I was eight years old when I first self-harmed-- very shy, internal. I didn't really know how to interact with other children. I felt so isolated and confused about why I couldn't seem to do what other kids could seem to do. [MUSIC PLAYING] I was upset and angry, and I just picked up a centimetres ruler and scratched my arm in frustration. And then I realised that calmed me down. That's how it started. [MUSIC PLAYING] One of the earliest signs of a young person who is at risk of self-harm would be the child who seems to experience very big emotions, so the amplitude of the emotions would be huge-- the pain, anger, sadness, anxiety. And then, very often, these emotions would be triggered by very small things and would take a very long time to return to baseline. Self-harm, in the majority of young people, is really designed to control emotions. The reason why self-harm is because I feel terrible, and then I have to do something. It's painful. It's almost physically painful, and then self-harm is something that actually makes that person feel better. [MUSIC PLAYING] I put a huge amount of pressure on myself. Straight-A student never got a detention. Head girl of my school couldn't do less than 100%. I just had to push myself so hard. Internally, I was having this awful experience. I felt I had no right to feel this sad in this state of pressure. [MUSIC PLAYING] Sometimes I'd be there, awake till 300 in the morning, just with these thoughts in my head. I can't stand this horrible physical feeling anymore in my chest. I need something to release it. It was the guilt for feeling that way, which then drove me to self-harm. The child would not be self-harming if they had a way to regulate their emotions in other ways. That's really quite a central thing to understand here. Self-harm is a complex, quite often painful and difficult behaviour, which the child is often ashamed of. And if they could find a way to regulate their emotions in other ways, of course, they would. No person would do something as dramatic, as damaging and self-harm if there was an alternative. It did gradually increase and increase until the point that I was doing it every day. I used to reach for every time I got emotionally overwhelmed, I'd just be like, I'll just do it again. The cycle of self-harm is such that it would very often start with some sort of interpersonal conflict, which then gives rise to a very complex and often negative thoughts and feelings in the young person's mind. We call that core pain, which then the young person has to do something with it. And they will do one of two things. They will either try to bottle things in for a long time, and then they move into self-harm. Or sometimes they act impulsively, and they would just move into self-harm without bottling things in. It can often become a vicious cycle. You keep going further and further and further to try and find that resolve. It did escalate because it wasn't giving me the release. So I moved to a different part of my body and did it much more significantly. If they are met in a warm, understanding and accepting environment in their family, but also with their friends and teachers, then that child is much more likely to develop ways of managing these emotions. There must be an open atmosphere in the family where the young person would feel able to come to you and speak to you about this. [MUSIC PLAYING] I remember having a big argument with my dad, and he was like, what are you doing to yourself? You're making yourself really ugly. I felt like it was all quite destructive the way that everyone was handling it. And he was like, you must stop doing this. Look at all this pain you're causing all these people. What I really needed was somebody to be compassionate and understand why I was doing it and understand that it was almost like an addiction in the sense that I couldn't stop. [MUSIC PLAYING] Important for parents to understand is that they really need to think about self-harm as something that the child should not be ashamed by. What often the young person would tell you is that what they are scared of is the reaction of the parent that will devastate them. I really worked hard to hide it from everyone, and it was partly the shame-- what would people think if they saw it. But probably more so was the guilt and the fact that if I was feeling this way, I would never want anyone to feel like that. Could see that I was causing them loads of distress. I felt like, at the time, that they were angry with me for creating the situation. And then I thought, oh, my parents don't love me. Now, once the child has told you about this, it's really very important not to ignore this, not to punish the child for this, to make sure that the child understands how much you appreciate their honesty. There's nothing to be ashamed about or feel guilty about. But once you've begun to understand self-harm and really validate the child's state of distress and difficult feelings, that's an important first step towards then seeking appropriate help. Our services tend to help the vast majority of these young people, and that's something that really is important to understand-- that self-harm is not some kind of a strange, weird behaviour that we have no idea about, and that it should be a taboo. And it's something that we have developed quite a lot of expertise in how to assess and build it. Having someone external help you process things that, until then, you have been the only one living with them and the only one hearing them-- helped almost defuse their power. [MUSIC PLAYING] Being diagnosed as autistic really helped me make sense of who I was. I went from feeling like a mental illness to realising my brain was just different. Get lost. Emotionally just started to really make sense. And it turns out there are lots of people just like me. As I've got older, I've just learned to rationalise my thoughts. The thought pops up. I just say to myself like it's just a thought. You don't need to give it power. The vast majority of people will recover. And we can speed it up perhaps a little bit. But it's something that needs to be recognised, discussed openly, properly assessed, and then treated. And the majority of young people will do well. [MUSIC PLAYING]