questions that create connection.

Michelle Michell – Yes.

Rachel Cram – So then what do we do after that?

Michelle Mitchell – We’re going to let them know that a caring conversation is coming, and so often when we feel emotional, we’ve got this emotional pounce that happens as parents and we tend to not give them enough lead-in time and warning of what’s coming. If we come at it with the intention of catching them out or interrogating them, it’s not going to go down well. So we want to tell them a caring conversation is on its way. We want to tell them that your greatest focus right now is to support them the best way that you can, and this conversation’s all about helping us do that.

Rachel Cram – So are you saying like, “Later on this afternoon, we’re going to have a conversation?”

Michelle Mitchell – I’d say something like this, “I need to have a really important conversation with you. OK? It’s going to probably take us about 40 minutes, and I want it to be something that’s just private between you and I.”

Try and give them some choice. “Do you want to do that in your room or out the back? Would you like to talk now or this afternoon?”

Rachel Cram – And 40 minutes, is that kind of a guideline of how long?

Michelle Mitchell – I will say this, when kids are self-harming they’re often very emotionally exhausted, so they’re coming to that conversation really tired and you’re processing it like it’s new. They’re not in the newness of it and so their fatigue is really important to factor in. I find that conversations that go over an hour sometimes go pear-shaped, and it’s simply because kids are tired and we have the opposite energy happening.

Rachel Cram – So brevity is key?

Michelle Mitchell – Yeah, but just remember, it’s not the last conversation that is going to happen. And I would aim for high-quality, shorter conversations that happen regularly because when your child leaves that conversation, they’re going to rehearse every single thing that you said to them. And sometimes they can misconstrue some of those things. Sometimes they can focus on something that you didn’t intend. And so coming back with regular conversations can be super important.

Rachel Cram – I’m just going to get really detailed here. Like, are you coming into the conversation asking questions? Like, are there questions that we should ask and questions that we shouldn’t ask? Or are we going into a little bit of a monologue? I’m sure part of that is knowing your child, but can you give more insight on that?

Michelle Mitchell – I think you’ve got to explain how this conversation has come into being.

Rachel Cram – Like how you’ve discovered your child is self harming?

Michelle Mitchell – Yeah. When parents have snooped in kids’ rooms or found something that they shouldn’t have, it just adds that little bit of a layer of complexity. And I would say to parents, please don’t lie. I’ll tell you why. Trust right in that moment is really important. And even though your child might not have liked that you snooped in their room, the fact is they know that you would do anything to protect them.

And if you have to ever justify your behavior and you have felt it necessary to delve into their personal life, one way I say to parents to explain that is to say, “I would do anything to protect you, and I would never have done that if I didn’t feel like I needed to do it to protect you.”

Teenagers are usually pretty good with truth, and they’re pretty good with genuine hearted mistakes. I say to parents, “Sometimes you know without knowing, so it’s always better to not delve. But if you have and you have to backtrack, that’s one way to tackle it.”

So let’s come back to your question Rachel. So you have to kind of explain how this conversation came about, but then you want some soft questions. Not hard detailed questions. Don’t go there straight away. But one thing you could say is, “Can you help me understand this? I’m sure that in your mind and looking through your eyes, this completely makes sense. But for me right now, I’m really struggling to see how this is helpful for you. And I need you to talk to me about why this is something that’s working for you right now.”

Rachel Cram – What would be the opposite of that? Like, what would be the, don’t say this compared to the say that.

Michelle Mitchell – OK, ‘don’t say this’ would be, “Tell me where you’re hiding your blades. How long has this been going on for? If you don’t stop this I’m going to have to punish you. Why do you want to kill yourself?” Things like that that are very direct and they’ve got that interrogational tone?

Rachel Cram – OK, OK.

Michelle Mitchell – Even questions like this, “If there’s anything I can do that could make a difference, I want to hear about it.”

So again, we’re putting the focus on me. “I need to understand this.” And what it does is to take the heat off them a little bit.

“Is there anything that’s going on right now for you that I could be missing?” That’s a powerful question.

“Would you be open to seeing a professional or a doctor or a psychologist? You actually deserve support.”

Not, you need support because you’re so messed up and you know, but you really deserve support. “And I want to make sure that you get the best support we can give you.”

