Sandra

Age at interview: 49

Brief Outline: Sandra’s older daughter started self-harming after being bullied at secondary school, but has now learned strategies to cope and has not harmed herself for two years.

Background: Sandra, 49, is a social worker, married with two daughters. Ethnic background: Black British.

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Sandra’s older daughter nearly died after developing septicaemia when she was born prematurely. She then had years of surgical treatment for a facial deformity. Sandra describes her as an impulsive, demanding child. When she was about six she was seen by a CAMHS therapist for about a year. Her behaviour improved but she was bullied at her secondary school and started cutting herself. Sandra took her to hospital and contacted the therapeutic services. Her daughter later took an overdose and tried to hang herself, but was saved by Sandra’s quick intervention. Sandra found this extremely stressful and alarming. She was also angry and questioned God for not intervening. She sought advice from her daughter’s god parents, but her daughter was very angry when she discovered this so Sandra did not involve them again. She has coped by accessing professional help and giving her daughter unconditional support, teaching her to take one day at a time, face her problems and not give up. She also found it helpful to distract her daughter by encouraging her to remember happy times in her life. She tried to make her daughter realise the effect her suicide would have on the rest of the family, but avoids making her feel guilty and praises positive behaviour. Her daughter has not harmed herself for two years and is now at college. Sandra is very proud of how her daughter has blossomed even though every day is still a struggle.

All the family had to be vigilant, hiding anything that could be used for self-harm. After her attempt to hang herself they were frightened to leave her alone in the house, and were very sensitive about saying the wrong thing to her. Sandra says the impact on the family was phenomenal, and there were times when she and her husband were on the verge of breaking up, but they stayed together and proved to their daughter that you can overcome difficulties by working at them. Her husband was angry at first and couldn’t understand why their daughter needed to harm herself. Sandra had to calm him down and explain that their daughter was stressed and unhappy. He now supports Sandra in her way of dealing with the situation. Sandra’s younger daughter was also very angry at her sister’s behaviour. Sandra bought her a punch bag so that she could release some of this aggression, and told her that it was her sister’s way of coping with pain, but that if she herself felt bad she should talk to Sandra instead of copying her sister. She has encouraged her older daughter to be a positive role model for her sister. Sandra thinks it’s important for both daughters to feel validated, so she and her husband make sure to spend quality time with each of their daughters and to reassure them that they are loved.

Sandra works as a social worker and found it difficult when her own family needed help, but she didn’t allow her pride to prevent her accessing services for her daughter. She decided against family therapy because of her professional position, but encouraged her daughter to engage with the CAMHS service, which she found very supportive. At times Sandra secretly checked her daughter’s diary and phone so that she could ring her friends if she was missing, and she would alert the school if her daughter had had a bad night. Sandra has a very strong faith and has found God and her church pastors a great source of help and inspiration. She feels that her intuition, common sense approach and professionalism have empowered her as a parent to cope with all the stress of her daughter’s self-harming over the years. She is planning to share her experience with members of a self-harm charity, and thinks that the taboo surrounding self-harm has resulted in a lack of funding for support organisations.

Sandra wonders whether she spoilt her daughter to overcompensate for all the operations she went through. She has now learnt not to give in to all her daughter’s demands and has been pleased with the way her daughter has reacted – she organised a holiday job and is focused on her college work. Although she is still anxious that her daughter might harm herself in future, Sandra concentrates on remaining positive and taking one day at a time. She tells her daughter that what she is going through won’t last and that she believes in her and her ability to excel in what she chooses to do. Sandra thinks this belief has helped her daughter turn her life around. 

Sandra says a lot depends on how you react when your child is self-harming. ‘It’s not always wise to get angry and shout at them, because they’re hurting and it’s a cry for help…It’s a way of releasing some of that pain that they’re going through’. She advises parents to communicate with their children, to understand them, and to follow their intuition if they suspect something is not right.

She advises clinicians to understand that people who self-harm are sensitive and need reassurance, and to recognise their unique qualities. She says ‘they need to be heard, they need to be validated, and they need to know that they matter.’

Sandra’s daughter had very caring friends who wanted to help.

