What to say to someone who self harms

If someone close to you tells you they self-harm, or you spot the signs yourself, it can be difficult to know how to respond. The experience can stir up a lot of emotions, like shock, fear, worry, guilt and anger. Trying to support the person while managing your own feelings can feel overwhelming. 

In this factsheet, you will find guidance on how to best support someone who confides in you about self-harm.

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 or loved one 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.

Check if they need immediate medical support

Unless a person is in need of urgent medical intervention, it may not be helpful to ask them about their injuries or scars. It’s important to remember that not all forms of self-harm leave visible marks as you might expect. 

Instead of focusing on the physical consequences of self-harm, allow the person to speak about how they’re feeling. When the time is right and if it feels appropriate, you may check in with the person to see if they have any injuries that require medical treatment. 

If the person is badly injured or has revealed that they have a suicide plan, it is critical that you get them immediate medical help. However, it’s best to inform the person involved before seeking help from emergency services.

Read more about what to do in a self-harm emergency.

Avoid blaming the person for self-harming

If someone tells you that they self-harm, you may feel upset or angry. You may be confused as to why the person is self-harming. Try to put your own anxiety and negative judgments to one side, and focus on having an open, supportive conversation. 

Learning more about self-harm and why people self-harm can help. Some people use self-harm as a coping mechanism. A coping mechanism is a pattern of thoughts or behaviours that a person uses to manage stress. It can be really difficult to stop using a coping mechanism if you don’t have an alternative yet. This is why it can be challenging to resist urges to self-harm, even when you want to.

Avoid blaming the person for self-harming, implying that the person is merely looking for attention, or pressuring the person to stop. 

It is also best to avoid giving ultimatums or telling someone what to do. Instead, do your best to stay calm, avoid expressing negative judgments, and acknowledge their emotions.

Listen

Talking about self-harm can be difficult, especially if you haven’t done it before. Give the person sharing the time and space they need to express themselves at their own pace. They can choose what they feel comfortable sharing, and if there are certain things they’re not ready to talk about, try not to pressure them. 

It’s important not to be intrusive or insist that the person shares everything about their self-harm with you. If you have a lot of questions, consider setting these aside for now and letting the person who is sharing guide the conversation. 

Samaritans has a list of tips that can help you be an active listener during especially difficult conversations. A helpful way of bringing these to mind is by remembering the word SHUSH:

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

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 to focus on why the person is self-harming and how they are feeling. There are many different reasons why a person might feel the need to self-harm and viewing their actions in the context of potential environmental stressors and psychological difficulties can sometimes be helpful. 

Rather than trying to stop the person from self-harming or solve the problem immediately, talk to the person about what may be leading them to self-harm and how you might support them to better cope during this difficult time.

Offer support

Let the person know that you are committed to supporting them and that they are not alone. Individuals in distress rarely reach out to loved ones with the hope or expectation of being ‘fixed.’ The person who is self-harming is most likely looking for someone to listen and offer compassion. 

Discuss next steps together

You may think you know what the next step is, but it is important not to offer solutions without asking the person what they would like to do. Ask them if they would like immediate help or professional support, and if so, suggest getting in contact with their local GP or a support service.

If the person who is self-harming does not want to take any immediate action, ask 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. 

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 or whether they would like to talk can make a big difference. Following up in this way lets the person who is struggling know that the door is always open.

What can I do if I regret how I reacted?

When a person lacks an understanding of self-harm and why people self-harm, they may respond in unhelpful and even harmful ways without realising it. Some people may criticise, set rules for, or try to restrict the person who is self-harming from repeating the behaviour. They might also threaten to withdraw from the person if they don’t stop self-harming immediately. 

While these reactions may come from a place of fear, they are unlikely to help the person recover or heal.

If someone in your life opened up to you about their self-harm and you now regret your initial reaction, give yourself permission to forgive yourself. Even if your initial response was unhelpful, you are taking a positive step towards supporting your loved one by seeking more information on the topic.

What matters most is listening to the person who is self-harming and letting them know that you are there for them. Try not to let your fear of saying the wrong thing stop you from having another conversation. You might find another time to talk, let them know that you regret how you responded, and ask them how you can help.

Caring for yourself when supporting someone with self-harm

Providing support to someone who is in distress can be draining. It’s important to mind your own mental wellbeing throughout the process. Talking to someone about how you feel can be helpful. When you know what support you can offer and understand your limits, you are more likely to avoid doing more than you are able. Do what you can to help, but where appropriate, it can be a good idea to reach out to others who can provide additional support, such as close friends, family members, mental health professionals, or trusted teachers.

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

Samaritans, in partnership with young people with lived experience, have developed a short video with recommendations on the topic.

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