Self-harming sibling
Question
My sister has a learning disability, which means she has minimal communication. Do you have any suggestions on dealing with this? I use sign language and symbols, but I feel it's difficult for her to express her feelings.
She has also started to self-harm and I am finding it very hard to understand why she is doing this.
Answer
Having a learning disability can have many mental health implications on an individual. A person can become very frustrated and possibly develop emotional problems such as low self-esteem in the face of repeated failure. Additionally, those with learning disabilities often absorb what others thoughtlessly say about them and may define themselves in light of their disabilities, as "behind", "slow", or "different"; this can further affect how they feel about themselves.
Self-harm is often a way for people to cope with and get through difficult emotions or situations. Difficult feelings are quite often the reason why people self-harm, as a means of communicating what they cannot put into words or even into thoughts. It may also be a way of releasing painful emotions such as rage, sadness, emptiness, guilt or fear. Since it's generally a private coping mechanism rather than attention seeking, it's possible that some people may feel too ashamed and unable to admit to anyone what they are doing.
You do not say how old your sister is and how long she has been self-harming but you do mention she has minimal communication. This must make it very difficult for her to engage with other people and form relationships. Also, as some people with learning difficulties seem unable to interpret tone of voice or facial expressions, they can misunderstand situations and turn people away. This can lead to intense feelings of isolation and frustration, which can be vented out through self-harming behaviour, such as burning or cutting.
There are organisations that specialise in confidential support in this area. You, or your sister, might like to consider visiting the website of the National Self-Harm Network, an organisation providing support to people who self harm and anyone concerned about a self-harmer. Their website features a range of resources and also includes a message board. There is also The Bristol Crisis Centre for Women who have a national self harm helpline on 0117 925 1119 (open Friday and Saturday evenings from 9pm to 12.30am and 6pm-9pm Sundays).
It might also be worth encouraging your sister to make an appointment with her doctor (GP) too. There may be certain underlying issues surrounding her behaviour, such as anxiety or depression. There are a number of ways of treating depression and anxiety, both with and without medication. If you feel this is appropriate, her GP will be able to discuss the medical and talking treatment options available, such as antidepressants or cognitive behaviour therapy (CBT).
Her GP should also be able to refer her onto an appropriate counselling service or she could try contacting Youth Access if she is under the age of 25 years and wishes to seek this form of support independently.
Sometimes individual or family psychotherapy can help to highlight any underlying issues that could be triggering the need to self-harm. Psychotherapy may help to strengthen your sister's self-confidence, develop greater self-control and a more positive attitude toward her own abilities. Family therapy also helps family members develop a better understanding, and may enable you to support your sister more effectively.
Quite often, it is easy to feel helpless when someone you know is self-harming. If you would like to talk to someone about the situation, you could call SANELINE on 0845 767 8000 (12 noon to 11pm Monday-Friday and 12 noon to 6pm at weekends). It is available to anyone affected by a mental health issue.
For further information about learning disabilities and support that is available, it may be helpful to know Mencap run a Learning Disability Helpline on 0808 808 1111.
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Question answered by Youthnet in association with SANE
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