What to say to someone who self harms

If someone opens up to you and tells you they self-harm, or if you spot the signs yourself, it can be difficult to know how to respond. It can stir up a lot of emotions, like shock, fear, worry, guilt and anger. Trying to support the person while managing your feelings can be overwhelming. It is easy to feel like you immediately want to offer a solution to the situation. However, what is most important is to listen to what the person is saying and to let them know that you are there for them.

It is important to note that if the person is badly injured or has told you they are suicidal then you will need to get them immediate medical help. Avoid contacting anyone for help without first telling the person involved that you are going to.

In partnership with young people with lived experience, Samaritans have developed a short video with suggestions on how to support someone who is self-harming.

What should I do if someone tells me they self-harm?

Opening up about self-harm takes a lot of courage. If someone tells you they have been self-harming or are experiencing urges to self-harm, it means that they trust you. However, it’s also likely that they are feeling anxious. They may be worried about how you will react, what you might say, or what you might think of them. Despite this, telling you is a positive step.

It can be difficult to learn that someone is self-harming. Supporting a friend can be a lot to carry on your own and it’s important to mind yourself and be aware of your own mental wellbeing. Here are some tips that can help you navigate that conversation and ensure you are meeting your loved one with support, understanding and care.

Avoid getting angry, blaming or shaming the person for self-harming

If someone opens up to you about self-harming you may feel upset or angry that someone you care about is going through a difficult time. Although it is normal to feel upset, trying to stay calm and having an open conversation is the best way to support the person. You may be confused as to why the person would self-harm. Try to put your own thoughts or opinions on the matter aside as the person you care about needs your kindness right now. Avoid blaming or shaming the person for self-harming or pressuring them to stop. Never say or imply that what they are doing is for attention. Learning about the myths that surround self-harm can help with this.

It is important to remember that self-harm is not a choice or someone’s fault. It is a complex situation in which the person needs support. Avoid giving ultimatums or telling someone what to do. Instead, do your best to stay calm, acknowledge their emotions, and above all try to remain non-judgemental.

Self-harm as a coping mechanism

Self-harm can be difficult to understand if you do not have your own lived experience. Some people use self-harm as a coping mechanism. A coping mechanism is something your mind does to help manage stress. It can be really difficult to stop using a coping mechanism if you don’t have an alternative to replace it with. This is why it can be challenging to resist urges to self-harm, even when you want to. The best thing you can do for a person who opens up to you about self-harm is to listen and offer to help them find support.

Listen to what they are telling you

If someone opens up to you about self-harming, listen to what they have to say. It is a big step for someone to share what they are going through and they have chosen to share this information with you for a reason. Let them know that they did the right thing sharing this with you, and you are there to support them. You will probably have a lot of questions. However, try and keep these to yourself for now, and allow them to control the direction of the conversation.

Talking about self-harm can be difficult, especially if you haven’t done it before. Give your friend the time and space they need to share at their own pace. It’s important not to be intrusive or insist that they share everything about their self-harm with you. They can choose what they feel comfortable sharing and if there are certain things they’re not ready to talk about, that’s okay.

Focus on the cause of the problem

It can be easy to focus on the symptoms of self-harm, but to get to the root of the problem it is important instead to focus on why they are doing it and how they are feeling. Self-harm is complicated. There are many different reasons that people have for self-harming. When a person is self-harming, it’s a sign that they’re in distress and they deserve care and support.

Do not ask the person to see their scars or injuries and remember that not all self-harm leaves a visible mark in the way you think it might. Instead, talk to them about what is causing them to self-harm and what can be done to better the situation. The aim of your conversation should not necessarily be to stop the person from self-harming. It is to support them and help them better cope during this difficult time.

Samaritans has a list of tips that can help you be an active listener during especially difficult conversations. All you have to remember is SHUSH:

• Show you care
• Have patience
• Use open questions
• Say it back
• Have courage

Let them know that you are there to support them

Let the person know that you support them and that they are not alone. They are not reaching out to you so that you can fix them. They are often looking for someone to listen and offer compassion. Let the person know that you’re sorry to hear that they have been finding things difficult, and want to support them.

Discuss together what you think the next step should be

You may think you know what the next step is, but it is important not to come up with solutions without asking the person what they would like to do. Ask them if they would like immediate help or support and if so, suggest getting in contact with a charity like Pieta. They offer support for people who self-harm. If they do not want to take any immediate action, ask what they would like to happen next and how you can be of help to them. You cannot force a person to get help, but you can still encourage and support them to do so. This article on supports available for self-harm can help.

Check if they need medical support for their self-harm

There are many forms of self-harm. Sometimes, self-harm can cause physical injuries that need treatment from a healthcare professional. If someone opens up to you about their self-harm, unless they are in need of urgent medical intervention, it’s often not helpful to immediately focus on the physical side of self-harm. Instead, allow them to discuss how they’re feeling. Then, when you feel the time is right, it can often be a good idea to check to make sure they don’t need any medical support.

A simple phrase like this is enough: ‘You don’t have to share anything you’re not comfortable with, and I want to hear more about what’s been going on for you and how you’ve been feeling. However, can I check if you have any injuries that you think need some medical treatment?’

If they do think they need medical treatment, you can help them get in contact with their GP or call an ambulance if they are in a self-harm emergency. If they say they’re okay, simply continue with the conversation.

Follow up on the conversation

Once the conversation is finished, it can be tempting to avoid the subject unless the person brings it up themselves. However, it can be helpful to follow up by checking in on how your friend is doing from time to time. A simple message asking how they are and if they need anything or would like to talk again can make a big difference. It lets them know the door is always open.

What can I do if I regret how I reacted when I learned about someone’s self-harm?

It can be shocking to hear that someone you care about has been engaging in self-harm. People react in many different ways when they hear news like this. When someone doesn’t have a good understanding of what causes self-harm, they can respond in unhelpful and even harmful ways without realising it. For example, sometimes people can criticise the person who is self-harming, try to set rules or restrict them from self-harming, or even threaten to withdraw from them if they don’t stop. These reactions come from a place of fear, but they won’t help the person recover or heal.

If someone in your life opened up to you about their self-harm and, after reading this article, and you wish you had responded differently to them, that’s okay. Even if your initial response was unhelpful, you have also taken a positive step towards supporting your loved one by seeking more information on the topic.

Ultimately, the most important thing is to be there for someone, and to listen. Don’t let your fear of saying the wrong thing or making a mistake stop you from having the conversation; the thing people normally need the most is emotional connection. Find another time to talk, and let them know that you have learned more about self-harm. Tell them you regret how you responded to them when you last spoke about what they’ve been going through. Let them know that you want to support them and ask how you can help.

Caring for yourself when supporting someone with self-harm

Providing support to someone else can be draining. It is important to mind yourself and be aware of your own mental wellbeing. Talking to someone about how you are feeling can help. You should be realistic about what support you can offer and try not to take on more than you have the capacity to take on. Do what you can to help, and reach out to others who can support your friend such as family members, mental health professionals, teachers or other trusted friends.

For more information on supporting a friend, read our articles on helping a friend with depression and tips for being a good listener.

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