How to help a loved one who’s self-harming

If there’s a loved one in your life who’s self-harming, there are many ways you can help them. Research shows that social support is one of the most protective factors for buffering against self-harm. Teens who feel more supported by their parents are more resilient against self-harm. The support you offer your loved one who’s self-harming could make a big difference.

At the same time, it can be frightening, frustrating, or confusing when you know or suspect a loved one is hurting themselves. It’s important to equip yourself with the right information so you can offer support and take care of yourself. Additionally, a therapist or crisis counselor can help you navigate this process.

Signs someone might be self-harming

When you know the signs that someone may be engaging in self-harming behaviors, you may be able to connect a loved one with the support they need faster. Watch out for these signs: 

• Having unexplained cuts, burns, or bruises: Marks like these — especially on areas like the wrists, arms, thighs, or stomach, which can be easier to hide — could be a warning sign.
• Wearing long sleeves or pants in warm weather: These can be used to cover up injuries, even when it doesn’t make sense for the temperature. Further, they might refuse to go swimming, change in front of others, or engage in activities that require short sleeves.
• Being more “clumsy”: They may blame injuries on being clumsy, scratching themselves, or other vague explanations.
• Collecting sharp objects: They might keep items like razors, scissors, lighters or matches, or glass fragments and express anxiety when you question them or take the objects away.
• Increasing isolation: Increased isolation or secrecy can be a sign that they’re struggling and don’t know how to talk about it.
• Expressing self-hatred or worthlessness: They may make comments about feeling like a burden or hating themselves. These can be warning signs of self-harm or other mental health concerns like depression.

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What to do if you suspect self-harming behavior

Often, people who self-harm try to hide it. This could be because of shame or fearing judgment and rejection by others. So, if you suspect your loved one is self-harming, you might need to initiate the conversation. 

Don’t ignore the signs of self harm, as it’s unlikely to stop on its own. Self-harm can be scary to deal with, but remember self-harm is considered nonsuicidal self-injury (NSSI). That is, someone who’s self-harming  isn’t harming themselves with the intent to end their life. However, NSSI can still be life-threatening,* and if you have concerns about their safety, it’s important to take immediate action. 

Dialing 988, the Suicide and Crisis Lifeline, or getting in touch with a mental health professional can help you support your loved one and provide next steps to keep them safe.

*The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. If you’re experiencing a life-threatening emergency or you need immediate help, please call 911.

Talking to your loved one about self-harm

When you start a conversation about self-harm with your loved one, it might bring up mixed emotions for you both. They might be relieved, but they could also feel ashamed. You may also be struggling with your own emotions around this topic. 

Here are some tips:

• Get support for yourself. It can be difficult to know your loved one self harms and may bring up many thoughts and feelings for you. Take time for self-care and emotional support before and after you meet with your loved one. 
• Choose an appropriate time and place for talking. It’s best to talk in private and in a place where your loved one feels safe. Don’t corner your loved one, and approach the topic gently (but directly), so as to not make them feel ambushed. It’s typically not recommended to do an “intervention” that involves multiple people, especially at first. Your first step should be a private and honest conversation.
• Keep the conversation centered on your concern for your loved one. Be direct about self-harm. You might say something like, “I’m going to be direct here: I noticed some cuts on your arm the other day, and I’m worried you’re self-harming. I’m not judging you; I just want to support you. How have you been feeling lately?” You can also ask them directly, “Are you hurting yourself?”
• Be patient but persistent. It can be tricky to find a balance between respecting your loved one’s autonomy and protecting their safety. Even if they’re reluctant to talk about self-harm, don’t completely abandon the conversation. Don’t pressure them or become angry with them, but continue bringing the topic up and offering your support. You can say something like, “I want to be respectful of what you’re telling me and where you are. Would you mind if I checked in with you every so often, even to discuss feelings? I want to go at your pace.” 

Responses to self-injury that may not be helpful

Avoid saying or doing anything that could make your loved one feel even more ashamed, judged, or criticized for self-harming. Some examples of what not to say include:

• “Why would you do that to yourself?” Even if these types of statements can be well-intentioned, it can come across as judgmental or critical.
• “If you don’t stop self-harming, I’ll… ” Ultimatums like this are often a sign of desperation, but they’ll only make your loved one feel even worse — and become even more secretive about their self-harm.
• “Just stop.” Try to understand that self-harm traps people in a vicious cycle that can be hard to stop. They may need professional support to escape the cycle. 
• “Nothing’s wrong, You just want attention.” Avoid responding in any way that makes your loved one feel dismissed or invalidated.

It can be frightening when you suspect your loved one is self-harming, but allowing fear to dominate the conversation isn’t helpful. In one review, young people reported that emotionally charged responses to their self-harm from parents and other adults were unhelpful and can often even make things worse. Take a deep breath, and approach the conversation in a calm and sensitive manner. 

Four ways to be there for someone who self-harms

Having the initial conversation is only the first step. Recovery from self-harm can take a long time. It’s important to keep following up with your loved one and offering continuous support. 

Refer to professional services

One of the most impactful ways you can support your loved one is by referring them to professional mental health support. Your presence and support are critical during this time, but this issue also requires professional guidance. You can help them find and connect with helpful services while keeping in mind that they may not be ready to receive help right away.

Keep the conversation open

Your loved one will continue to need your support long after the initial conversation. Regardless of what their reaction was when you first talked with them, let them know that you’re available to talk. 

Continue to check in with your loved one — especially after you know they’ve been in stressful or triggering situations. If they’re comfortable, ask them directly whether they’ve self-harmed since your last conversation, and discuss how you can help them avoid it next time.

Understand (and don’t judge) relapse

Relapse is often a part of self-harm recovery. If they relapse, don’t judge or criticize them for this. The journey of self-harm recovery isn’t always linear, and your loved one can get back on track with the right support. 

Ask directly how you can help

Teens who self-harm have reported it’s helpful when their parents ask them how they could support. So don’t assume you know what your loved one needs. Instead, ask. Do they need you to just listen? Do they need you to keep them company to distract them when self-harm urges come on? Would they like to be taken to a hospital? All of these responses are possible and valid.

Find care with Rula

It can be frightening when your loved one is self-harming, but having the courage to offer support can be an essential part of their recovery. You don’t need to navigate this on your own. By contacting a therapist or a crisis counselor, you can take care of yourself and offer support in the most effective ways. Further, working with a therapist can help your loved one understand the root of their self-harming behaviors and discover healthier coping mechanisms. 

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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