Dealing with self harm

Dealing with self-harm People injure themselves for many reasons. It can replace emotional distress with physical pain. Many people say that when they cut themselves they experience a release of tension and so they often feel calmer.

In a strange way self-injury may help people feel that they can achieve some degree of control in their lives. Self-injury is very often not a suicide attempt; however people who do self-harm are at a greater risk of suicide than the general population due to their high risk behaviour so should not just be seen as “attention seekers” or “manipulative”

Relatives, friends or professionals trying to help the person can find it very stressful, especially when the person does not want to talk about or explain their behaviour. It is easy to feel “shut out” and just left to pick up the pieces when in crisis.

If someone we care about is deliberately damaging him or herself and not willing to let us help we feel isolated and powerless. The person usually has very low self-esteem and poor self-worth, or they may be in a state of psychosis, and they think that others will see them in the same light and be critical of them.

There are therapies that can be used that have been shown to be effective in breaking the negative cycle. Useful pointers:-

  • Respond to an incident of self-harm in the same way that you would for an accident. Give first aid as you would for any physical injury
  • Do not assume that the person either enjoys or does not feel pain. A response which implies criticism or some form of punishment simply reinforces the persons feelings of guilt and self-blame
  • Acknowledge the persons distress – say something like “I can see you are very upset. How can I help you?” This is reassuring to the individual and gets a rapport going
  • Aim to be positive and comforting rather than negative or emotional. This can be hard to do but do not show annoyance or criticism.
  • Don’t promise everything will be ok. Acknowledge there is a problem but reinforce there is help available
  • Try to have a contingency plan in place in times of crisis so you know what to do. This can help reassure you.
  • If you think someone is suicidal as there is a change in usual behaviours let someone know.

You can contact the person’s care co-ordinator or contact an emergency crises team. The contact details of any crises contact should be documented in a crises and contingency plan. The information provided to assist you in managing difficult situations is a guide only and we would encourage to seek help at the earliest opportunity if you feel in danger or your loved one is at imminent risk.