How can I help someone who self-harms?

What is self-harm? Why do some people engage in this behaviour? And if someone you know engages in self-harming behaviour, what can you do about it?

Self-harm behaviour is when someone intentionally inflicts injury, pain or damage to their body. When someone self-harms it’s usually neither a suicide attempt or an action that is intended to be fatal. However, self-harm can still result in a serious injury or even accidental death.

 

What is self-harm?

There are a number of ways people generally hurt themselves. Self-harming behaviour might include cutting, burning, taking small quantities of medications or illegal drugs, scratching, biting or pinching.

The reason for the self-harming behaviour is typically quite complicated. Often, it is used as a way of coping with, or feeling relief from strong and sustained negative emotions. These feelings may be based around guilt, depression, anxiety or self-hatred. Sometimes this is associated with experience of earlier trauma. People who self-harm often report that they experience some relief from these emotions when they harm themselves.

Self-harm can be a one-off incident (when someone is in acute distress) or it may be that the person regularly self-harms as a way of coping.

When someone regularly self-harms as a means of coping over a period of time, it can become difficult to change that behaviour. Self-harming behaviour is a complex combination of emotions, actions and reactions to the external world and requires expert assistance to manage and resolve.

 

Why do people self-harm?

People who use self-harm have often experienced difficult times in their lives. Some situations that have led people to hurt themselves might include:

  • Being persistently bullied or abused (e.g. emotional, physical, and/or sexual abuse)
  • Losing someone close, like a parent or sibling
  • Relationship break-ups and intense emotional pain or loss
  • Living with mental illness (e.g. anxiety and depression).

Self-harm is usually a response to the powerful distress associated with these situations.

These emotions can range from hopelessness, anxiety, rejection, anger, and despair through to guilt. People who self-harm may find it difficult to express strongly negative feelings or may feel helpless and powerless in the face of overwhelming difficulty. People self-harm as a means of relieving, controlling or expressing the distress and emotional pain of these intense emotions.

 

How can I help someone who self-harms?

Self-harm can be a highly confronting experience, particularly if you witness the event. It is important to take incidents of self-harm seriously and assist the person in getting professional help.

If you are with the person during an incident there are some things you can do to help them:

  • Try to control your emotional reaction and respond as calmly as possible.
  • Help the person to administer first-aid to their injuries. If the injuries are severe, call an ambulance or take the person to the hospital. If the person is ambivalent about seeking help it is still important to have them talk with a professional experienced in managing self-harming behaviour.
  • Ask the person if they are suicidal. It is important to either rule this out, or get the appropriate mental health support. For tips about how to start a conversation about suicide, see our suicide prevention pages for information and tips on how to talk to somebody about suicide.

 

Moving on from self-harming behaviour

It is helpful for the person to start to move through a process of exploring and understanding the reasons for their self-harm and at the same time learn other ways of coping with the thoughts and feelings that precipitate the self-harm.

Stopping self-harm is something a person needs to make a conscious decision to do, and this decision cannot be made for them. However, there are a number of ways you can help someone who self-harms.

How you can support someone who self-harms:

  • Encourage the person to seek professional help. It is essential that the person receives appropriate health care that is sensitive, skilful and non-judgmental. Ongoing support delivered in this manner could reduce the person’s self-harming behaviour and therefore reduce the likelihood of accidental death.
  • Assist the person to access professional support. Suggest options for support and offer to accompany the person to an appointment. Your local GP can advise about specialist mental health professionals who can help.
  • Remain calm and supportive. A person who self-harms needs the support of family, friends and professionals.
  • Keep an open attitude. It is likely that the person will feel ashamed by their behaviour and worried that others will judge them. Aim to create a caring space where the person feels safe enough to discuss their feelings if they wish.
  • Listen to the person so they feel heard and supported and taken seriously.
  • Encourage the person to talk about their feelings, rather than self-harming. Explore with the person what other strategies he/she could use to cope, as an alternative to self-harm.
  • Find ways to enhance the person’s self-esteem and acknowledge their positive qualities.

Things to avoid when caring for someone who self-harms:

  • Do not condone self-injury. At the same time, try to be non-judgmental and let the person know you will support him or her to find alternatives to self-harm.
  • Do not give ultimatums. This could increase feelings of rejection for the person and decrease trust between you, as the person may feel unheard. The motivation for change must come from within the person.
  • Do not pressure the person into undertaking any treatment they feel uncomfortable with, but at the same time make your feelings about the importance of proper professional care known to the person.

 

Look after yourself

Caring for someone who self-harms can be emotionally demanding and stressful, so it is important to look after yourself and use extra support when you need it.

 

Need help? You can find support services in northern Queensland or complete a self-administered K10 test for depression and anxiety. You can also join the online social and mental health forum to talk with like-minded people.