For many people who self-harm, the act of harming themselves is something they try to keep secret. Adolescents hide their self-harming from teachers, friends and family, while adults may have partners, friends and workmates, and in some cases their children, from whom they hide their self-harm. Some people may have one or two close friends who know that they self-harm, but in many cases family and friends might only suspect that something is going on with their family member or friend or be completely unaware.
While there are obvious signs that someone is self-harming, such as exposed cuts and burns, and overdoses that require intervention, there are some less obvious signs that someone may be self-harming.
Some factors that can predispose people to self-harm include:
Finding out that someone you care about is hurting themselves is tough. Many people can’t understand why someone would want to hurt themselves. It’s hard not to take it personally and wanting to convince the person to stop.
Here are some tips for helping someone who self-harms:
SEEK SUPPORT OF A HEALTH PROFESSIONAL – Self-harm is a complex behavior that may go on for a long time. It is important that you have the support and advice of a health professional.
DON’T TAKE IT PERSONALLY – When people self-harm, they don’t do it to intentionally make you feel bad or guilty. Even if it feels like they are trying to manipulate you, that may not be the reason they self-harm.
MAKE A PLAN – If you’re able to, sit down with the young person and make a plan about what to do if he or she feel like self-harming or has self-harmed. This might make things feel safer for you and the young person. This may also reduce the ‘secrecy’ around the self-harming and make the young person feel supported. If in doubt, talk to a health professional.
BE SUPPORTIVE AND REMAIN CALM – Often, people react by making a big fuss about the self-harm and become upset, angry or both. This may make the situation worse as the young person is already trying to cope with his/her own emotions. They may then self-harm in secret because they fear your reaction. In a calm voice, ask the young person if he/she want to talk – this leaves the control in their hands about this. Make the initial approach but don’t push them.
Being supportive doesn’t mean you’re saying the behavior is OK – it’s saying that you want to be there for the young person to help him/her. You might start by saying, “People hurt themselves when they are feeling bad. Do you want to talk to me about it?”
DON’T TELL THEM NOT TO DO IT – A normal reaction to self-harm is to tell the person not to do it or that it makes you feel bad. This often leads to the young person feeling guilty and they may start to hide their self-harm so you don’t feel this way.
TAKE CARE OF YOURSELF – This is really difficult! You will need time to adjust. Make sure you are taking care of your own needs, as well as those of the person you care about. The more you are able to relax, the easier it will be to deal with the self-harm.
BE CLEAR ABOUT WHAT YOUR LIMITS ARE – Most people feel completely out of their depth when it comes to self-harm. It’s OK if you feel uncomfortable with it and it’s ok if you don’t feel able to talk about it. Let the young person know this and together seek out the assistance of a health professional such as a psychologist, psychiatrist or counsellor (see also the page “where can I turn to?”).
TRY TO UNDERSTAND WHY THE YOUNG PERSON IS SELF HARMING – Some people feel sick at the thought that someone they know is hurting themselves. Try to understand what the issues behind the self-harm are and how you can support that young person to find different ways of coping.
Suicidal behaviors may occur when there is a situation or event that the person finds overwhelming, such as:
Risk factors for suicide in teenagers include:
Often, but not always, a person may show certain signs and behaviors before a suicide attempt, such as:
If the person tells you about his or her suicidal thoughts the first step is to listen. This might be scary, but a patient, non-judgmental listener, can be a great help for a person in distress. Validate the pain the person is feeling. By that you are validating their experience, not the act of suicide.
The next step is to seek help, work with the person to find the help they need. Suggest to them to call the crisis line (1717), use the webchat www.1717.is and/or offer them to book a time with a psychologist, psychiatrist or another mental health professional. If the person is an immediate threat to themselves, accompany them to the emergency room of the psychiatric department or call the emergency services 112.
If a person displays some of the warning signs and you suspect that they might be a risk to themselves but they have not discussed it with you yet, ask. Be direct, but non-accusatory or judgmental. Some people are afraid of bringing up the topic of suicide or suicidal thoughts and think that it might give the person ideas. There is however no evidence that talking about suicide increases the risk of suicide. On the contrary, talking about it, listening and showing support have been shown to be a protective factor for people having suicidal thoughts.
Do not try to argue with the person having suicidal thoughts. They most often feel isolated, alone and/or misunderstood. Arguing, shaming or getting angry at them only supports that believe. Showing support, empathy and understanding, is the greatest gift you can give and could save a life.