Someone I care about is harming themselves

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It can be very difficult to support a friend or family member who is self-harming. You might feel uneasy and worried about how to best help them. Being supportive of your loved one and knowing what types of resources are available can help go a long way in helping them get assistance for some of their emotional distress.

Learn about self-harm and how it differs from suicide.

When you find out that one of your loved ones is self-harming, you may feel shocked, saddened, and concerned that they want to take their life. Self-harm is actually a coping mechanism used for a variety of reasons to alleviate emotional pain and does not always signal suicidal ideation.[1]

  • A significant difference between suicide and self-harm involves intent. An individual who possesses active suicidal thoughts is seriously considering taking their own life because they see no other escape from their current distress.
  • An individual who is self-harming is likely using this technique as a coping mechanism to alleviate psychological or emotional distress, to affirm they are alive, or to experience a mental rush.[1]

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Be present and listen.

Someone who is engaging in self-harm is in a significant amount of distress. It is important that they have individuals who they can count on and who will be open to listening to their experience. Tell the person who is self-harming that you are here to listen to them whenever they would like to talk.[2]

If you have a friend who's engaging in self-harm, try talking to them about it in a kind, caring way. It's normal to worry about seeming intrusive or judgmental, but it's important to let your friend know that you're there for them and you're worried about them. You can offer to help them find resources or mental health assistance, but keep in mind that self-harm is a sign of deep psychological pain, so the person may not be able to stop just because you ask them to.
Liana Georgoulis, Psy.D.

Show empathy for their current emotional distress and the self-harming behavior, while also relating to them as a whole person. You may say something like: “I know you’re in a lot of pain right now, and I just want you to know I’m here for you in whatever way you need. We can talk if you are ready, or we can do something else you enjoy right now.”[3]

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Ask them how they are feeling.

It can mean a lot to a person who is in distress to be able to open up to someone about how they are feeling. Initiating this conversation can also help your loved one feel less guilt if they are feeling like they are burdening you for seeking your help.

  • You can say: “I just wanted to check in and see how you’re feeling today. I’m here if you need to talk about something.”

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Avoid judgment.

The way you react to self-harm is important because it sends a message to the individual about how others perceive them and their current struggles. If you respond in a way that signals judgment, they may be hesitant to reach out to others for help in the future.[2].

  • Your immediate reaction might be to tell your loved one that how they are reacting is dangerous or harmful, but instead say something like: “I don’t know exactly why you’re self-harming, but I can understand that you’re in a lot of pain. I want to better understand what you’re going through.”

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Respect your loved one's autonomy.

Self-harming may be the only coping mechanism the individual can use currently to alleviate emotional distress. Overcoming self-injury is likely going to be a long and difficult journey. Only the individual can decide when they are ready to stop self-harming.[4]

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Do not gossip.

It can be overwhelming to find out a loved one is self-harming, and you might be tempted to tell other people. However, self-harming is often a private matter and it is important that your loved one has your trust. It should be noted that you should gain additional help if you are worried they may be suicidal.[5]

  • If others express their concern or ask you what is going on with your loved one, you can say: “I know you want to help and you’re concerned, but it’s probably better if you talk to them yourself. I don’t want to betray their trust.”

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Do not set ultimatums.

Telling your loved one they have to stop or you will tell someone, or you will stop talking to them, will only push them away and make them feel more isolated.[4]

  • Rather than setting an ultimatum, tell them: “I know you’re in a lot of pain right now, and I would like to see you stop doing this one day. But I know only you can decide when to stop, and I’m not going to force you to do anything.”

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Share resources with your loved one.

There are many free and valuable resources that can help your loved one learn more about self-harm as a coping mechanism and also how to learn to cope in different ways.

  • Visit http://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm to debunk myths about self-harm, learn about the dangers of self-harm, and how to cope with emotional stress in different ways.
  • The S.A.F.E. Alternatives Information line available in the U.S. at 1-800-366-8288 is a resource that your loved one can call to get support with self-harming behavior and referrals for mental health professionals.[6]
  • You can tell your loved one: “I’ve been looking around for different resources to help you. I just wanted to share a couple with you to see if you might want to use them. There is no pressure at all if you don’t find them helpful though.”

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Seek additional help when you can’t do it by yourself.

While you want to respect your loved one's privacy, there may come a point where you feel like there is nothing more you can do, and you might be worried for their safety.

  • Encourage them to seek professional help, such as a counselor or psychologist, in order to get extra support and to get to the underlying causes of their self-harming behavior. You can even offer to go with them to the counselor’s office to show that you care about their well-being. Say something such as: “I know you’re scared right now, but I think getting some extra help might be really good in helping you heal right now. I can even go with you to see the counselor.”[5]
  • If you are both under 18, it will be especially important to tell an adult that can monitor the situation and get extra help as needed. Talk with your loved one and see if they can choose an adult who they trust with this information.
  • Call 911 in the United States, or the emergency line in your country, if your friend’s self-injury appears to be medically concerning or life-threatening.

References

  1. https://www.psychologytoday.com/blog/teen-angst/201210/understanding-suicide-and-self-harm
  2. http://www.lifesigns.org.uk/guidance-for-others/
  3. http://mind.org.uk/information-support/types-of-mental-health-problems/self-harm/for-friends-and-family/
  4. http://www.befrienders.org/how-to-support-someone-who-self-harms
  5. http://www.lifesigns.org.uk/fact-sheets//
  6. http://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm

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