When someone you love is self-harming, it’s confusing, confronting, frightening and the feelings of helplessness can be breathtaking. You might not understand why this is happening, but you don’t have to. I wish we could give the people we love everything they need, but sometimes we can’t. Sometimes we, the world, it isn’t enough. This is scary for you and it’s scary for them.
Whatever their struggle, there are things you can do to help. You can’t stop their pain and you can’t change the feelings driving that pain, but you don’t have to. You don’t have to fix anything. You couldn’t anyway, however much you want to. The healing is theirs but your being there is so important. It’s enough – more than enough – that you are a loving, gentle support that holds things steady and makes the world a little less painful while they heal.
If someone you love is self-harming …
There is always a good reason.
There is always a good reason the person you love is doing this, and it’s not about attention. The reasons will be different for everyone, but it’s generally driven by emotional pain. Whether it’s a need to distract from the pain, soothe the pain, distract from the need that’s driving the pain, or cut through the endless and exhausting cycling of negative thoughts – self-harm will be an attempt to meet an important need. That doesn’t mean it’s an effective way to meet the need – it’s just a way to try. Emotional pain is a faceless, nameless beast that breathes fire and confusion and shame. It can drive the strongest of us to take extraordinary steps to make it stop.
Judging and criticising will always make it worse.
People who self-harm are strong and brave and they want to get better. The worst thing you can do is judge. Self-harm is driven by emotional pain. When you judge, or criticise it makes the emotional pain worse, which will intensify the need to self-harm.
They know it doesn’t make sense.
Self-harm doesn’t make sense to them either. Self-harm is inflicting physical pain to release emotional pain. It’s not about the logic, it’s about the feeling, or trying to get rid of the painful ones. Some of our most human experiences and feelings are completely devoid of rationality and logic. But they are honest and real all the same.
Be open to being educated.
Don’t ask why. Ask what. Asking why is confusing because generally, people who self-harm don’t know why they do it. Instead, ask what happens when they self-harm. What feelings or thoughts come? What feelings or thoughts go? Be patient if it doesn’t make sense. The experience of having the conversation is as important as anything either of you can take away from it.
But if they don’t want to talk about it …
Let them know they don’t need to explain. Silence, words, let them decide. Let them also know that when they reach out, they don’t need to know what to say. They don’t need to say anything at all. You can hold them, listen to them, watch a movie, go for a walk – no explanation needed. Finding the words can be so exhausting, especially when none of the words fit.
It’s often not about one feeling.
Pain is a shape-shifter and it often moves beyond words. There might not be one dominant feeling that drives the decision to self-harm. Fear, hopelessness, sadness, shame, anger – one of them, all of them, none of them. It can be driven by too many feelings pushing to come out. Or it can be nothing – a deadness, a numbness, hollow space and an emptiness that feels unbearable.
No. They can’t remember how it felt last time.
When feelings feel big, the ‘thinking, rational part of the brain is shut down. In that moment, logic and rationality won’t exist. The brain switches to survival mode and in that moment, self-harm feels like the only way to get through.
They don’t do it to hurt you. Even though it does.
Know that this isn’t about you. It’s about what’s happening for them. They don’t do it to punish you or to get your attention. The vast majority of people who self-harm keep it a secret. If they’ve told you, it’s because they trust you. They trust you to love them, fight for them and stick with them through it. Know how important you are.
It’s something they do, not who they are.
Don’t call them a ‘cutter’, or a ‘self-harmer’. It’s something they do, it’s not who they are. It’s a coping strategy. We all have them. None of us are defined by them.
They don’t want to die.
Self-harming behaviour rarely comes with thoughts of suicide. People who self-harm don’t want to die. They just want to stop the pain to stop.
Don’t try to change them. They wish they could change too.
They wish so much for things to be different, that the longing can feel unbearable. There is nothing you can say that will give them more of a need to change than what they are saying to themselves. Be the safe, secure person they can come to when it feels as though the rest of the world doesn’t understand. It’s paradoxical, but the more we fight who we are (or who somene else is), the more shame, hurt and anger is stirred. Let them invest their energy in healing, not in justifying, or having to be someone different front of you. Understand, accept and let them know that who they are is okay with you. Let them know that you love them because of who they are, not despite it.
Ask what they need.
Do they need you to stay? Go? Listen? Talk? Find a counsellor? They might not know what they need and that’s okay, but let them know you’re ready to hear it when they figure it out.