You know, but then she went to school and she got through the day, got through the week and at times when it got a bit more regularly regular with the self, superficial self-harming, she would literally go to school sometimes without no bandage on and literally show it to her peers to say, “Look. I did this last night.” As a way of saying, “Well, I am struggling here. I need help.” And some of her peers said to her, “Why, why do you feel the need to do that to yourself and why don’t you talk to us and why don’t you talk to someone?” You know, but then she said obviously, by their reaction she didn’t know what to say because she didn’t expect that and she didn’t think they cared about her and she thought no one cared.
Strapline: Sandra’s daughter had very caring friends who wanted to help.

Yeah, that’s right and I wouldn’t say it’s anything that I’ve read from any manual or any book or leaflet. It just intuition, common sense approach, you know, combined with professionalism, you know, all rolled into one has enabled me and empowered me as a parent, as a mother, you know, to cope with all the stress and dilemmas and impulsiveness of my daughter and her self-harming behaviour over the years. And had it not been for that, I think I would have been on tranquilisers by now or needing therapy myself, you know, but I’m a very hands on person. I’m very dogmatic, very practical and I just do whatever it takes to get her through the day. If it means transporting her to college, you know, driving her like a taxi service, you know, if it makes her happy, I’m happy. It’s less stress for me, you know. If she’s happy, if she’s getting through the day and that and she’s not getting any absenteeism, at least something is working. 

Sandra helped her husband calm down when he was angry at their daughter.

How did her dad react to her self-harming?

He was angry because men, obviously, they react to things differently. When I say angry, I mean he shouted at her, “Oh why the hell are you doing this to yourself?” You know, “You know we love you, we care for you. We’re supporting you whatever you do, you know. Why do you feel the need to want to do that to yourself?”

And that, you know, it’s very stressful for the family so then she reacted by saying, “Well, I’m stressed too and that’s why I’m doing what I’m doing. I need help. It’s is a cry for help. I I’m not happy. I’m sad.” So then I had to sort of calm my husband down, said, you have to intervene, and I said, “Well, you know, the way you handled it is not the right way. She is stressed. She’s hurting. That’s why she’s doing what she’s doing. It’s new to us. It’s new to me. Even though I’ve worked in it but it’s different when it’s home, when it’s applied to your family” and I said to him, “Just learn from me. Observe the way I deal with her and you can learn from that.” And that’s how we’ve handled it. So now if there’s a situation, he lets me deal with it and he observes but he will support me. 

Sandra and her husband were vigilant, but didn’t want their daughter to think they were checking up on her.

We had to be vigilant. We had to be on the alert, you know. We had to be proactive and not panic so, you know, times if I was probably going to a function in the evening, I’d say to my husband, “Whatever you do make sure you’re vigilant. Keep checking on her. Make sure, you know, if she comes downstairs, just come and check on her. Make sure she’s not taken any knives or anything.” Obviously, you can’t keep hiding knives away but, you know, you have to use them for cooking but I said, “Just be on your guard.” You’re checking up but you’re not making her think that you’re checking on her. You can just pretend that you’re going to make a drink but you’re still being vigilant. So we have to sort of keep communicating, being vigilant, using strategies, you know, and that strategies of safe-keeping and hiding things, you know, just for her own protection. 

When her daughter threatened to kill herself Sandra did her best to stop her

And there was one time she was having, she had a hospital appointment but it was for to do with her facial situation and that was like a follow-up appointment and she was just stuck in the car. She wouldn’t come out and she was being really dramatic that day, “I’m going to do this to myself. I’m going to hang.” No, she didn’t say “I’m going to hang.” She said, “I want to die, you know. It’s come to this time. I can’t go on anymore. I’ve had enough.” And I was just getting that all way driving to the hospital. It was just so distressing. I had to drive very slow. I had drivers honking their horns and I’m thinking, “If I go too fast, I’ll probably lose concentration and I’ll crash the car or something.” So I had to drive slow, concentrate but, at the same time, pay attention to what she’s saying but not giving in to it at the same time and then I managed to get myself into the car park and she was just she was just going on and on about the same thing. And then she said to me, “Mum, I need a piece of paper. I need to write my will. I need to do this. I need to write a letter for my sister.” She said, “This is it. I’m going to jump over this fence. I’m going to finish it. I can’t take it no more. I can’t face any doctors. I’m sick and tired of hospitals. I’m sick of my life. I’m sick of everything.” 

