How to Help Someone Who Self-Harms

Note: This piece discusses the topics of self-injury and self-harm in detail. Please use your discretion.

When we say “self-harm,” what do you think about? Long-sleeve T-shirts in summer? Sharp objects? Maybe even suicide? There is a longstanding history of individuals misunderstanding self-harm and/or ultimately equating it to suicidal ideation.

It’s imperative to note that the action of physically hurting oneself does not mean that one wishes to die by suicide. Self-harm or self-injury is defined as, “hurting yourself on purpose.”

How To Recognize Self-Harm

This desire can be acted out in multiple forms and can consist of any of the following behaviors:

• Ripping or tearing the skin
• Cutting, pinching, or scratching
• Burning
• Preventing wounds from healing
• Pulling out hair
• Punching or banging objects until injury occurs
• Purposefully overdosing on medication without suicidal intention.

These are some of the more commonly seen examples, but by no means is this a fully expansive list. And while nonsuicidal self-injury is an action taken by those who do not wish to end their life, serious risk-factors are still associated, such as:

• Intense negative feelings of shame and guilt
• Low self-esteem
• Infections
• Scarring
• Uncontrolled bleeding
• Worsening mental health challenges
• Serious, possibly fatal injury

Helping Someone Who Self-Harms

While it can be overwhelming to realize that someone you love and care about is engaging in behaviors you may not fully understand, it’s important to know that self-harm is not a mental illness. The action of causing oneself harm is a sign of the need for stronger coping skills.

When it comes to offering support, a great place to start is emotionally checking in with the person you may be concerned about and reminding them that you are always available to be a safe space for them. And while at times challenging, it is recommended that you do your best to separate your emotions from theirs. They are not doing this to you or because of you, but rather as a way to process what they are currently thinking and feeling.

The reasons that lead someone to act in such ways are diverse, but self-harming can occur at any age and might not be as easy to identify as you may think. While it is most common among adolescents and young adults, this behavior is not excluded amongst adults and is equally prevalent amongst all genders.

Checking in on someone will not cause them to further engage in self-harm practices. If anything, it will remind them that they are not alone and may possibly prevent them from engaging in the practice. Some of the reasons behind why folks choose to engage in self-harm are as follows:

• A way to process negative or overwhelming feelings
• To distract themselves from their current feelings
• A way to feel something, particularly if they are feeling numb or disconnected
• A means to feel a sense of control
• To express emotions that they don’t want or know how to verbalize

Some of the common signs to be aware of in someone who may be experiencing self-harm are:

• Unexplained, frequent injuries
• Attempts to hide the injuries, like wearing long sleeves or pants on hot days
• Difficulty processing heavy emotions
• Self-isolation
• A low sense of self or self-esteem
• Scars on the skin in patterns or shapes

Things To Do Around Someone Who Self-Harms

When looking to support those in your life who may be engaging in such behaviors, Dr. Srivathsal, a psychiatrist at Banner Behavioral Health Hospital, shared these recommendations:

• Avoid judgment
• Be understanding
• Be genuinely interested in learning how these actions provide relief
• Remain supportive—even if you don’t understand the why behind their actions
• Try and refrain from asking for promises, such as them promising to stop or talk to you before engaging in said behavior.
• Encourage them to seek help and gently remind them that there are additional coping mechanisms available.

While self-harm isn’t something that stops or is resolved overnight, it is important to remember that recovery is possible. Our friend Adana shared her healing journey with us:

“Every day you wake up is a win. Every hard night you make it through attests to your strength. You don’t have to feel strong to be strong, and you don’t have to be moving forward to be healing. It’s okay to stand still for a moment, to breathe and reflect on where you’ve been and how much road is behind you now. The road ahead can be an overwhelming concept—I know it was and still is for me.”

Seeking support from a mental health professional is recommended so that evaluations can be made, any potential underlying diagnosis can be found, and healthy coping skills can be learned. If you are in need of immediate support, know that Crisis Text Line Counselors can be reached 24/7 by texting TWLOHA to 741741—their services are free and confidential.

Most importantly, remember that this does not make you or someone you love broken. Asking what, if any, triggers they have can help you to avoid unintentionally causing more difficulty for and around them.

This reality does not need to be theirs and yours forever, but it will take time, love, and support to find hope and healing.

Additional Resources

• Use our FIND HELP Tool to find a counselor near you by entering your zip code
• Learn more about Meru Health x TWLOHA for digital mental health support
• Access Talkspace for online therapy with a licensed therapist
• Read about people’s honest experiences with self-harm and self-injury on the TWLOHA Blog