How to Help Someone with Self-Harm

The common mental health problem of self-harm is often dramatized and sensationalized to the point where people aren’t sure what to even think about it. Therefore, many people deal with the self-harm of others in a way that’s not constructive for anyone involved.

If someone has come to you about their self-harm, the following is a guide on how to handle it as a friend or family member. You can do more than you may think!

First, some points:

  • If someone talks to you about their self-harm, or shows you the results, try not to express disgust. It may be a natural response, especially if you’re squeamish about gore, but many people who self-harm already feel awful about their bodies and/or their self-harm problem. Don’t give them another reason to feel ashamed. If you’re truly freaked out by what you’re seeing, excuse yourself, shake it off as best you can, and then come back and deal with the situation.
  • Related: don’t guilt trip. Making someone feel even worse about something they did is not a sure-fire way to prevent it in the future, especially when it comes to a distress-related behavior like self-harm.
  • Self-harm is actually not closely linked to suicide. This means that self-harm, no matter how severe, is usually distinct from a suicide attempt. Don’t panic, and don’t automatically assume that the other person is suicidal.
  • Self-harm is a sign of ineffective coping strategies, but it’s actually not really a problem in itself. It’s a self-regulatory symptom of a larger problem. To put it another way, no one self harms without a pressing reason. Most people react to self-harm by trying to police the behavior and/or telling someone why they shouldn’t self-harm. Instead, it’s more effective to deal with the reasons that someone self-harms. It will go away on its own with proper mental health treatment/recovery.

Here’s a concrete guide on how to deal with someone else’s self-harm: 

  1. Your first step should be assessing the need for medical attention. If they haven’t already shown you, ask to see what they did so you can try to tell what they need physically. You may need to take them to urgent care, or you may just need some Neosporin. 
  2. Then, try to deal with the reason(s) they self-harmed. People self-harm for many reasons, but it’s generally a way of calming down in the face of extreme stress. Maybe they do it to punish themselves or to feel less numb, but it has actual chemical benefits. Self-harm calms the nervous system by releasing feel-good endorphins. It’s not just senseless self-violence, as much as it may seem that way to someone who hasn’t personally experienced the problem. So see what you can do for them. Shift the attention from the self-harm behavior and discuss what made them do it in the first place. Maybe they got a bad grade on a test and need a tutor to get back on track. Maybe they need to express themselves about being sexually assaulted. If they’ve come to you with their self-harm, they trust you, so see what practical steps you can take to help them.
  3. If you feel it is necessary, see what you can do to help them with their self-harm problem in general. This is a good opportunity to see if they need any concrete help in their recovery. For example, they may need rides to therapy appointments or they may want you to take their self-harm tools away from them.
  4. If someone comes to you for help avoiding imminent self-harm, congratulate them (because it’s hard to reach out for help with a behavior that is often shamed!) and then provide some constructive distractions. Remember that everyone has a fundamental need for connection in the face of negative emotions, and do something WITH them. Go get ice cream, watch a movie together, or even just stay on the phone with them. (Distraction is a good fallback strategy, but don’t forget that if they would rather talk about what’s on their mind, you should let them. Engage with them about their feelings in an empowering way and you can do a lot of good!)

The above would be the ideal situation, in which everything went smoothly and in the best interests of the person who self-harmed. However, if you’re reading this, it’s very likely that you already had your initial reaction and something different happened. What do you do next?

If you handled someone’s admission of self-harm badly, go back to them and apologize. We can’t deal openly with mental health problems and their stigma by avoiding the topic.

Once you’ve apologized, then go back and use the guide above for taking next steps.

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