And finally …
The compulsion to inflict deliberate physical pain on the self is confusing for everyone – for the people who do it and for the people who love them. People who self-harm don’t want to be hurting themselves and they don’t want to be hurting you. They just want the pain to stop. We all have our ways of dealing with pain but sometimes, the pain can become too much to be put back to small enough. If someone you love is self-harming, know that you don’t have to fix anything. The healing is theirs and you can’t do it for them – as much as you would if you could. What you can do is be there. You might feel scared, frustrated and so confused at times and that’s okay. Self-harm is a frightening, frustrating, confusing thing. What’s important is that you’re there beside them as the gentle, loving, non-judgemental presence that we all need from time to time.
If you or someone you love is struggling with self-harm: For Extra Support – When Being Human Gets Tough.
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my boyfriend has always had depression, he was institutionalized for a brief period before w meet, he’s always has small depressive episodes but never anything physical against himself, but the other day he just relapsed. I’ve never dealt with this before, I don’t know who to talk to, he won’t really talk to me, I don’t want to force him to either. But the reasons stem from deep trauma that I don’t even know the half of, he says he’s okay and hasn’t mentioned it since he texted me. I’m worried.
the person i love and care about the most, is self harming and i’m very close with his parents, he doesn’t want too tell anyone which i understand and will respect, but what if it gets too much and something even worse happens and i could’ve helped but he doesn’t want too talk about it and leave it, i can’t just leave it because i don’t want him to hurt himself even worse. i’m struggling with what to do. but this article has helped me understand without speaking to him about. thankyou
Absolutely beautifully written. I have read so much on this concept as a middle school teacher and this is, by far, the most powerful and poetically worded way of sharing how to help. I know that sounds silly, but reading “advice” that sounds medical blends together and makes you feel like you’ve done everything, now what? THIS article felt like I am in the mind of my student and FEELING what they need from me. Some of the lines I am planning on modifying and speaking back to them as strength and empathy. Some of the lines spoke to my own raw soul, “They trust you to love them and fight for them”. Thank you from the bottom of my heart.
Thanks so much Brittany. Your students are very lucky to have you.
Excellent article. My oldest used to self harm. She has been clean for 3 years. It was a horrific period when she was cutting. At one point, she had over 200 cuts and had to be hospitalized. It was heartbreaking. Thank you for this article.
Why did she have to be hospitalised?
I disagree. I am a picker. I will pick at a scab or pimple knowing I will look worse, knowing it will bleed and scar. That this poor skin of mine is all I have got.
I know there is no control. Several times a day that same sore is going to hurt. I am not pretty never have been why do I make things worse ?
Hi someone I love very much is hurting themselves with drugs. Everyday and I’ve tried everything to understand why and maybe get him to stop. But he doesn’t want to. He believes they’re helping him. I want to believe that’s what he thinks anyways. But I know it’s not. He’s changed since he started taking them and it worries me. We are almost to the point of splitting over it because I have my own depression and anxiety to combat and my own issues with self harm and mutilation so I am worried my own predisposition could worsen his depression. I really need advice from someone about this. Thank you.
It’s okay to be concerned, the best thing you can do for them, is just remind them of the person they were before the substances. It’s okay to not be okay and it’s important to share the concerns in a way that makes all parties involved feel like the choice is theirs. Reminding them that they are not alone is one of the most important things you can do.
Is skin picking (cuticles) or hair pulling the same thing as self harm? Have a dear friend just starting these habits and would love to know how to help her.
Debbie this is a great question. No, skin picking (dermatillomania) and hair pulling (trichotillomania) are not the same as self-harm. Self-harm is generally driven by emotional pain. Skin picking and hair pulling are generally driven by anxiety. Here is some information about skin picking http://www.skinpick.com/dermatillomania.
Here is some information about hair pulling http://www.arcvic.org.au/anxiety-disorders/trichotillomania.
The symptoms of skin picking and hair pulling will often intensify with the anxiety, so managing anxiety is important. Here is a link to the anxiety articles with information on how to do that https://www.heysigmund.com/category/being-human/anxiety/. Exercise and meditation are the big ones that can make a difference. They can change the structure and function of the brain in ways that strengthen it against anxiety. There is so much research around this and it’s continuing to grow.
I hope this helps. Your friend is really lucky to have you in her corner.