And I thought, “Oh my god, what do I do?” You know, I’m in a public car park, you know. People don’t know what’s going on. If I try to, I’m not even going to try and pull her out of the car because she’ll try, she’s quite a big girl and I’m not going to shout at her because then it’ll just escalate the situation. So I had to just be very calm and think about what I was doing but she was just going on and on. She wouldn’t get out of the car. She was just, you know, saying all sorts of things. 

Anyway, I got her the paper and she wrote some stuff on there and she said to her sister, “I love you, you know. I’m sorry I’ve got to leave you but the time has come for me to die. I need to, I just need to go. I need to go. I need to end this life.” And I thought, so then after she wrote it I said to her, you know, “Have you thought about the impact it’s going to have on your sister?” I said, “Your sister dotes on you. She loves you. She worships the ground you walk on, you walk on.” And I said, “If you were to take your life or end your life, it would be so destroying for her.” And then she said to me, “Oh Mummy, I never thought of that.” 

And then she started coming to herself but then after that, she started back again, the whole drama again and I thought, “You know what? I’m just going to get the bull by the horn and I’m just going to say what she’s saying.” And I said to her, “Well, if you take your life, I’m going to take mine too.” You know, I said, “We’ll just do a pact and we’ll do it together.” And then she says, “Oh no Mum. You can’t do that. You’ve got to think about, you know, my sister and who’s going to look after her.” She says, “I know you’ve got, I know that Daddy is there but.” She says, “He’s not going to cope.” She says, “You are the maintenance person in the family. You keep things going. You are the strong one. So…” She says, “You can’t take your life. You’ve got to look after my sister.” And I thought, “Yeah, something’s working.” And then she says, “Mum, you know what? Let’s go home.” She says, “I’m not going to this appointment today. I can’t face anybody. Just take me home.” 

And that’s what I did. So I turned the car round, took her home and she was calm and she went to her bedroom and she just went to sleep and then when she woke up, some few hours later, she came downstairs, came and hugged me and she says to me, “Mum, I’m so sorry. I’m so sorry. I’m so sorry for all the things I’ve said today and.” She says, “Yes, I do feel like I want to end this life. I do feel at times I do want to go but,” she said, “What’s the point? If you take your life, you’re committing a sin.” She said, “It’s not good. It’s not right is it, you know, to take one’s life.” And then she started thinking again and then she said, “And, you know, and then I think about my life and I do want to help people. I do want to be a solicitor. I do want to study law. I do want to get good grades. I do want to, you know, be somebody in life but.” But she said, “Mum, it’s a struggle.” And then I said to her, “Yes, darling, I do understand.” And I said, “I do understand it’s a struggle, every day is a struggle.” And she said, I said to her, “When you’re going through your highs, I’m there with you. When you’re going through your lows, I’m there with you. I’m with you a hundred per cent and.” I said, “Even at times, when you’re having a headache, my head is hurting me too but I just don’t tell you because that’s what mums do.” I says, “But,” I said to her, “That I’m glad. I’m glad that you’ve had a reality check and, you know, you’ve thought about things and.” I said, “Let’s just take one day at a time. Let’s just take one day at a time. Don’t think too much into the future, just take one day at a time and let’s see how things go.” And that’s how I’ve been dealing with her on a day to day basis. So if the next day she gets up and she talks about, you know, wanting to take her life or she doesn’t want to be here no more, I’ll just say to her, “You know what? It’s a new day. It’s a new season. Let’s see how the day goes.” You know, and then because I’m being positive she won’t talk about wanting to take her life no more. 

Sandra and her husband almost broke up because of the stress of their daughter’s self-harm but they had ‘staying power’ and are still together.

