Whether you suspect a loved one is self-harming or they’ve opened up to you about it, knowing what to do next can feel tricky. Here, we explore some essential ideas on how you can be there for them

The act of self-harm, when someone intentionally hurts themselves, is often shrouded in shame and stigma. A lack of understanding from others, combined with a deep psychological pain from within, makes it difficult to bring out into the open. It’s often done in secret, with the self-harmer going to great lengths to hide what they’re doing. Lies become second nature for many – I remember blaming everything from a drunken stumble, to my cat for my scars (sorry, Tigger).

Like most things steeped in shame, the key to overcoming it is releasing it – telling someone what’s going on and admitting you need help. This can be difficult though, and the role of loved ones can’t be underestimated. Whether it’s to give the gentle nudge someone needs to reach out for help, or simply to be a listening ear as they navigate recovery, your support could be integral. If you’re keen to be there for someone who’s self-harming, learning about self-harm is your first step.

Understanding self-harm

It can be difficult to comprehend why someone would want to cause themselves pain, but being able to support someone in this position requires you to educate yourself on self-harm. Lukas Dressler is a psychologist and integrative psychotherapist who supports children, adolescents and young people with a range of concerns, including self-harm. Noting the stigma attached to this issue, Lukas encourages us to recognise self-harm for what it truly is.

“If you suspect a friend or loved one might be self-harming, and you want to encourage them to talk about it, you must understand that self-harm is usually a coping mechanism,” Lukas says. “Deliberate self-harm is most often carried out in secret, so the stigma of it being ‘attention-seeking’ or that it’s ‘the behaviour of a drama queen’ seldom applies.”

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What can I do if I suspect a loved one is self-harming?

When it comes to broaching the subject of self-harm with someone you love, it’s important to do so in a way that will help them open up, rather than retreat. Therefore, Lukas says your attitude towards the conversation is key.

“If you hold a non-judgemental, open, and supportive attitude, and genuinely want to support the person who might be self-harming, they will be able to feel this. Your compassionate attitude will put them at ease, and encourage them to open up.”

As well as having a supportive approach, Lukas notes you shouldn’t be afraid of addressing the topic head-on, as long as you do so in a calm and compassionate manner.

“If you want to do this, try to create a situation where you genuinely believe the other person will feel safe and comfortable to open up,” Lukas says. “You might then say something like: ‘I have been worried about you. Can I ask you if you have been self-harming?’ Self-harm often occurs with feelings of shame and guilt, so they may not open up straight away. Patience, compassion, and kindness are key.”

What can I do if a loved one has opened up to me about their self-harm?

Whether you’ve been the one to encourage them to open up, or they’ve come to you on their own, when this happens it’s an incredible step. Lukas suggests acknowledging that opening up is brave, and explaining that you’re there to listen and support.

“And this is exactly what you will then do. Provide a safe and non-judgemental space for the other person to open up. You can also ask them: ‘Do you know if there is something I can do to help? What do you need from me?’”

Because deliberate self-harm is often a sign of underlying mental health difficulties, Lukas highlights the need for professional input.

“Ask the person if they would like support from you in finding a professional to talk to. Please do not feel that it is your responsibility to help them stop self-harming.”

You could offer to accompany them to a GP appointment, or help them find a private therapist online. You could flag resources such as harmless.org.uk (a Community Interest Company supporting those who self-harm and their loved ones), and nshn.co.uk (an online support forum related to self-harm).

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How can I be there for them during their recovery?

When your loved one is in recovery from the underlying cause of the self-harming behaviour, Lukas says ideally you’ll receive advice from their mental health professional on how to continue supporting them.

“Generally speaking, continue to be kind and supportive. If you know of some of their non-harmful coping strategies, try to support them in using those,” Lukas says. “Be patient and allow the person to process what they’re going through at their own pace – with their professional support in place. Provide as much of a safe haven to talk to as you are comfortable with.”

"Whether it’s to give the gentle nudge someone needs to reach out for help, or simply to be a listening ear as they navigate recovery, your support could be integral"

It can be helpful to also bear in mind that recovery is rarely linear. As tempting as it may be to think that once they have professional support in place, everything will be OK, unlearning these coping strategies can be tough. Relapses may happen and this can feel frustrating, but remember your loved one is doing the best they can. As Lukas says, patience is paramount.

Taking care of you

Throughout all of this, it’s important to ensure you’re taking care of yourself. It’s admirable to support others going through a difficult time, but you can’t underestimate how the situation affects you. In order to truly be there for them, Lukas reminds us that making sure we’re looking after ourselves is just as important as helping others.

Try to check-in with yourself regularly, and ask yourself what you need. Remember, there is support available for friends and family of those who are self-harming – you may find it helpful to join a support group and chat with others in a similar boat. Carve out space for self-care, and keep in mind that this ultimately helps you be a better support.

Being in this position is difficult for everyone involved. Therefore, treating both yourself and your loved one with radical kindness is essential. Having these difficult conversations, releasing the shame, and bringing our dark parts into the light, is how we heal. So keep talking, keep supporting, and keep shining that light.


To connect with Lukas, or further information on self-harm at counselling-directory.org.uk