How to help a loved one or friend who is self-harming

Updated: May 26

If you have discovered a friend or loved one is self-harming, do not panic.  We are here to assist you.  Remember to be kind, compassionate and patient.




Address any immediate medical concerns straight away by contacting the emergency services on 999.  Below is a comprehensive guide on everything you need to know about helping someone through this tough time.


What is self harm ?


Self-harm is when someone inflicts physical harm on themselves, often without anyone else

knowing.


Self-harm is a behaviour that is often the expression of the person’s emotional distress.

Some examples are cutting, burning, biting or hitting, pulling out hair or scratching and picking at sores on skin. Self-harm also includes forms of behaviour with some level of suicide intent such as overdoses.


Self-harm is not necessarily a suicide attempt and engaging in self-harm may not mean that someone wants to die.

Most commonly, self-harm is a way of coping with difficult or

painful feelings.


However, people who self-harm are statistically at a greater risk of going on to take their own lives. If the emotional problems associated with self-harm escalate, and are not dealt with, the behaviour is likely to continue and become increasingly concerning.

If you learn that a young person is self-harming: — Don't panic.


  • Deal with any immediate medical concerns.

  • Listen and find out what they need.

  • Acknowledge their pain without being intrusive.

  • Try to understand the severity of their distress; self-harm is often an expression of intense inner turmoil.

  • Provide a safe and open environment in which they can freely discuss their thoughts and feelings.


Talk about the self-harm; pretending it doesn't exist will not make it go away and not talking about it often reinforces the shame and secrecy associated with it.


If they don't want to talk straight away, let them know you are there to talk whenever they want.


Let them know how you feel; many young people who self-harm have trouble expressing their thoughts and feelings, so don't withhold yours. See the person, not the injuries; self-harm is a symptom of deeper underlying issues.

Encourage them to cry - crying is a healthy and normal way to express sadness or frustration.


Distraction techniques:

Suggest that your loved one use a distraction technique when they get the urge to self-harm. This involves distracting themselves until they feel the urge has passed.


Distraction can involve:

  • talking to someone, a friend or family member, a helpline or online support

  • doing some exercise - even running-on-the-spot or jumping jacks

  • shouting or singing at the top of their lungs – they can do this into a pillow if they don't want other people to hear

  • New ways to cope

  • To move past self-harming, your loved one will need to understand why they self-harm. Then they can learn new ways to deal with it.


Talking therapy can be an essential part of overcoming it.


Talk to your loved one about what kind of support they might consider. This can help to get them to attend appointments. Parents may be asked to take part in the therapy process.


Patience

It's also important to be realistic. Don't expect the behaviour to stop immediately. It may take a long time to replace the self-harm with a healthier coping strategy. Talking with you may be the first step.


Things that are unhelpful


Telling someone not to self-harm is both ineffective and condescending.

Most people who self-harm would stop if they could. Remember, it can be a coping mechanism they use to stay alive.


Avoid:


  • casual comments encouraging them to stop

  • making them feel guilty about self-harming or trying to punish them

  • The key thing in moving past self-harm is open and honest communication.


Understanding why people self-harm:


Everyone is different, but some common reasons why people may self-harm are to:


  • express overwhelming emotional distress

  • express difficult feelings

  • feel in control of their lives

  • Overwhelming emotional distress

  • In most cases, people who self-harm do it to help them cope with overwhelming emotional pain. This could be caused by social problems, trauma or psychological reasons.

  • Social problems:

  • being bullied

  • having difficulties at work or school

  • having difficult relationships with friends or family

  • coming to terms with sexuality

  • coping with expectations

  • Trauma:

  • physical or sexual abuse

  • death of a close family member or friend

  • having a miscarriage


Psychological causes:


  • having repeated thoughts or voices telling them to self-harm

  • disassociating - losing touch with who they are and with their surroundings

  • borderline personality disorder

  • You may not know who to turn to for help and self-harming may become a way to release these pent-up feelings.


Self-harm is linked to anxiety and depression. These mental health conditions can affect people of any age.


Express difficult or hidden feelings:


It's not uncommon to feel numb or empty as a result of overwhelming feelings. Self-harm may provide a temporary sense of feeling again or a way to express negative emotions. It can turn invisible thoughts or feelings into something visible.


People may also be trying to:


  • change emotional pain into physical pain

  • escape traumatic memories

  • punish themselves for feelings or experiences

  • stop feeling numb, disconnected or dissociated

  • express suicidal feelings and thoughts without taking their own life

  • feeling in control

  • you may feel it is one way to have a sense of control over your life, feelings, or body. particularly if you feel other things in your life are out of control.


Types of self-harm


There are many different ways people can intentionally harm themselves, such as:


  • cutting or burning their skin

  • punching or hitting themselves

  • poisoning themselves with tablets or toxic chemicals

  • misusing alcohol or drugs

  • deliberately starving themselves (anorexia nervosa) or binge eating (bulimia nervosa)

  • excessively exercising


People often try to keep self-harm a secret because of shame or fear of it being seen. They may cover up their skin and avoid discussing the problem.


It's often up to close family and friends to notice when somebody is self-harming. They should approach the subject with care and understanding.


It can also include behaviours that have some level of suicide intent, such as overdoses.


Signs of self-harm:


If you think a friend or relative is self-harming, look out for signs, including:


  • unexplained cuts, bruises or cigarette burns - usually on the wrists, arms, thighs and chest

  • keeping themselves fully covered at all times, even in hot weather

  • pulling out their hair

  • alcohol or drugs misuse

  • self-loathing and expressing a wish to punish themselves

  • speaking about not wanting to go on and wishing to end it all

  • becoming very withdrawn and not speaking to others

  • changes in eating habits or being secretive about eating

  • unusual weight loss or weight gain

  • signs of low self-esteem, such as blaming themselves for any problems or thinking they're not good enough for something

  • signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything.




If you need further support remember to let us help you here at Talk To Tom. We can be your guide - contact us on (0818) 303061or via Whats App.  To launch a chat now click here.   You can find out more about our counselling service here. 

Other services you where you can reach someone to talk to are:

Samaritans offers a 24 hour listening service over text message, text 'Hello' to 087 260 9090 to get started (standard text messaging rates apply) or call 116 123 to talk to someone over the phone.

Childline text and instant messaging services are available from 10am - 4am every day to young people under 18, text 'Talk' to 50101 to talk to a trained counsellor by text message or call 1800 66 66 66.




Visit Your GP:

We always recommend that you visit your GP if you have not been feeling yourself.  Don’t feel embarrassed or ashamed.  Your doctor is a professional health care provider and will be familiar with how you are feeling.  You mental health is just that - your health.  You would visit your GP if you had been feeling physically unwell right ?  Your emotional health is just as important as your physical well-being - in fact the two go hand in hand.  If you don’t have a current GP you can find a list of services in your area here.  You can also contact the CareDoc service on 1850 334 999





Contact the Emergency Services:

If you are an immediate danger to yourself and are going through a suicidal crisis  please contact the emergency services by dialling 999 or visit your nearest Emergency Department.


Content supplied by the NHS and adapted for Ireland by the HSE.