How to Help Someone Who is Self-Harming

Self-harming is a form of self-inflicted abuse, though the individual does not intend to take their own life. People who resort to self-harm frequently are those who struggle with feelings of loneliness, emotional emptiness, complicated or unstable relationships, and stress management. They may have difficulties expressing their emotions and may lack coping skills due to past trauma, abuse (physical, emotional, or sexual), or other difficult life experiences. If you suspect someone you know is self-harming, there are ways you can offer support to them.

Make sure you are prepared to help. If you truly want to assist someone engaging in self-harm, it’s essential to be mentally and emotionally strong before you start. Helping someone in this situation may require you to listen to and witness some very difficult and painful experiences. You must commit to this from the beginning and cannot back out halfway through. Turning your back after they have shared their pain will only make things worse. Understand that helping someone who is self-harming may bring out new emotions in you, such as anger, empathy, or deep disappointment. When you experience these feelings, it's important to remain calm and manage your emotions so you can respond with kindness and love.

Approach the person with calmness and compassion. If you notice your friend has cuts on their arms or if you see them covering their skin even when it’s hot, or if there are any other signs that suggest they may be self-harming, you should try to offer support. When approaching, stay relaxed and gentle. Avoid accusing them of hiding something, yelling, or arguing at any cost. They need support, understanding, and help, so blaming them or becoming aggressive will not be helpful. Instead, approach them with love, understanding, and let them know you are always there for them.

Acknowledge their emotions. Since many people who self-harm do so to release inner emotions, it can be helpful to let them know that you recognize and understand their feelings, or at least empathize with them. You need to connect with them on a personal level to help them, engage with them, and become part of their healing process. Tell them you understand the overwhelming emotions and that sometimes you also feel overwhelmed like they do.

Be consistent. Don't hesitate to reach out to someone who is self-harming. Do not act as if you doubt their intentions, feelings, or actions. If you feel you cannot trust them or what they say, do not show it. Be present to support them and make sure they know you are by their side. Earning their trust may take time. If you approach them with a desire to help but later show indifference, it will do more harm than good.

Do not control. Avoid trying to help your loved one or friend by acting as if you are controlling their life. While you may want to change their self-destructive behavior, you do not need to take responsibility for everything or control them. Don’t be too strict or controlling. This could make them anxious and feel like you are distant.

Although you may really want to help a friend or loved one, you cannot make them calm down or change their attitude. In order to truly stop self-harming, the person themselves must find a way to achieve this.

Keep the connection open. You may find it difficult to reach your friend immediately. If they aren't ready for help, you can't force it. Make sure to leave your contact number and let them know you're there for them, but don't push them to listen, even if you've attempted to talk. Pressuring too much might drive them away, and it will be harder to help later.

• Keep an eye on their behavior if self-harming escalates. In such cases, it's essential to recommend professional assistance to manage the self-injury behavior.

Encourage physical activity. Try to motivate your loved one to stay as active as possible. When they're confused or tempted to harm themselves, they need a more positive and energetic way to cope. Suggest intense physical activities like running, dancing, aerobics, swimming, tennis, or boxing. These exercises can help alleviate sadness, frustration, or unhealthy emotions that may lead to self-harm. Suggest joining them and exercising together.

• To soothe their mind, they might also try yoga, meditation, or Tai Chi. These practices will help them gain a fresh, energetic, and confident perspective on life.
• Exercise releases endorphins in the body, which help them feel good. When someone self-harms, the endorphins are directed to the injured area, causing bleeding and a sense of relaxation, happiness, and relief. Instead, exercising is a positive way to release endorphins.

Help improve their self-esteem. Low self-esteem is a major reason for self-harm. You need to help them understand that self-harm won't improve their self-image, but accomplishments can. Help them prove to themselves that they are amazing and have achieved great things. Success can come from studies, work, friendships, or volunteer activities. As they become more aware of their achievements, their self-esteem will rise, and they'll feel more comfortable with who they are. This will reduce their desire to self-harm.