And how about something like this? “I can only imagine how personal this is and how hard this conversation might be for you. And I’d feel really privileged if you would talk to me. I want you to know that I’m grateful for you just the way you are, and there’s nothing that we can’t get through together.”

Rachel Cram – That’s very helpful. Would that almost be the package of what you’d want an opening conversation to entail?

Michelle Mitchell – Yeah. Trying to take the sting out of it for them. And a lot of kids just collapse in tears at that point because they don’t want to hurt us as parents. It’s just an amazing thing when parents come to their young person so genuinely wanting to be supportive. And kids can pick up on that sense. They really almost feel like, ‘I owe it to my parents to really show up here and to care about where they’re at in this process as well.’

Musical Interlude #3

Thanks for listening to family360 and our conversation with author, speaker, and adolescent specialist, Michelle Mitchell.

Our next episode is about attachment and belonging, with the sensitive, and well-seasoned insights of clinical counselor Dr. Deborah Macnamara. Deborah writes, “The secret to [developing relationships] is helping a child see that it’s not their job to strive to hold on to us but to take for granted that we won’t let go of them.” Dr. Mcnamara is the author of the best selling book Rest, Play, Grow, which has been translated into 9 languages across the world. I invite you to join us for this conversation.

And now back to our conversation with Michelle, as she brings us toward a conclusion of hope in how we help our children struggle through stress and grow their capacity to cope.

Rachel Cram – Now if you offer those soft questions, I imagine there’s some kids who can articulate quite well what they’re experiencing and other ones who, for whatever reason, don’t. Maybe they can’t, or maybe they don’t want to. What do you do at that point if they’re not giving you much information back?

Michelle Mitchell – Remember how we said the aim of the first conversation is to really be able to sit with that emotion and to be in the moment of it? I wouldn’t even worry about what they can articulate or can’t. But if your child’s not in that place, what you don’t want to do is just launch into any judgments or criticisms of that. Try and be careful of big overreactions or trying to push confessions, trying to push language.

You don’t want to come in with a lack of knowledge, either, because that just wrecks trust and credibility. So you want to be honest about what you understand and what you don’t understand, because it can bring a level of insensitivity when there’s not understanding behind the questions that you’re asking or the comments that you’re making.

Rachel Cram – So after you’ve had this soft conversation, or maybe a few of them and you’re offering for them to go to further help, if your child is willing to go to a professional, like a psychiatrist or psychologist, how do you move that direction and what if they’re not willing to do that? Which one of those do you want to pick first?

Michelle Mitchell – Yeah, I’m so passionate about this because I’ve often seen parents think that the professional is going to be the answer, and they get very fixated on making that transition to a professional when getting a kid in a room and talking about feelings is not the answer for every child. And I think we have to be a lot more holistic in how we approach self-harm.

For every young person, what kind of helps them find better ways of coping is different. And for some young people, it can be as simple as getting a part time job and building their confidence up and learning new skills. You know, for other young people, it can be changing schools or expanding their social networks. So I don’t want parents to think that the psychologist is the only answer. It’s a part of the equation.

But, let’s talk about the importance of getting them to a place where they can process with a professional, though, because it does have validity. It’s really helpful for them. So we’ve talked about the caring approach of saying, “We’re really concerned about you. We think you really deserve support.”

You can suggest a trial period if they’re very resistant. “Would you give this a go for just three sessions? And if it doesn’t work, I will fully listen to that, we can review that, but this is something that I think could help you.”

Another thing you could do is tackle it as a family and go to counseling together as a family. And for some situations, that’s actually really helpful. And for other situations, that young person doesn’t want their parents anywhere near this topic and needs a lot more privacy.

You can appeal to their sense of compassion. “Would you go for me?” And I don’t see that as manipulative. I see that as saying, “Hey, look, can you follow my lead here?”

Sometimes I’ve seen parents simply be the parent and say something like, “There’s some decisions that we have to make as parents, and this is an adult decision.”

Now, I always recommend that after a trial period, if that is not working, you backtrack. You don’t want to force that, but sometimes just getting that over the line can take a bit of in charge energy, Rachel. It can take a bit of that big person’s presence that says, “This is the way forward and this is what we’re doing.”

And always leave the door open. If they say no today, it doesn’t mean they’re going to say no in two weeks’ time. So it’s just realizing that this is a journey.

