Tips on some very difficult conversations
It isn’t an easy topic, self-harm. Out of all of the mental health-related difficult topics, it’s pretty high up the list there. Consider it for a moment, how do you feel about talking to someone about self-harm? It isn’t something that comes up often, but if a loved one came to you with questions or needing advice, how would you handle it? If it’s something you have experience of, you might feel fairly comfortable with it, but if you don’t, you may feel a bit lost.
It isn’t possible to prepare for all eventualities. If I could prepare you for them all, I would, but I’m just a stranger on the internet who (unfortunately) knows a lot about this. One thing that might be more important than what you do say, might be what you don’t.
Don’t: ever tell someone to ‘just stop’ self-harming. There are good reasons why people self-harm. Though it might not be a positive behavior, it is coming from a place of self-preservation. If you try to just take it away, without offering all of the necessary support and talking through different, more healthy, coping mechanisms, you’re all going to be disappointed. That’s how my parents dealt with it when they found out. They told me to stop, that it upset them, threatened to punish me for it, and told me to ‘come talk to us when you’re feeling stressed’. The result? I continued to self-harm on a regular basis, struggled with depression and anxiety way into my late twenties, and never talked to them about that stuff again.
Do: talk about other coping mechanisms. Ask, and most importantly, listen to the reasons behind it. Don’t rush to offer solutions right away, take the time to learn more about it, especially specific to them. When you’re both ready, have a conversation about other coping mechanisms. It would be highly unusual if talking about it in the moment of feeling the urge actually helped, so you’ll be talking about things like holding ice cubes tightly in their hands, drawing on their skin, or flicking an elastic band around the wrist. Bear in mind that they may have tried some, or all, of these in the past, to varying degrees of success.
Don’t: No matter the level or type of self-harm you’re dealing with, never try to describe the wounds as though there is a scale. It is a fact that the depth of a cut, the amount, or the color of burn scars do not correlate to the emotional distress that was felt in the moment of the act. If your loved one is self-harming, and to you, it looks as though the cuts aren’t ‘deep’, don’t ever refer to them using words like ‘superficial’. Although this is a factual description, it can have a terrible effect. To describe wounds as superficial tells the self-harmer that 1) it isn’t that bad, so there isn’t cause for concern, 2) they aren’t a ‘real’ self-harmer, 3) the most dangerous one — they need to do something more extreme to be understood and taken seriously. This one is from my own experience as well as things I’ve seen at work. My GP took one look at my cuts and said ‘Ah, just superficial ones then.’ I knew what he meant, it was a medical and practical way to describe them. Except that the moment he said it, I thought ‘I’ll show you superficial!’ What followed are the only scars I still have several years later.
Do: Express your love and support. Make sure to tell your loved one that you care about them regardless, and any unpleasant emotions or reactions you’ve shown are out of fear or concern. It is common to feel ashamed of acting on the urge to self-harm, it’s not like we don’t know we shouldn’t do it, or the dangers and how much it can hurt people who care about us. That’s how strong the need is — none of that matters in the moment. So be as supportive as you can, remain open, keep the communication going. This isn’t a one and done conversation. That is something that I never had and I know it would have made all the difference.
Do: Make sure that you have support too. It’s upsetting to hear that someone you love is feeling so down or anxious that the only way they can cope is by hurting themselves. It’s also not easy and can be draining to help someone who needs it. So make sure you get the support that you need too. You’ve got this.