Helping Someone Who Self-Harms
People injure themselves for many reasons. It may replace emotional distress with physical pain. Many people say that when they cut themselves they experience a release of tension and so they often feel calmer. In a strange way, self-injury may help people feel that they can achieve some degree of control in their lives.
Self-injury is very often not a suicide attempt; however, people who do self-harm are at a greater risk of suicide than the general population and should never be dismissed as just ‘attention seeking’ or being ‘manipulative’.
Relatives, friends or professionals trying to help the person can find it very stressful, especially when the person does not want to talk about or explain their behaviour. It is easy to feel ‘shut out’ and just left to pick up the pieces at times of crisis. If someone we care about is deliberately damaging him- or herself and not willing to let us help, we can feel isolated and powerless.
The person usually has very low self-esteem and poor self worth and they think that others will see them in the same light and be critical. There are therapies that can be used that have been shown to be effective in breaking the negative cycle.
- Respond to an incident of self-harm in the same way that you would for the victim of an accident; provide first aid as for any other physical injury.
Do not assume that the person either enjoys or does not feel pain. A response which implies criticism or some form of punishment simply reinforces the person’s feelings of self-blame and guilt.
Acknowledge the person’s distress. Say something like ‘I can see you are very upset. How can I help you?’ This can be very reassuring and can help the process of communication.
Aim to be positive and comforting; don’t be negative or highly emotional. It may be hard but don’t be judgemental, critical or dismissive. This applies to non-verbal as well as verbal communication. Try to show concern rather than disapproval, facially as well as in what you say.
Try not to be over protective i.e. promising that everything will be all right. Acknowledge that there is a problem, but that it is possible to get help.
Having contingency plans in place ready to use in times of crisis is vital and can often prevent a crisis happening. Knowing what to do and who to contact in an emergency can be very reassuring for the person and those who care for them.
If you think someone may be suicidal then contact the relevant agencies such as the emergency services and anyone else involved in their care, like their care coordinator or the GP.
For more information contact National Self Harm Network
©2016 Somerset Partnership NHS Foundation Trust