Coming back to the point you made about the impact, yes, it’s been quite stressful for myself and my husband and there are times we’ve felt like breaking up. There are times, you know, I had to get away for a weekend just to have time out. There are times he had to do the same and there are times we’ve had to have separate holidays, you know, just to have time apart so we can reflect and, you know, and refresh yourself. But the fact is, we’re still together and, you know, it shows that we’ve got staying power and I think for my daughter, it’s also proven to her that, when you have difficult, you go through difficulties, you know, it’s not always the best policy to walk away but to work at things. 

Sandra explained to her younger daughter that self-harm was her sister’s way of coping, but told her to talk to her mother if she felt upset rather than copying her sister.

Every aspect of her self-harming episodes has been very stressful for the family on the whole. Her younger sister witnessed her self-harming and rushed downstairs and told me once, “Mummy Mummy, my sister is hurting herself.” And for me as a mum, that was difficult but I, you know, and I felt it was even more difficult for my younger daughter witnessing her sister hurting herself. So I had to say to the younger daughter, you know, “Whatever you do, don’t get no ideas. You know, your sister’s hurting. That’s why she’s doing what she’s doing and it’s her way of coping. It’s not the right thing to do but whatever you do, if you’re going through anything, make sure you talk to Mummy about it, don’t  hurt yourself.”

Sandra’s daughter was so angry that she wanted to attack her sister but Sandra encouraged her to release her anger in other ways.

What impact has it had on her younger sister?

[Sighs] I would say it’s impacted on my younger daughter adversely as well because my daughter went through a period where she became quite angry, sullen, you know, would just get into rages and fits of anger. She’d direct some of that anger at her older sister and she’d just attack her and hit her and say, “I hate you. I hate you.” So then I would say to her, “No, you don’t hate your sister. You’re angry. You’re angry because she’s, you’ve witnessed things that you shouldn’t have seen. She’s exposed you to things that you shouldn’t have been exposed to but by virtue of being a member of the family, you’ve seen them, you’ve witnessed them and you’ve been party to it but,” I said to her, “It’s all right to be angry.” 

So what I did, I bought my younger daughter a punching bag so if she’s angry I say, “You get that bag and just punch at it, you know, release some of that anger.” You know, so she said, “Well, thanks Mum.” And I got her gloves as well, you know, [laughs] so I said, “Rather than hurting your sister, punch at the punching bag but release the anger, release the aggression, don’t keep it inside. If you feel like you want to cry, cry.” So she’s if she’s having a temper tantrum, I just let her cry and I said, you know, “Just let it out, release it but don’t keep it inside because if you do it will make you ill.”

So, you know, I said to her, “But, at the same time, don’t cry for anything, you know. Cry because you’ve got a reason. Cry because you’re not, you’re not happy or you’re feeling sad about something or your sister has said something to you and she’s hurt you, you know, but don’t just cry for the sake of crying because.” I said, “After a while, you’ll become like the crying wolf. The boy who always cried and then, when he was seriously in trouble, no one paid no attention because they got used to him making those noises, you know.” So I think she got the message [laughs]. Yeah.

Sandra says it’s important to take one day at a time and let your children know you love them.

So she, it swings about, you know, she still has her good days and her off days but, you know, as parents you just have to take one day at a time. When it’s good, you enjoy the goodness. When it’s bad, you work through it as a family, you know, and you still reassure that child, even when they’ve been nasty and horrible to you, you still let them know you love them. You love them through the pain. You love them through the hurt. I never once said to my daughter I hate her, even when she tells me she hates me, even when she tells me, “I wish you were dead.” I know she doesn’t mean it. It’s because she’s hurting, you know. So I let her know she’s still my princess. I say to her, “You’re Mummy’s princess. You always will be. I love you.” 

You know and everything and so when she’s on a good, when she’s on a good day, you know what she’ll say to me? She’ll say to me, “Mummy, even though I don’t feel like a princess, I know that I’m your princess because you tell me all the time, you know, even when I’m being horrible.” So she knows that, you know, and children, they just need things reaffirming to them, you know. They just need that reassurance. They need stability. They need consistency and one thing I’ve learnt over the years and being a parent myself is being consistent because that has helped me through many difficult situations, yeah.

