The main thing to remember when talking to someone who self-harms is that they will probably be scared and embarrassed, and find it a very difficult subject to talk about. Peppering them with lots of questions will probably make them feel very uncomfortable and misunderstood. At the same time, our caring for them means that we want to know as much as possible. We think that, if we understand, they will magically feel better and their self-harm will be a thing of the past.
As people who love self-harmers, the best we can do is to support them on their own journey. As much as we would love to sometimes, we cannot make the journey for them, nor can we just make it all better. There are times when we feel we are making progress, and times when we feel it will never end and there is nothing we can do. The one thing we can do is keep hope that, one day, it will be better. By keeping that hope, we can lend a little hope to those we love who are stuck in the cycle of self-harm and see no way out.
We need to remember is that self-harm is a problem that takes a long time to heal. It is a way of life, and something that is not easily surrendered. However, there are things we can do and things we can avoid doing which can make it easier for those who are self-harming to confide in us and let us help.
Helpful things to say or do…
One of the most helpful things you can do is to be as encouraging as possible. Because it is likely that the self-harmer will feel that they’ve failed people, you are in a unique position to increase their confidence. Encouraging someone might include recognising that there are positive outcomes of self-harm, and congratulating them on finding a mechanism of survival.
It is likely that they will find it hard to think of any option when the urge to self-harm comes. One way of helping might be by providing a list of alternatives to hurting themselves that they haven’t thought of before. By making suggestions you can build choices into their behaviour that they may not have realised they have. At the same time, it’s important to remember that these alternatives won’t immediately replace self-harm as a coping mechanism, and that recovering from self-harm is a slow process. If the person you care for tells you that they tried one of these things but still self-harmed, congratulate them on trying.
If you have to treat someone’s injuries, be as gentle as you can – treating them roughly will not encourage them to stop, it will just encourage them not to ask you for help anymore. They will normally be embarrassed and ashamed of their wounds – the best thing you can do to combat that is by making sure you concentrate on their emotional hurt as well as their physical pain. Ask how they are feeling and whether they can tell you what prompted them to hurt themselves, but don’t pretend that their wounds don’t exist. The best way to do this is just to say “tell me if I hurt you”.
The things we’ve looked at are all positive moves, but at the end of the day the best help you can give is letting someone know that they aren’t alone and that they are still a human being. Make sure that you include self-harming friends or relatives in activities, not making them an outcast because of their behaviour. Also keep them involved in your life by talking about the mundane, everyday things that you always used to share. By sticking by them, listening to what they say, and staying even when things get difficult, you are helping them understand the most important thing – that they are loved.
Unhelpful things to say or do…
The most natural response to self-harm, particularly if you are seeing someone’s injuries for the first time, is shock. It is also usually the least helpful. Unfortunately, this can be a very hard reaction to hide. The best thing to do is to be honest by saying “I’m sorry that I’m shocked. It’s just that it’s hard for me to think of you hurting yourself because I care for you.”
The biggest mistake is to assume that they were trying to commit suicide. Remember, however bad their injuries are, they are hurting themselves to survive what is happening in their life.
Often, one of the scariest things for someone who self harms is someone saying they need to get better. It is understandable that you want them to stop hurting themselves, but remember that this is a coping mechanism that they feel they can’t do without. Give the self-harmer the right to choose what to say and do, and don’t take their choices away.
Although we’ve already said that it can help to make sure that we don’t only talk about self-harm, it is also important not to make light of it. Comments like “You’ll grow out of it” or “Pull yourself together” are never helpful. Likewise, calling someone weird, psycho or crazy is not going to help, nor is accusing them of attention seeking.
We briefly mentioned not taking choices away. As long as the person is an adult, we need to leave all choices with them. As hard as this is to do, this includes not taking away the things that they use to self-harm. Confiscating razor blades is not helping them to give up, and will often make the problem worse because they will feel even more out of control. Self-harmers can be very resourceful and may end up using something that does more damage, or could cause infection. If the self-harmer is still a child, it’s important to get professional advice regarding how to support the whole family
The most important thing is not to make assumptions. You may think you know what someone is thinking, but it’s rare that you will get it exactly right. It is a good counselling technique to get someone to describe their own feelings rather than give them words to say. You may not be a counsellor, but you can still use this advice.
If you feel you have already acted wrongly…
Be honest with the person you care about. Tell them that you feel you responded in a way that you feel was inappropriate and say sorry. Explain that it shocked you because you care about them and were upset to hear how much they were hurting. Encourage them to talk to you by saying that you want to understand what they are going through and be as supportive as you can be.
Tell them that you have done some research to try and find out what they are going through, and encourage them to find some help by whatever means they feel comfortable with. Let them know that you understand that they can’t stop immediately, and that it will be a long journey, but that you want to stand by them and help in any way you can.
They are the ones who are self-harming, and the decision to stop is theirs to make – you cannot make someone stop self-harming. Don’t try to take the responsibility for stopping them hurting themselves, because you can’t. Only offer as much support as you can cope with, and try and find a network of friends who will support you and perhaps pray with you.