Sara Garvie works for LCET in Luton where she has been involved in therapeutic work with young people, and where she is now setting up a charity called selfharm.co.uk. Interview by Jenny Baker, co-founder of The Sophia Network.
What was your route into youth work?
As I was growing up, I went to a church that had very few young people, and the response to me being there as a young person was to ask me to lead one of the Sunday school classes. At fourteen I guess this was one of my first experiences of youth work.
As I got older I got involved in bigger churches with other young people and things that the local youth outreach charity Luton Churches Education Trust were doing. I'd always had a really strong sense that God was calling me to something around working in the Church, and felt a real spark in me when I was on summer camps and at events. Partly because as a teenager I looked up to those people and wanted to be a part of the community and creativity of how they explored Christianity, and that I was as most young people were at the time in awe of them as people, with them on a pedestal.
I pushed lots of doors around 17 or 18, thought about doing a year with LCET and did some short term mission. I realised that that I was very definitely called to the UK. Languages were not my strong point and there was something about responding to western culture that drew me. At the time I thought it was about comfort zones, but now realize it was something much more specific. I then toyed with Bible school and in the end went to university to study textile design.
I loved uni. I found the creativity of my course really suited me and I felt in many ways like I got to a degree in something that was a hobby, while I got involved in youth work around it - in my local church, and back in Luton over the summers, and in mentoring a number of girls. As my degree came to an end I knew that I wasn't meant to going into the textile industry, tempting as it was, but that I was called to go into working with young people, and young people in Luton. When I was very small my father had worked in a church on a very difficult estate in the town, and I felt a real passion for the area, for it to experience community and healing. So I came back to Luton to be a part of what was going on there and joined a year out program with LCET which gave me experiences in lots of different styles of working with young people. And I'm still at LCET seven years on, working with young people.
When and how did you first get involved in working with young people who self harm?
Although I personally have never been a self harmer, I really struggled growing up with very low self-worth and anxiety. When I started meeting young people who were cutting themselves, I found I was really able grasp the anguish they had at the things going on around them, and how they felt about themselves.
While at University I'd been mentoring a few young people, who unbeknown to me when I took them on were self harming fairly prolifically. I had no idea where to start in supporting them, and at that time there was almost nothing available for them that was easily accessible. So I did my best and made lots of mistakes, but stuck with those girls through the ups and downs and hospital visits.
Then when I joined LCET a number of the workers said they too were coming across a lot of self harm, and didn't know what to do with it or where to go. I was asked as part of my remit to research into self harm, and look at what could be done and how it could be done. Very quickly I found I was having young people referred to me, and it grew from there. LCET started offering groups in school for those who self harmed, giving them space to learn about the issues, therapeutically reflect, and to develop their coping skills. Incredibly for most of the young people they had never had the chance to talk about it before, let alone with other young people experiencing similar things. The groups saw incredible results, with nearly 90% significantly reducing harming.
Since then the self harm work at LCET has really grown to include art projects, prevention work, lessons in schools and delivering training to professionals. And I've been lucky enough to be in the middle of that.
You're setting up a charity to continue that work - selfharm.co.uk. Tell us some more about that.
As the work in Luton grew we became more aware of how little there was elsewhere in the country, even though increased press coverage and research showed it to be a national issue that was affecting 10% of young people. And we felt it was time to look at ways of taking the heart of what we were dong locally and roll it out on a national scale. selfharm.co.uk is the outworking of that.
Selfharm.co.uk is about supporting young people who self harm, giving them a place where they can get information, advice and support. It's both directly for them but also by providing materials and information for parents, friends and professionals working with young people.
In the short term this will be through the website which we hope to launch later this year. This is really exciting for us as for the first time there will be one place that people can go to were they can find information that is relevant. It will have areas on first aid and when to get hospital treatment, dealing with difficult emotions, right through to information sheets on how a parent can explain what self harm is to young siblings.
Another area we are really excited about is developing a self harm first aid kit, that contains all the basics for administering first aid to common self inflicted wounds, as well as containing information on the emotional aspects of self harm and how to get help.
Also this year we have been able to increase the areas we can offer out our training seminars and workshops in. Longer term we are looking at ways to offer online therapeutic group work.
I work full-time on the project and am massively excited about seeing a difference in the lives of young people that self harm.
Is self harm more common among girls? Are there differences in the way that girls and boys self harm?
A recent survey LCET did with 600 year nines across Luton found that 25% of girls and 12% of boys had self harmed. About half of those will go on to harm in the future (Samaritans 2002), which means that at any one time 10% of young people are self harming (MHF 2006).
It's thought that boys self harm in ways like punching walls which aren't picked up in research on self harm in the same way. Talking to lads over the years I'm sure that what goes on when they punch a wall is very similar to what goes on when someone cuts themselves.
What's your advice to a youth worker about what to do when a young person discloses they are self harming?
Listen, and listen some more, it is likely that this is one of the first times a young person has spoken about the subject. Be really aware of how you are responding; those who self harm will have a heightened awareness to the reactions of others, so will be very aware of your reaction to them. Be sure to affirm them and express your acceptance of them as a person.