Rachel Cram – Michelle, you’re talking about how we can get our kids to counseling, which can be so important, but it brings a question to my head. When our children are struggling, during any time in their life, we often realize it’s part of the developmental period they are in. I know you already talked about this a bit at the beginning but I’d love to pick it up a bit more. Could teens grow out of this?

You’re mentioning that this is something that happens around the onset of puberty, is self-harm something that our teens will grow out of? And is there even a bit of hope in that if they don’t want to go to see a professional that if we just wait it out with them, that they will grow out of the stage? How realistic is that?

Michelle Mitchell – If people could see me now, I’m smiling the biggest smile because I want to say yes, yes, yes, yes, yes. Interesting, research tells us that the majority of young people only self-harm for 18 months, and that’s a long, long 18 months, let’s not minimize that, but they do find other coping strategies as they grow. And self-care and our coping strategies look different in every stage of our life. I’ve had a lot of young people say to me, “I grew out of it.”

I believe them. You know, this capacity we’ve got as adults to hold the fort during those really intense times in our kids’ lives is part of our job as parents. It’s development, a lot of times it is those developmental drivers that are really exasperating.

Rachel Cram – Well, I think also too, remembering that development isn’t always linear. Even going back into preschool years. You know, you can have a time that your child’s toilet trained, they’re doing great. And then all of a sudden they’re wetting their beds and you can feel like, “Oh, have they regressed?” But it’s just that there’s other things that they’re suddenly working on like, a new siblings come into the family and they’re learning to adapt to that. And it doesn’t necessarily mean that our child has lost their development that they had, that got them to be a tween, but that there’s these other competing developmental stages that make it so messy and complicated.

Michelle Mitchell – And we often look at teenagers and think, Oh, they’re so self-centered. And look, there’s a lot of ruminating that happens at this age. They get very stuck on the negatives. They find it much more difficult to move past them. But their self-centeredness is actually necessary because they’re going through so many changes to become the adult version of themselves. And I think even in the decisions that we go, “Oh my goodness, that looks so dangerous, it looks like a backward step,” It’s sometimes in those decisions that they’re actually really finding themselves.

In our dark moments we can really see light. I’ve seen this so many times, Rachel, just sitting and talking with young people when they really are very reflective and intense, you can see how much development is actually happening.

Rachel Cram – Well, as we talk about all this, I know that a lot of our listeners have children that are not yet at the tween stage. And so it begs the question, are there ways that parents can be proactive in preventing self-harm from being something that their child needs to explore? Is there something that we can be doing even when our children are preschoolers?

Michelle Mitchell – Yeah, I can imagine this is quite a heavy conversation for parents who have got preschoolers. I hope they’re able to gain something from it, you know.

This was really important for me when my kids were toddlers because I was working with teenagers I could see the potential for this to happen in their lives. And so what I really wanted to do is make sure they were able to understand what they were feeling and have great tools to regulate what they were feeling.

Rachel Cram – Great! So what did you do for that?

Michelle Mitchell – I used this emotional thermometer on the fridge at home. I would say to my boys, You know, “What are you feeling,” when they’re upset, “And how intense is that feeling?”

And so they might, point to 10 out of 10 or seven out of 10 or 5 out of 10? And then I’d say, “How can we look after ourselves?” Or “How can we reduce the temperature on the thermometer?”

And obviously, with toddlers, they might be a little bit young. So maybe I’m talking grade one, but it’s just this concept that their feelings are valid. There’s no feeling that is not OK. All feelings are welcomed. We can sit with this. We can give it language. We can describe it. And then there’s this moment where it’s appropriate to shed light on the way forward and we try and bring out their wisdom.

And so we might bring out the wisdom of, ‘Are we going to go for a walk and look at some beautiful green trees? Are we going to have a hug right now?’ And give them a lot of autonomy and choice in how they’re caring for themselves? I found that really worked for my kids. And I think that starts from when they’re young.

Rachel Cram – Well, you’re describing really a self-care kit for preschoolers. Right?

Michelle Michell – So beautiful.

Rachel Cram – We need them at every stage of life.

Michelle Mitchell – And when you look in preschools, that’s exactly what they have. They have, sensory toys. They have the quiet reading corners. They have those options for kids when they do need to take time out and be with themselves. So that is actually a really practical way that we do it in everyday life.