• You can help them realize their successes by sharing a list of their positive traits and accomplishments with them.

Avoid lecturing. Nagging won't motivate them to change their self-destructive behavior. Don't try to teach someone by scolding or lecturing them for long periods. Keep your conversations brief and straightforward. Give them time to understand and reflect on what you've shared with them.

• Offer small words of encouragement in a peaceful, calm setting, ideally in nature, where there’s no rush and minimal chance of disturbance. If you can’t find an outdoor spot, try a quiet corner in your home or a secluded study area in a local library. The location doesn't matter, as long as it’s a place where you can have an honest and uninterrupted conversation.
• Give them ample time to talk with you. Let them take the time they need. Don't rush them and always choose a location and time when they feel at ease.

Be patient. Your loved one won’t quit self-harming overnight or just because you tell them to stop. This is the coping mechanism they know to handle their emotions. Telling them to stop right away can cause fear, as they’ve grown accustomed to this method and feel lost without an alternative coping strategy. It also makes them feel worse because you are attempting to take away the only way they cope with pain and psychological trauma. Be patient and understand that it will take time. Don’t get frustrated and make sure to invest time helping them.

• Issuing an ultimatum without offering support or an alternative safe solution isn’t a wise choice and could cause more harm than good.

Suggest reading books. Those who self-harm often feel anxious about social interactions due to the judgment and curiosity from others. To help them avoid thinking about self-harm and to steer clear of uncomfortable social situations, encourage them to read more books. Books can open up new worlds for them. They can journey beyond the walls of their room without physically leaving home. They may also discover numerous ways in which others have faced difficult experiences.

• Books also present an opportunity to learn about positive and accepted coping strategies. Introduce them to motivational books that help them understand their inner feelings and evaluate their challenging personal situations.

Consider journaling. One excellent way to help your loved one accept the situation of self-harming is by keeping a daily journal. Encourage them to write down their thoughts, pain, and joy. Writing can relieve emotional distress and leave them feeling lighter and at peace. Suggest that they write whatever comes to mind.

• Don’t advise them to specifically write about self-harm unless they’ve consulted with a doctor or therapist. You never know what complications might arise, so suggesting they focus on self-harming behaviors to cope with psychological trauma isn’t a good idea unless they see a professional for guidance.
• Journaling can also assist psychologists, psychiatrists, or counselors in understanding their condition before diagnosing and treating them.

Remove triggering items. The risk of self-harm is higher when they are at home and have access to various tools. This could include items like razors, knives, scissors, or glass bottles. You should encourage them to remove these items from their living space to avoid temptation.

• Stay with them as they move these items out of their living area. If they’re not ready to remove them, help them place them on a high shelf or in a separate room. This gives them more time to think before acting, which could help prevent self-harm.

Boost their morale. Clearing their mind of troubling thoughts is a great way to help your friend avoid self-harm. With their consent, try changing the environment and objects around them to help improve their mood. Travel, rearrange and redecorate their room, change the wall color, or put up some fun, humorous, or motivational posters. You can also help them pick out a few changes they'd like for their room and help them make those changes a reality. This could involve altering the scent, appearance, or overall atmosphere of the room.

• Always accompany them from start to finish. Take them shopping for new room items and stay with them until the project is done. Help them enjoy the process of welcoming change into their life.

Provide distractions. Battling the urge to self-harm is especially difficult when they are home alone or feeling overwhelmed with pain. Ask them to call or meet up with you when they feel the urge to hurt themselves. Try engaging in activities together that will help take their mind off the self-destructive thoughts. Think about what they enjoy, their interests, and hobbies, and encourage them to engage in those activities.

• If they love nature, go hiking. If they enjoy painting, encourage them to paint. Creative activities like storytelling, playing an instrument, or drawing can be helpful. They could also watch movies, TV shows, listen to music, play games, or do whatever brings them joy.
• By keeping them busy with enjoyable activities, they will often be distracted from their urge to self-harm.
• If they don’t go outside much, encourage them to meet new people, expand their social circles, and nurture relationships. This can help boost their confidence, self-esteem, and trust in others.

