Self-harm is a complex behaviour that can be devastating for the individual involved and also for those around them.
Self-harm may include self-injurious behaviour like cutting, burning, or scratching the skin, pulling out hair (trichotillomania), or engaging in behaviours such as disordered eating, misusing alcohol and other substances, over-exercising, or getting into risk situations.
It’s important that we know how to support someone who self-harms, and how to help them keep themselves as safe as possible.
Self-harm is typically a sign of underlying emotional or psychological distress, and individuals who self-harm are often coping with overwhelming emotions or difficult life situations, including, but not limited to:
They may hurt themselves as a way of managing these difficult feelings. They may not have the tools to deal with traumatic memories or experiences, and may use self-harm as a coping mechanism, albeit a maladaptive one.
When emotions are overwhelming, self-harm can ‘seem’ to help by providing temporary relief and re-instilling a feeling of control. It offers a physical outlet for intense, overwhelming distress that is otherwise hard to cope with.
Emotional pain can often be incredibly difficult to articulate verbally, so for some people, self-harm may serve as a way to communicate their pain or distress to others when expressing their feelings verbally is impossible. In other words, it can be an external representation of how someone is feeling internally.
Engaging in self-harm behaviour can also be a form of self-punishment, often due to feelings of guilt, shame, or low self-esteem, where individuals may try to justify or rationalise the need to self-harm.
Supporting someone who self-harms can be challenging as this behaviour often happens ‘behind closed doors’ and individuals can often conceal the true extent of their distress, sometimes in an attempt to protect those around them.
However we decide to support individuals, we need to tread carefully, sensitively, and with compassion to avoid exacerbating an already distressing situation. Moreover, we need to recognise when further external help may be required. Safety is paramount and if we are concerned that someone is at immediate risk of serious harm, we should not hesitate to contact the appropriate service or healthcare provider.
Download our individual risk assessment template.
Guilt, shame and embarrassment are some of the emotions associated with self-harm, which is one of the reasons that individuals may be reluctant to seek help.
If an individual is experiencing feelings of shame or guilt, it can make it more difficult for them to open up. Providing opportunities to listen without judgement, using reassuring, supportive language, and creating an emotionally and physically safe space can all help someone talk about how they are feeling.
Self-harm is not the individual’s ‘fault’; there is no room for blame or judgement.
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