Understanding Self-Harm: How To Help A Friend Going Through It

Useful dos and don'ts for a difficult situation.

Self-harm is something that many people of all ages may suffer from at some point in their lives. Whether it’s you or a friend or family member, it can be a scary thing to deal with.

We spoke to Lise Alford from 3Ts, an Irish suicide prevention charity, to get a better understanding of the difficult subject.

What is self-harm? 

“Self-harm is the act of intentionally causing injury to oneself which can include both self-harm with suicidal intent (e.g. suicide attempt) and self-harm where there is no / little intent to die.  Both these forms of self-harm can serve different functions for different people.  Some describe it as a way to feel physical pain to stop the emotional pain,” Lise explains.

She went on to say that, self-harm is often used as a coping mechanism and a method of managing stresses in life. It can be a temporary activity or can be prolonged over an extended period or over the life span.  It can develop into a dangerous, addictive habit. It can cause permanent damage to the body if nerves are injured and can even result in death.

Self-harm can take many forms, and while most people might only think of it as cutting, it can also be punching, hitting, excessive exercise or substance abuse among other things.

Why do people do it?

The reasons people self-harm are as varied as the people themselves.  Self-harm doesn’t discriminate, so it doesn’t matter about your gender, your background, race, age, physical or mental condition, whether you’re an over- or underachiever, whether you’re sociable or not, have had a troubled past or had a perfect childhood.

“To those who self-harm, when they’re feeling overwhelmed by situations, emotions or thoughts, self-harm is a genuine coping mechanism that they use to regulate their emotions and to regain control in their life,” Lise explains.  “Any emotional extremes (good or bad) can make the person turn to self-harm to regulate their emotions. To them, self-harm brings an immediate, albeit temporary, sense of relief.”

She adds: “Self-harm is not a ‘condition’ that needs treatment; it’s a behaviour that requires management.”

What do I do about a friend who self-harms?

There are lots of ways you might find out, from witnessing it yourself to someone confiding in you.

But no matter the circumstances or how you feel about self-harm, it’s important to stay calm, says Lise.  “Overreacting will help nobody and will only push your friend away. They are likely to be embarrassed and devastated that you’ve discovered their very private secret and will be worried about what happens next.  They’ll be expecting the worst but at the same time will be hoping for acceptance and understanding.”

What NOT to do:

  • Don’t overreact. You may be shocked. You may both be emotional, but it’s important you remain calm.  This will encourage them to open up.
  • Don’t show disgust, however hard you find it. It makes opening up even harder. It’s ok to show shock, surprise or fear, but try to moderate it.
  • Don’t make them self-conscious about their scars. They already are.
  • If you don’t know what to say, say nothing. Just listen.
  • If you don’t understand it, tell them you don’t. Don’t make assumptions or jump to conclusions.
  • Don’t ask them to stop – it’s not that simple. Similarly, don’t demand, don’t threaten or don’t prevent them by force. Self-Harm is their safety net and they need to have another coping skill to replace this harmful one before they can successfully stop hurting themselves.
  • Don’t judge the person or add any guilt – they feel that enough already.
  • Don’t remove their self-harm tools or any alternative means unless they ask you to. Their mind will just go into overdrive to find another object to use.
  • Don’t punish them in any way for their actions. This will only cause more stress and make them more secretive.
  • Don’t say things like “Sure, you’ve got everything going for you, why would you need to do this?” or “Why would a good-looking girl like you want to harm yourself in this way?”
  • Don’t tell them they are attention-seeking. Remember, it’s a very private activity and the last thing they want is attention.  It has a genuine foundation in distress, so don’t belittle their pain.

What you CAN do to help:

  • Stay calm
  • Ask them what’s going on and how can you help.

If you don’t feel comfortable or are worried about doing the wrong thing, you can get an adult involved who can take the next steps:

  • It’s ok to ask the “S” word. Try to find out if their self-harm was a suicide attempt.  If so, see 3Ts Need Help Section.
  • Remember this is a sign they’re distressed and struggling with situations, emotions and thoughts and this is their coping method. Recognise how distressed the person is, even if they aren’t openly showing it at the time.
  • Remember It takes courage for them to open up. Acknowledge that.
  • Listen – building trust is important.
  • Be honest – if you don’t understand, tell them.
  • Don’t underestimate the power of kindness and empathy. They will appreciate it.
  • Reassure them. Show an accepting attitude.
  • Discuss the idea of seeing a therapist or getting professional. Their GP can help with this.
  • Show support and be there for them. There are lots of ways you can do this from the very simple being at the end of the phone to specifically pro-active actions listed in the resources.
  • Try to discuss it and try to help them think of what their triggers are and ways to control it.
  • Offer practical help that might help lighten their load eg minding kids, doing shopping.
  • Encourage them to stay in company where they will be less likely to self-harm.
  • Provide them with helpline numbers in the event of an emergency e.g. Pieta 1800 247 247 or Bodywhys if they have issues with anorexia or bulimia.
  • If wounds need medical treatment, seek medical help or dial 999.

Most importantly, speak to an adult about the situation, whether it’s a sibling, friend, cousin or anyone else, it’s a serious issue and not something you should carry the weight of on your own. It’s totally fine to tell an adult you trust because you’ve got the person’s best interest at heart.

If you’ve self-harmed and are struggling to understand why, or wondering what to do next, check out 3Ts for more