Suggest seeking professional help. When you first learn that a friend or family member is self-harming, it’s crucial to find out whether they are willing to seek professional help from a psychiatrist, psychologist, or counselor. These professionals are trained to help people combat harmful behaviors in their lives. If your friend insists they’re not crazy, agree with them. Let them know that many people visit mental health professionals for various life issues, and they often do so multiple times for personal development. If they’re concerned about the stigma of seeing a mental health professional, suggest they see someone outside their area. Good, helpful services can genuinely assist them in addressing the issue. Experts have a better understanding of why they engage in self-harm and what they’re trying to accomplish with that behavior.

• Involving a mental health professional is essential if you care about the recovery of your loved one. There is always stigma associated with seeking professional mental health help, but it’s important to encourage them to pursue treatment.
• If they’re not ready for treatment, offer to help them research self-harm and its triggers. There is plenty of information online on many topics, and self-harm (self-cutting) is no exception. Make sure the sources you find are credible, such as psychological organizations or helpline websites. Some content can be misleading and counterproductive, hindering your efforts to help your friend or family member feel better.

Encourage them to join a support group. A support group consists of individuals who come together because they share similar problems, concerns, face common challenges, and have experienced similar situations. While you may act as part of the support group for a while, they may eventually need companionship from someone who understands exactly what they’re going through. After spending time with you, they might eventually gather the courage to meet others like themselves to hear different stories, frustrations, and learn how others have successfully overcome self-harm. They can explore how and why they failed in their own efforts.

• They may hesitate or feel unwilling to join a support group for people who self-harm. To encourage them, you could go with them to offer support and encouragement as they take this final step toward treatment.

Consider Dialectical Behavior Therapy (DBT). DBT is an effective approach for treating individuals who engage in self-harm behaviors. It builds upon cognitive-behavioral therapy and involves a thorough assessment of the individual’s self-harm tendencies. In DBT, clinicians not only work with the person seeking help but also investigate the family dynamics, as understanding the individual's environment and experiences can provide insights into what triggers these harmful behaviors. Furthermore, the therapist will focus on teaching healthy coping skills tailored to the individual's needs.

Intervention is essential. Intervention is carried out under the guidance of a trained professional. This method is one of the most effective ways to facilitate a conversation between someone who self-harms and the significant people in their life. While it is helpful for understanding the individual’s struggles without fearing self-harm, the process is emotionally challenging as it brings up the painful feelings related to self-injury in front of loved ones. However, this exposure is critical for progress.

• Professionals play a crucial role in eliminating self-harming behavior among those they care for. A trained interventionist will organize the session for both the individual engaging in self-harm and their family members. You, too, can participate if you care about them.

Explaining the scars. Self-harm often leaves physical marks on the body, and these visible scars may lead to feelings of embarrassment. This can create a barrier to socializing with friends and family due to the fear of judgment. Such feelings can also diminish self-esteem, contributing to a cycle of insecurity and prompting further self-harming. It’s important to explain to loved ones that recovery is possible, and there is hope for ending this pattern without leaving any more scars behind.

Warn them about the health risks. At some point, superficial cuts may no longer satisfy the person, and they may begin cutting deeper, which poses serious health risks such as infections. Unprotected wounds from self-harm can lead to infections and other severe medical complications.

• The individual may also accidentally cut in a dangerous area, leading to excessive bleeding or even death.

Be aware of anemia. Repeated self-harm can impair the function of vital organs and systems in the body. This is because frequent blood loss through self-injury reduces the hemoglobin levels in the blood, leading to anemia. If left untreated, anemia can cause symptoms like shortness of breath, rapid heartbeat, sweaty palms and feet, chest pain, heartburn, excessive sweating, and vomiting.

• In children and adolescents, severe anemia can affect motor skills and mental focus, making it difficult to concentrate, stay alert, or respond quickly.
• Untreated anemia in adults can lead to heart-related issues, and even increase the risk of stroke and cardiovascular problems. Anemia can also impair cognitive function.