Sandra’s daughter didn’t want her system ‘to be a medicine trolley’. Now she only takes sleeping pills occasionally and is coping well.

And if anything, I would say she’s at her best and she’s at her most stable and she’s had to take some control in getting to that place because one time, when she was, a really bad day, the consultants put her on some medication, can’t remember what the name was, but anyway, she was on some medication to help her moods and that but then she said the medication wasn’t helping so she tried it for about nine months and then she felt that it was giving her more psychotic thoughts, you know, to self-harm and eventually, she weaned herself off it. 

And she literally said to her consultant that she’s not taking them because she doesn’t think its helping. She she’d rather help herself naturally, you know, and even if she’s having the thoughts she’s going to fight them and, you know, she’ll use her rubber band. So if she’s having a thought, she’ll just keep flicking it or she’ll try and think about something positive, you know, and that and that that’s what she’s been doing. So she’s been applying some of the principles that she’s been taught through therapy and that seems to be working for her. And so the only medication she’s on is the one that helps her to sleep, which is melatonin, and she’ll only have it when she’s really, really struggling. 

She said to me, “Mum, I don’t want my system to be a medicine trolley so I’m not going to take medicines, like a popping, like popping pills. I’ll only have them when I really need them.” And again for her, that’s self-discipline, you know, so she’ll only say to me, “Mum, can I have some sleeping pills just to help me through the night?” And other nights she’ll go for a whole week and she won’t have them so she’s really disciplined and she’s coping really well. 

Sandra and the school communicated very well. Sandra thinks it is important for all parties to be aware when children are vulnerable.

I mean the school, obviously, communicated well with me and I with them so there was a good communication line going and times when she was self-harming, in the early days, I didn’t know what to do. I was despairing putting my professional work aside and just being a mum, I had to obviously, consult with the school and let them know, obviously, she’s had a bad night or she self-harmed last night but, however, she’s coming to school off her own steam, not from any pressure from myself, just be alert, just observe, you know. And they would do that and they would report to me at the end of the day or the end of the week to let me know she’s had a good week. So at least there was some communication and some dialogue going, because I think in in cases where children are self-harming that has to happen so that all parties are aware and they are on full alert and because the young people are so vulnerable. 

Sandra helped her daughter by spending ‘quality time’ and ‘being there’ for her.

So there are times I have to say to my husband, “You know what, I’m going to have mother and daughter time so can you just make time for [name].” So I’ll do a plan. I’ll say to him, “This week, I’m going to have three days where I spend quality time with my older daughter and you spend time with the younger one so she also feels validated.” 

But because the older one is going through so much stuff, she needs that extra time so I might have to go to her room, read with her, you know, just lie by her, talk to her as opposed to her talking to herself because there are times she does talk to herself. And so by doing that, it’s helped because then my older daughter is thinking, “Oh, Mummy is spending time with me.” So what she’s started doing, when I’m spending that time with her, she’s started feeling more comfortable to share things with me and she’ll rest her head on me and she’ll cuddle me and she says, “Oh I love you, Mum you’re so cuddly.” You know and that’s been quite therapeutic for her as well and I think it’s also aided and assisted her in reducing, you know, the self-harming or even having thoughts and carrying them out because she knows I’m there for her. And I’ve supported her in most of her, I would say ninety five per cent of her attendance at her therapeutic sessions, yeah.

Supported her in the sense of…

Taking her and staying with her.

Staying with her?

It’s just since she’s turned sixteen and a half, seventeen, I’ve sort of let her go by herself. I said to her, “You need to go by yourself now and, you know, access the services because I want you to be independent. I want you to do it for you. You know that Mummy’s there but you need to go.” Yeah.

Sandra says God gives her inner strength and inspiration.

Yes, my faith means a lot to me. It’s something that I embrace wholeheartedly. I see God as being my everything. He’s my, he gives me inner strength. He gives me peace. He’s my reason for living. He’s my soul’s survival. So even when things are going wrong and even when I feel like my back is pressed against the wall and when things has been at its lowest, you know, he’s been my inspiration. He’ll give me an inspiration. He’ll say to me, “What, you know, have you thought of trying it, trying this or, you know, approaching it this way or talking to her that way.” You know, or just doing things with her, you know, to make her feel validated, you know.

