How to help somebody who self harms

This is part 2 of a 4 part blog series for Swindon Mental Health Festival 2019 forming part of a pamphlet to hand out at the event.

It must be a terrible shock to find out somebody you care about self injures. As somebody who does I can only imagine since I’m on the other side of the fence. If one of my children came to tell me they were self injuring it would probably be devastating to imagine them hurting themself. To be honest the hardest part for me would be to know how much they must be hurting or struggling to be desperate enough to inflict that physical pain upon themselves. However logically I would know this though, the immediate feelings I would have would be visceral and emotional.

This blog will attempt to cover how to help that person but does come from the point of view of somebody who does self injure rather than a family member so there may be more things that can be covered and it is always worth looking at online peer support. So how is the best way to deal with it?
Honestly I don’t have a single answer for you as every situation and individual are different. However, the main thing to do is avoid the huge emotional response. Self injury is often kept secret because it is considered socially unacceptable and people can be scared of being judged. It can also be hard to see the hurt and confusion of the face of a loved one and the thought of harsh words of disappointment or anger can drive people to secrecy. If you have had an emotional response initially it does not mean the situation is lost. Once things have calmed, or the next time it happens there are some things that can be done that can help facilitate a conversation

Ask if they are ok

Self injury can cause a lot of physical health problems. Nerve damage can occur as can skin damage, pain and wound infection. A lot of people will avoid seeking help because of the judgement of others. The main thing to do first is to check the person is ok, and consider if they are in immediate need of urgent medical or psychiatric help. If they come to you and talk about it this is easier than if you happen to see the injuries as it means that person is ready to talk. However, if you do see signs of self injury and are concerned you can broach the subject. You just don’t have to make accusations of self injury. Simply point out you have noticed they have an injury or a wound and ask if they are ok or whether they need some help or treatment for it. Please don’t be surprised however, if they do not wish to discuss it. This is something that will take time. Simply knowing you care can be enough at first and the foundation for a conversation.

Keep in mind the reasons people self injure

As pointed out previously, your immediate response will probably be emotional. It’s worth taking a deep breath and reminding yourself of the possible reasons this could have happened. If need be remove yourself from the situation while you are processing this assuming there is no imminent need for intervention
Nobody will find this easy to manage initially, if you care it’s natural and human to feel emotional, but a logic check can help in moving a conversation forward. There will be a blog later on the causes of self injury.

Validate their feelings

Whilst I personally think it is ok for you to voice that the person you care about self harming can make you feel sad, it’s still very important to avoid anger, emotional blackmail or making the person feel they have let you down. There will be enough guilt and shame in this person’s head already for both of you and more believe me. Acknowledgement that you understand that they have self injured because they are struggling, can not only be reassuring and make it easier to open up next time, but it can also open the conversation about what situation triggered the harming in the first place. Don’t make them feel bad for doing it unless you want them to clam up next time.
No it isn’t easy. Anyone who self injures will be acutely aware how hard this is for you as well, and be all the more thankful for your support.

Reassure them

If someone self injures there is always a fear that the person they love will leave them for continuing to relapse. Letting them know that you still love and care for them is reassuring. Try not to make them feel you love them ‘in spite’ of their self injury. It might seem well intentioned but can make them feel they don’t deserve that love if you clearly feel they are a failure or a screw up when it does occur. Simply express your feelings without caveats.

Don’t ask them not to do it again

This is a hard one. I discuss reasons behind self injury in another blog, but the long and short of it is that it’s a coping mechanism for a variety of reasons. Its maladjusted and inexplicable if you have never had an inclination to do it, but for some people it’s the only way they can manage difficult emotion. If you ask them to stop it will only add to the stress of them trying hard not to hurt themself anyway, creating more pressure; it will also add to the guilt and shame afterwards and potentially cause them to cease to open up in case they fail to fulfil your request. In some cases it can also cause more difficulty if they don’t have another coping mechanism to fall back on and are ‘white knuckling’ their way through trying to not harm themselves which often leads to relapsing more acutely.

Educate yourself

If you are reading this blog then thank-you from me, not only for taking the time to read my words, but for trying to learn about self injury. Whilst the best way to learn is to ask someone who self injures and is willing to talk about it to talk to you about it, it never hurts to read around.
There are plenty of good resources out there like LifeSigns or The Mighty. A simple Google search can usually find you sites specific to the person you want to help if they are of a specific demographic – young, older, male, female or different ethnic origins. Every bit of education will help and there are often online support groups that can be found for peer to peer questions.

Don’t body shame

People who self injure can be sensitive about their scars. Some might have no problem if people see them but some people make concerted efforts to hide them. Don’t force them to show you their injuries or scars if they are not comfortable to do so, and don’t react negatively or force them to cover up if you do see them.

Lastly and MOST importantly:

Make sure YOU have support too

This last is so important, maybe the most important point in this entire blog. You cannot pour from an empty glass, and you cannot support someone else without your own support network. It’s great if you have somebody else you can download to on a personal level, but even better if you have some professional help. A GP can put you in touch with a counsellor, there are forums and groups on Facebook for relatives, friends or carers, and plenty of information on some of the websites I’ve mentioned (or that you locate on your search) for places you can contact for support and advice, either by phone or in person. Your feelings are important and it’s important to express to somebody the anger or sadness you might be feeling before you unleash it on the person who is already vulnerable through the act of self injury.

I sincerely hope this information is of some help to somebody who reads it


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