As time goes on don't keep going back to practical questions of how much and how often, but focus on things that will increase their understanding and progress them forward, like when they have been feeling low and what have they done that has helped in those times. The key to supporting them is to enable them to think about their coping mechanisms. Any on going conversation should have a focus on this and not the harming itself.
If they don't tell you, but you have your suspicions, make sure you they have opportunities where they could tell you if they wanted. If this doesn't work and evidence of harming is obvious, it may be that the young person wants to talk about it but doesn't know how to start the conversation; in which case at a discreet moment comment that you've noticed some things, opening up the conversation for them to start.
Can youth workers and parents make things worse if they don't know how to handle it properly?
I did my Masters dissertation on this and it was fascinating to find they can't make it worse, only become more secretive and shut down the relationship with that person. So if a parent hits the roof when their child tells them they are self harming, what is more likely to happen is that the child will not go back to the parent for help on the subject. The actually pattern of harming is unlikely to change.
The only exception to this is when people take from a harmer their usual means of harming - for example clearing the house of sharp implements. If some one wants to self harm they will find a way to harm, and if their usual routine is interrupted they will be more panicked and may harm in ways that are more unsafe - for example cutting with a rusty nail instead of a clean razor blade. Trying to prevent a person from harming very rarely will stop the person from harming, unless the young person has initiated that type of support themselves.
What youth workers and parents can do however is make a huge difference, by not placing expectations on the young person, by seeing the self harm as just one aspect of what is going on for them, and by making them feel loved and accepted.
The key to overcoming self harm is to develop the coping skills a self harmer has for when they feel overwhelmed, by exploring what emotions they struggle with and looking at other ways of alleviating those feelings. This is enhanced by supporting the young person to reflect on their experiences and be able to think critically about the situations they face - all skills you'd be working with any young person to develop.
When should someone seek professional help?
As a general rule when they are presenting symptoms of other mental health issues. These could include obsessions, hearing voices, anxiety, poor relationship skills, or depression. Or if you are concerned that the level of the young persons harming could be putting their life at risk. As general rule if you feel out of your depth encourage them visiting the GP is a great place to start, as they will be able to make a mental health referral, and will know about any other services in the local area.
How have you personally developed as a youth worker?
My role at LCET quickly grew from intern, to therapeutic worker to therapeutic director at the same time as developing and overseeing the self harm work - in the space of just a few years. It was an incredibly steep learning curve, which has recently got steeper again now as I manage a national project. In the middle of that I completed a distance learning masters in Community Education, in which I focused on young people and self harm. I was also asked to write a book with Kate Middleton, director of ABC Anorexia Bulimia Care, on self harm.
Alongside studying, the experiences you gain along the way all add to the portfolio of skills and tools you have to draw on in the new things you meet. I've had some really good people around me at LCET as I've grown who have modelled good practice and thinking.
I think the most important thing I've learnt is to not take on the problems of each person I meet, but support them as I can do where I am. I can't be everyone's answer, but I can walk with them while they look for their own answers. Trying to do it any other way you can burn out really quickly.
When I started out in management I wanted a mentor who was ahead of me professionally and spiritually, understood some of the tensions of working in a Christian organisation, and of being a woman in my role and at the time being young, (I was just 23 when I became a senior manger at LCET). I didn't find anyone, and had to carve a different way for myself. I found a professional mentor who challenged me on my work practices, which benefited me hugely as time and again I was able to draw on her expertise and talk through issues to work out what really was the issue and if there were any solutions to that.
I also really intentionally developed a circle of close friends, who could and frequently do ask me anything. It's not always comfortable, but they keep me really accountable and are fantastically supportive in the ups and the downs. They have been incredibly important in keeping my mind on what God is doing and saying, both to me personally and in the projects I'm leading. They have been my wake up call many times, enabling me to find a rhythm in combining my spirituality and my role in selfharm.co.uk. This has given me the confidence to be myself in the work I do, and freed me from any sense of conforming to the models of leadership around me.
You're doing therapeutic work among young people. Are there more women than men in this area? If so, why do you think that is? Is there a need for more guys to be involved? What benefits would they bring?
There are more women that men working therapeutically with young people, it's not easy for a guy to work in the field. Some issues young people find easier to share with a woman, but there is definitely something that men can bring that women can't. Both have significant roles to play the development of young people, roles that can often overlap but not replace the other.
In my experience boys who self harm often say they find it easier to open up to female staff, because they generally feel such shame from the harming that they feel in someway more of a failure sharing this with a man. Because it is often seen as being a female issue they feel it inadequate as a man in that context. Much of this is about perception and their previous experiences with men, and not about the men that they may work with. But this is an indicator of how broken the young people we work with are.
I think it's easier for women to establish themselves in caring professions than for men. I know some incredibly skilled men who work therapeutically, who would say they love it and find it very rewarding, but also that it can feel very isolating being the only males in a female environment. One once said to me he had sympathy for women who worked as builders or plumbers, because he knew what it felt like not to be understood by those around them.
Personally I would like to see more men working in the field because they can powerfully respond to the negative experiences young people have had of men in their past in ways that women simply can't. There are aspects of the work at LCET that has been very difficult to run when there aren't any men on team, like residential work or drop in café sessions.
Sara Garvie is the director of selfharm.co.uk which launches later this year. Her book 'Self Harm, the path to recovery' was co-written with Kate Middleton and is published by Lion.
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