Rachel Cram – We kind of need that still in middle school and high school, don’t we? Those sensory corners?

Mitchelle Mitchell – Yeah. And some schools do a great job of it, but it is a little bit more complicated with their peers watching, all of those things make it a little bit more tricky.

Rachel Cram – Yeah. Well, there is no getting around it, adolescence is a complicated transition from childhood to adulthood and our teens really need our connection, our attachment, and our attention, that “big person presence” you mentioned.

Michelle Mitchell – Yeah, that’s right.

Rachel Cram – Well, Michelle, we are going to need to start to draw to an end of this conversation. I’m going to try this as a last question, tell me if this works for you. When it comes to care and support, what do our teens need most from us as parents? Does that work for you?

Michelle Mitchell – I love that question. OK. I want every parent right now, it doesn’t matter how old your child is, imagine they’re in the gym of life. OK, and they’re doing squats. And at some point in the workout, they’re going to start to feel the burn that comes with those squats. They’re going to start to hit their capacity. And what we do during those moments in our kids’ lives, regardless of whether they’re toddlers or whether they’re teenagers, helps them feel that capacity that they’ve got in them.

During those moments, we’ve got two options as parents. We can go, “Ah, you’re hurting? Oh, come and take a seat honey, sit down. You want a Coca-Cola, a latte, McDonald’s driveway on the way home from school? Ah, mommy will take care of you.”

You know, and we pull them out of their training at a time where they need to be feeling that they have the capacity to handle the burn that comes with squats.

The other thing we can do is be a really great personal coach and we can get right up beside them when we can say, “Gosh, I know it hurts doesn’t it? Shake it out. Let’s wipe your brow a bit. Let’s just shake out those legs that are hurting. Do you know what? I think you can do five more.”

Now we don’t want to squat them to death. You know, we don’t want to push them past their capacity to the point where they’re in hospital. But we want to get five more squats out of them at a time where they’re under pressure because right there, what that does is tells them that they can tolerate emotional pain and that they’re stronger than they think they are. And what we want to do is give them the tools to build that strength in their life.

Rachel Cram – Even though they’re wanting us to take the pressure off.

Michelle Mitchell – Yeah. One thing teenagers lack is perspective. And when we come in like a really great personal trainer would, we give them that perspective that they don’t have.

Think of this, Rachel. If we hired a personal trainer to help us get in shape and every time we started hurting during our workout, they took us to the sideline and gave us time out, we would sack them as a personal coach. I’ve worked with a personal coach a while ago. I’ve never seen a woman love pain so much in all my life. It’s like she got excited when I started to hurt. And we don’t want to go that far, but we do want to help them in those moments, stand beside them and squat with them for a while and tell them that they actually are stronger than they think they are.

Sometimes all they can see is out of the dark, gloomy window that is their soul at that moment. But we’re saying, “Take a look at what I can say. Take a look at the child that I’m so grateful for.”

When we do that for our child we’re transferring hope, and that’s the one thing we never want to lose as parents. When a child doesn’t have eyes to see a bright future. It’s a parent’s love that sees it for them.

Rachel Cram – Michelle, I love that as an ending, thank you so much.

Michelle Mitchell – Thank you.

Rachel Cram – It has been so fun talking to you again on a difficult topic.

Michelle Mitchell – Thanks for having me. This is a this is a big topic.

Rachel Cram – It is. I just want to say again, your book is fantastic. I know that you have not been able to cover all of it. It would have been a 12 hour interview, but it is so accessible to parents and I thank you so much for the research and work you put into creating such an incredible resource and for talking with me today.

Michelle Mitchell – My pleasure. Love to everyone.

Roy Salmond – Bye Michelle.

Michelle Mitchell – Beautiful, Ok, love to you both. You’re amazing.

Roy Salmond – Take care.

Rachel Cram – OK, bye

Michelle Mitchell – See ya.

“For the New Year, 1981”
D E N I S E L E V E R T O V

I have a small grain of hope
one small crystal that gleams
clear colors out of transparency.

I need more.

I break off a fragment
to send you.

Please take
this grain of a grain of hope
so that mine won’t shrink.

Please share your fragment
so that yours will grow.

Only so, by division,
will hope increase,

like a clump of irises, which will cease to flower unless you distribute
the clustered roots, unlikely source
clumsy and earth-covered
of grace.