What can you do if you or someone you know is self-harming?

Self-harm (Self-injury) can often be a subject that is difficult to talk about or that is very scary to find out that your friend, child, partner is doing. A key thing to remember is that self-harm is not in itself an indication that someone may be having thoughts of suicide.

At its core, self-injury is often an outlet, or coping mechanism for dealing with intense and overwhelming emotions. There is not really a standard definition of the behaviour, as it can look like almost anything.

Rather than talk in a great deal of depth about the behaviours and their roots, I think it’s better to explore the options and alternatives that are available to anyone who may be struggling, or for those who are trying to support someone. The key to managing harmful behaviours is finding an alternative, more positive outlet, while helping the intense feelings to pass – these techniques can be very helpful but are not a replacement for therapy or counselling. If you are struggling with self-harm, you should try to speak with a mental health professional if possible. If you are supporting someone who is self-harming then you should encourage them to speak with a professional, however do not push or force them to do so.

Some specific techniques/alternatives

• Use a relaxation technique such as 4-7-8 Breathing or Grounding and a timer (egg timer or on your phone) – often the most intense urges will pass if you just give it a few minutes. Even if you do end up engaging with self-harming after a few moments, you still managed to sit with the feelings and each time they arise, you can slowly build the time up until the feelings do begin to pass.
• Hit a pillow or cushion – as we have already talked about, self-harm is often an outlet or coping strategy to manage an overwhelming emotion. Hitting a cushion can be a great way to safely release some of this energy in a short and intense manner.
• Scribble on a piece of paper – Really scribble, don’t think about it. Just put the pen/pencil/crayon on the paper and just scribble for 1 minute. This is a really simple and expressive way in which you can release energy, you may find that you want to keep these scribbles (or scrunch them up and throw them away if you want!) as each one will be a reflection of what you are feeling in a given moment – try scribbling when you’re feeling other kinds of ways too and compare them.

The aim of all of these techniques is simply to give your feelings an outlet and to allow some time to pass. This may sound simple, but it is a fundamentally good way to approach self-harm. This is because it teaches you alternative coping strategies, whilst also building confidence as you are able to increase the time that passes before you do, or don’t, engage with a self-injurious behaviour at all.

If you do still harm yourself after trying a technique or allowing time to pass, this does not mean you have failed.

Start small and build up slowly. It is difficult at first and we all slip backwards at times. This is ok. Acknowledge that you are trying your best and are still moving forwards.

We can all help by enabling those close to us to feel safe speaking to us about how they are feeling, or if you are struggling with your emotions, I would encourage you to speak with a close friend or family member about this. Sharing how we are feeling and supporting each other is how we can resolve any issues before they become more serious.

If someone approaches you to talk about how they are feeling, you do not always need to jump in and try to find solutions, often people just want to feel heard and all you need to do is acknowledge what they are saying and let them know that you are there for them. It’s also important not to push someone to talk or ask too many questions. You may not fully understand what they are telling you, but that’s ok. If you are unable to support someone then you can direct them to one of the following services, or if you feel they are in immediate danger you can call:

• Your GP
• Community Wellbeing Service (for people aged 16 and over) – Tel: 642540
• Samaritans – Tel: 116 123
• The Crisis Response & Home Treatment Team (If you are concerned that someone is at immediate risk) – Tel: 642860
• Emergency Services – Tel: 999

Further information, support and apps:

• Calm Harm – Provides tasks to help you resist or manage the urge to self-harm.
• Mind – Self-harm: helping yourself now
• Harmless – Self-harm coping strategies

Some recommendations from the NHS:

• Try talking about your feelings to a friend, family member, trained volunteer or health professional. You could contact Samaritans, call: 116 123 (free).
• Try working out if feeling a certain way leads to your self-harm – for example, when you’re feeling sad or anxious you could try expressing that emotion in a safer way
• Try waiting before you consider self-harm – distract yourself by going out for a walk, listening to music, or doing something else harmless that interests you; the need to self-harm may begin to pass over time
• Try calming breathing exercises or other things you find relaxing to reduce feelings of anxiety
• Write down your feelings – no one else needs to see it
• Read about mental health and wellbeing – including help for common feelings such as stress, anxiety and depression
• If you struggle with suicidal thoughts, it may help to make a safety plan to use if you need it – the Staying Safe website has a guide on how to make a safety plan

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