By focusing on nonjudgmental support and alternative coping strategies, you can learn how to help someone who’s self-harming.
You may not always know when someone you love is engaging in self-harm. It’s often a secretive behavior, hidden by clothing or under the guise of injuries from sports and other activities.
When self-harming behaviors become known, it’s natural to want to stop your loved one from hurting themselves. Punishment isn’t the answer, however. One cannot discipline someone out of self-harm. Instead, it requires a nonjudgmental, supportive approach from those who want to help.
Self-harm, known clinically as nonsuicidal self-injury, is not a mental health disorder.
Hitting, biting, burning, and cutting are common examples of self-harm. These behaviors can range from mild to severe and can be repetitive or episodic. While anyone can engage in self-harm, it’s most commonly seen among adolescents and young adults, affecting as many as 22% globally.
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Why do people self-harm?
Causing deliberate harm to yourself becomes a way of neutralizing negative thoughts and emotions.
“Think of it as a pressure release valve for intense emotional pain,” explains Amanda Turecek, a licensed marriage and family therapist from Parker, Colorado. “When someone self-harms, it’s often an attempt to regain a sense of control or to numb the emotional turmoil they’re experiencing.”
She adds that the physical pain can provide a momentary distraction from emotional anguish. In this way, self-harm becomes someone’s method of self-soothing and regulating emotions.
Why some people self-harm to cope and others do not isn’t clear. Self-harm is a maladaptive coping mechanism, which means it’s there instead of beneficial strategies like engaging in creative outlets or relaxation techniques.
There are many different reasons you might develop a maladaptive coping method. Self-harm, specifically, is linked to higher rates of:
The physical signs of self-harm aren’t always obvious to others. Many people who self-harm are skilled at hiding marks or injuries or only self-harm areas of the body that are rarely exposed.
Signs of self-harm can include:
- wearing clothing inappropriate for the temperature, like long sleeves on a summer day
- always carrying sharp objects or having them readily accessible
- high rate of accidental injuries
- going through significant amounts of bandages or first aid products
- negative self-talk
Self-harm can be alarming, but remaining calm and supportive is important. Your loved one’s actions come from a place of emotional distress — self-harm is just the visible outcome.
“It’s important to remember that when talking to someone about self-harming behaviors that this is a strategy they’ve been using for some time to deal with strong emotions, and the idea of someone judging them for it, or pushing them to stop doing it, can feel very threatening,” says Dr. Aaron Weiner, a board certified counseling psychologist from Lake Forest, Illinois.
Weiner indicates the most important thing you can do is help your loved one connect with professional resources, like a therapist, who can help them develop more effective ways to manage their negative emotions.
In addition to seeking professional guidance, Turecek recommends:
- focusing on being empathetic
- encouraging open communication
- educating yourself about self-harm
- ensuring to check in with your loved one regularly
- respecting your loved one’s boundaries
- offering to help with alternative coping strategies, like mindfulness or grounding
Lastly, you can help someone who is self-harming by focusing on their safety. Ensuring safety means providing plenty of first aid materials or transport to medical care for more serious injuries.
You’re not going to stop self-harm by hiding sharp objects. You can, however, encourage trust and support by making sure medical needs are met.
How to approach the first conversation
Nonjudgmental support is the focus of the initial self-harm conversation. Weiner suggests approaching from a compassionate standpoint, finding common ground by seeing how someone is doing overall.
“For example, you can start by asking them about how they’re doing from just an emotional standpoint: are they struggling with stress, anxiety, and so on,” Weiner suggests.
“After you show them that you care about them and their feelings, then you can mention that you’ve noticed the self-harm marks and can ask them to share about what’s driving that behavior and how they feel about potentially changing it.”
How to support someone long term
Turecek says that when it comes to providing long-term support for a loved one who self-harms, there are three areas to focus on:
- safety planning
- praise and acknowledgment
- ongoing encouragement
Your safety plan is the steps you and your loved one should take in a crisis situation. It includes emergency contacts, alternative coping strategies, and how to seek professional help. It provides the ways to best support your loved one during their most challenging times.
In addition to knowing how to help, praising progress and providing encouragement are also key factors in long-term support.
“Celebrate even the smallest achievements, as they signify steps in the right direction,” says Turecek. “Remind them that you believe in their ability to overcome challenges and reassure them that you’re there to support them through ups and downs.”
Someone you know or your loved one can overcome self-harm behaviors. Several types of psychotherapy are useful in treating self-harm, depending on the factors underlying these behaviors.
Common approaches include:
These therapy frameworks can help identify the root cause of self-harm and can help create new, beneficial thought patterns and coping mechanisms.
You may also benefit from the use of medications, like antidepressants, to help relieve distressing emotional symptoms during treatment.
Knowing how to help someone who is self-harming isn’t always easy, but approaching them from a place of compassion, without judgment, is essential.
Open communication and support can help your loved one talk about their experiences and be more willing to seek professional services or ask for help.
You can stop a loved one from self-harming. Psychotherapy can explore the underlying causes of emotional distress while also teaching new, helpful ways to cope with negative thoughts and feelings.