What To Say To Someone Who Self-Harms

It can be challenging to talk about self harm, especially if it's with someone you love. Learn how to navigate this conversation with care and compassion.

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This post discusses self-harm and other types of self-injury. If you or a loved one are struggling with self-harm or are experiencing a mental health emergency, please call or text the National Suicide Prevention Lifeline at 988.

Self-harm is a serious and dangerous action that often stems from poor mental health. It can leave the individual feeling shameful, embarrassed, and alone due to the stigma surrounding discussing it. To that end, arming yourself with all the information and knowing how to talk to someone engaging in self-harm can make a big difference.

Here’s what you need to know about identifying self-harm and speaking to loved ones about it.

What to say to someone who self-harms

Speaking to someone about their engagement in self-harm is a tricky and delicate task. It also differs tremendously based on if you suspect it or if they’ve shared the information with you.

According to Samaritans, the first conversation is all about providing a calm, non-judgmental space in which you are an active listener. Be curious, not critical.” For example, avoid questions such as “Why would you do that?” or “Are you crazy?!”

Keep the following points in mind as you enter and move through the conversation.

Avoid anger and frustration

Of course, you’re upset that someone you care about is hurting themselves. But getting angry at the person about it won’t make them want to open up or accept the support they need to navigate their mental health. Instead, try your best to create a calm, open space. Acknowledge that they must be distressed and emphasize how much you care about them. 

Ask open-ended questions about their feelings

Are they especially bothered by a specific or ongoing occurrence? How are they feeling right now? They will open up at their own pace, and it’s important not to rush them into providing the answers they think you’re looking for instead of the truth. 

Don’t judge their actions

Self-harm holds a stigma, and many people may be reticent to discuss it due to fear of judgment or embarrassment. You are not looking for an apology for their actions or to shame them in any way. These things will only add to their mental burden and cause them additional pain.

Try these responses

1. "I'm here for you, and I care about you." 

Let your friend know that you're available to listen and support them.

2. "You don't have to go through this alone."

Encourage your friend to seek professional help, and offer to help them find resources if needed.

3. "I'm worried about you, and I want to help."

Let your friend know that you're concerned about their well-being, and that you want to help them in any way you can.

4. "Have you talked to anyone else about this?" 

Encourage your friend to open up to a trusted adult or a mental health professional.

5. "Is there anything I can do to support you right now?"

Ask your friend how you can help, and let them know that you're there for them.

As in any difficult conversation, try to put yourself in their shoes. What would you want to hear from your loved one? What would bother you to hear? 

This conversation can be overwhelming to have on your own. Ask if your loved one is open to speaking with you and another friend, family member, parent, or whoever they also trust. Having two people there can relieve the stress you may feel about getting everything right and show them how even more people care about them. 

It’s good to show your ongoing support and care towards someone you know who self-harms after this initial conversation. Healing is not quick or linear, and overcoming a habit of self-harm can be incredibly challenging. For young people, this comes on top of pressure from school and parents, as well as a lack of autonomy, at times, to easily explore the coping mechanisms that work best for them. It can help them to have someone in their corner as they go.

A sample conversation to have with a friend who’s disclosing self-harm

Friend 1: 

Hey, can I talk to you about something?

Friend 2: 

Of course, what’s up?

Friend 1: 

I’ve been struggling with something lately, and I don’t know how to handle it.

Friend 2: 

Whatever it is, I’m here to listen. You can talk to me about anything.

Friend 1: 

Well, the truth is that I’ve been self-harming.

Friend 2: 

I’m sorry to hear that. It takes a lot of courage to share something like that. Can you tell me more about what’s been going on?

Friend 1: 

I’ve just been feeling really overwhelmed and anxious lately, and it’s like the only way I can cope is by hurting myself. I know it’s not healthy, but I just can’t seem to stop.

Friend 2: 

I understand that self-harm can feel like a way to cope, but it’s not a sustainable solution. Have you talked to anyone else about this?

Friend 1: 

No, you’re the first person I’ve told.

Friend 2: 

I’m glad you felt comfortable sharing this with me. I want you to know that you don’t have to go through this alone. There are resources out there that can help.

Friend 1: 

I don’t know where to start, though. I’m so embarrassed about all of this.

Friend 2: 

There’s nothing to be ashamed of. Self-harm is a common issue, and there are people who understand what you’re going through. I can help you find a therapist or support group if you want. It’s important to get professional help to address this.

Friend 1: 

That would be really helpful, thank you. I just feel so lost right now.

Friend 2: 

It’s okay to feel lost, but remember that there’s hope. You’re not alone, and there are people who care about you. I’m here for you, and we’ll get through this together.

What is self-harm?

Self-harm is any act of pain inflicted by a person onto themselves. Self-harm is often associated with cutting one’s skin, but it encompasses a wide range of dangerous actions. Types of self-harm include, but are not limited to: 

• Burning
• Hitting
• Heavy scratching
• Head banging
• Piercing the skin
• Carving things into the skin, such as letters
• Drinking toxic chemicals
• Pulling out hair

Self-harm rates are exceedingly high across the United States. A study from the American Journal of Public Health looked at the number of high school-aged boys and girls across 11 states who self-harmed. The rates ranged significantly, with 6.4% of boys in Delaware and up to 14.4% of boys in Nevada engaging in self-harm. The same was true for girls but at a larger scale, with 17.7% in Delaware and up to 30.8% in Idaho engaging in self-harm.

A person will likely self-harm due to reasons such as emotional pain, to find a sense of control, or to punish themselves. 

What are the signs of self-harm? 

It can sometimes be difficult to distinguish if someone has engaged in self-harm. To this end, it’s important to keep an eye out for self-harm signs, including: 

• Excuses about new injuries
• Scars
• Frequent injuries 
• Recently wearing clothing that covers their arms and legs in hot weather
• Avoiding previously enjoyed hobbies
• Struggling with a sense of self
• Impulsiveness
• Expressing feelings of helplessness and hopelessness

These signs can indicate a person is engaging in self-harm, but each can also be a sign of something else, such as abuse by another person or a medical condition. A person exhibiting more than one of these at a time may be more likely to have self-harmed. 

If there is an emergency situation or you need additional guidance, contact a mental health organization such as the ones below. 

• The Crisis Text Line (text HOME to 741741)
• The National Suicide Prevention Lifeline (988 or 1-800-273-8255)
• The National Alliance on Mental Illness HelpLine (1-800-950-NAMI (6264))
• SAMHSA’s National Helpline (1-800-662-HELP (4357))

Receiving help for self-harm from Charlie Health

Receiving the proper care can help a person tremendously in ending self-harm. Reaching out for help is not a sign of weakness–it is an act of courage. Our virtual Intensive Outpatient Program is designed to meet the mental health needs of teens and young adults who are struggling with high-acuity mental health issues, including self-harm.Reach out today to learn more.