Sandra’s daughter realised that people cared about her. Sandra reminded her of good times and tried to distract her.

She eventually stopped doing it anyway because then she realised that there were people who did genuinely care about her and there were two friends or peers from her school who started coming in the mornings, when it was proving difficult especially during the winter months. It was very difficult for her to get up and go to school, so there were two of her peers who’d come religiously every morning and call for her, you know. So for me, that was a great support and it was also a motivation for her to get up because there were people waiting for her and literally willing her on to come to school. 

Yeah, and eventually the self-harming just phased out, you know, because she realised that, you know, she couldn’t keep doing it. She couldn’t keep hurting herself. She was, obviously, leaving scars on her skin. She’s got beautiful skin and I would say to her, you know, “You you’re beautiful. You know, you’re my princess. You don’t need to keep hurting yourself. You don’t need to keep, you know, inflicting all that wound on yourself. I know that you’re hurting. You know, Mummy, she doesn’t have the capacity to take the pain away.” Because a lot of it is internal and that. 

“But.” I said, you know, “Just try and take one day at a time, you know, just think about the things that you want to achieve in life.” And then I’d sometimes take her down memory lane and, you know, because, as a family, we’ve always taken her on holidays and we’d take her to exotic places and stuff so she was well travelled as a child. And so I said to her, “Try and remember the last holiday you’ve been on and things you did and, you know, the times when you were at your happiest playing in the pool, you know, or in the children’s club or.” You know, and things like that so I sort of try and do things to distract her and that seems to have helped as well. Yeah.

Sandra tries to be positive and tells her daughter to take one day at a time.

I do see her future as being one that is bright but then there’s still some elements of doubt, you know, in terms of the self-harming aspect because, you know, because of how things sort of evolve, you know, and how her journey has been, there’s still that doubt at the back of my head that, you know, one day will she really do it, you know. But, at the same time, I push it aside and I try and be positive and think of all the positive things, you know, that she can be and the things that she wants to aspire to and her goals and the things that she wants to achieve. So that’s why I say, you know, we just take one day at a time, so every day she gets up and she’s happy, I’m happy. If she’s sad, obviously, I try and, you know, jolly her along and help her to get through the day and so that’s why I always use that phrase, you know, just take one day at a time. I try not to plan too far into the future and that but, at the same time, we still make plans. We still plan holidays and we still do family things together and that so that’s how I manage my life, yeah.

Professionals should be sensitive in treating people who self-harm, recognise that they are needy and reassure them, says Sandra.

Just staying with the idea of messages, is there any message or advice that you could give to providers of health and social services or educational services about the ways they respond to young people who self-harm?

I think, from observations and from my experience of how some professional providers deal with people who self-harm, I think sometimes it can be a bit flippant in their approach or, you know, probably insensitive sometimes, the way they say things because what they need to recognise is that people who self-harm, they’re needy, they need a lot of reassurances and they’re also very sensitive. So it’s about being sensitive in terms of how you say things. Not making them out to be victims, but treat them like a human being, that they’re, you know, they’re valid, they’re important and that they’re unique. And you know, just tapping in, tapping into their unique qualities and that.

Sandra did not look for information and support as she used her own intuition and professional experience to cope with her daughter’s self-harm.

Yeah, that’s right and I wouldn’t say it’s anything that I’ve read from any manual or any book or leaflet. It just intuition, common sense approach, you know, combined with professionalism, you know, all rolled into one has enabled me and empowered me as a parent, as a mother, you know, to cope with all the stress and dilemmas and impulsiveness of my daughter and her self-harming behaviour over the years. And had it not been for that, I think I would have been on tranquilisers by now or needing therapy myself, you know, but I’m a very hands on person. I’m very dogmatic, very practical and I just do whatever it takes to get her through the day. If it means transporting her to college, you know, driving her like a taxi service, you know, if it makes her happy, I’m happy. It’s less stress for me, you know. If she’s happy, if she’s getting through the day and that and she’s not getting any absenteeism, at least something is working.