How to help someone who self-injures
If you have been feeling helpless, frightened or despairing about someone’s self-injury, it may be difficult to imagine that anything you do will make any worthwhile difference to them. It may seem like a problem that only “experts” can cope with but you can make a difference.
Many people who self-injure feel terribly alone with their distress and their shame about what they do. Your support, caring and friendship can make a real difference to someone’s life right now and perhaps longer-term to their ability to live without needing to harm themselves.
Acceptance doesn’t mean that you have to like what a person does, or that you do not see it as a problem. You can acknowledge that it is his/her right to hurt themselves if they need to and that they have valid reasons for coping in this way. Sometimes people try various means to prevent someone from hurting themselves, they might ask them to promise not to do it, and they may hide anything that might be used to harm or, threaten to withdraw their support. Although this is all well meant, it is not helpful. If someone could stop injuring him or herself that easily, they would have done so already. Instead, this approach might make them feel more isolated, guilty and self-hating forcing them to become more secretive about their self-injury
He or she are probably used to people telling them that they are “just doing it for attention”, or that they are sick, manipulative and a nuisance. You will be giving them a precious gift if, with you at least, s/he doesn’t have to hide or feel guilty or ashamed about what they are doing.
Many people who self-injure have seldom been listened to in their lives. Their feelings and views have not been sought or taken seriously. In particular, it is likely that people will have made false assumptions about why they self-injure and told them why they are wrong to do so.
Simple though it seems, it is rare and special to be really heard by someone. You will be doing something very valuable if you just listen, respect and try to understand what s/he is saying about themselves, their feelings and their needs especially in relation to their self-injury.
Although it is less visible, the emotional pain behind the physical injuries is probably much more distressing for this person. If you are able, perhaps you could encourage them to talk about the feelings that lead them to self-injure, the way it works for them and so on.
Over time, this might help them to recognise when and why they are likely to self-injure and to develop alternative ways of communicating and coping with their distress.
Remember to respect your own needs and limitations, only offer what you are able to cope with, and remember that you aren’t responsible for stopping him/her from injuring themselves.
If he/she shows you a recent wound, try not to panic – it will probably look worse that is really is. Show your concern for the injury, and help them look after it if you feel able and they want you to.
If the injury is severe, you might go with them to hospital or the doctor. It is not uncommon for people who self-injure to be treated unkindly or with condemnation by medical staff. Attempts may also be made to have them admitted to a psychiatric hospital against their will.
The basis of good communication is listening. People are most able to talk when they know that there is plenty of time and that you will listen and accept what they say. That you won’t immediately try to find solutions or give advice, but will just hear them out and try to understand.
It is also very helpful for someone to know that what they say doesn’t have to make perfect sense straight away. They can explore things in a roundabout or confused way until they become clearer.
It may help to talk about what he/she finds difficult about talking honestly and directly to people. Communication is also helped a lot if you know that you can trust each other – be honest about your limitations and the limitations of confidentiality in your role.
For more information about self injury, text or email support, or details of a free telephone helpline, please contact the specialist organisation Self Harm UK by clicking here.