Family and Friends
What to Say
"I don't know how to be your friend. Please help me."
It's okay to admit this, and it's much better to say something like this than to pretend that you know exactly how to fix everything.
"Is there a way I can help you get through the crisis times?"
If you have a good relationship with the person who's self-injuring, you might offer to do what you can when she's really struggling. Some self-injurers find it helpful to talk with someone else about what they're feeling; others prefer to do something different to distract them. Either way, reaching out to someone else is a great way for a self-injurer to make it through difficult times without self-injuring.
"I'm so sorry you're hurting so much inside."
The injuries are secondary. What's more important is the fact that the self-injurer felt that she needed to do those things. It's better to acknowledge that she was hurting inside than to focus on the visible scars.
"Can you help me learn more about self-injury?"
A question like this would indicate your willingness to learn about her struggles. If she doesn't feel comfortable talking to you about it, perhaps she would like to recommend a book or a web site.
"How can I pray for you?"
If you mean it. This is one of many ways to let a person know that you care.
What Not to Say
"Why don't you just stop?"
It's not that easy. Self-injury is a coping skill, a way to deal with life, and it takes time and work to learn new coping skills. Your friend wouldn't be self-injuring if she had other ways to deal with the things going on in her life.
"You shouldn't be doing this. Your life isn't that bad."
You may not know all of the story. Even parents can sometimes be unaware of the difficult things their daughter may be dealing with. What matters, though, is that the person who's self-injuring is struggling somehow. From her point of view, something is going wrong. You can help her most by respecting this fact, and by supporting her as she fights through this.
"It's all your fault that this family is falling apart."
This is illogical: everyone who belongs to the family (except for babies and young children) is responsible for how the family functions. The self-injurer may be a convenient target of blame, especially if her problems are the most visible, but she is not the sole source of family problems.
"I could never do that to myself."
You may never have cut yourself on purpose, but you've probably had times when you were under a lot of stress and did something you're not so proud of now. Even if you can't imagine self-injuring, you can probably imagine doing something out of desperation to survive a really difficult time. When you look at it through that lens, it's not so different after all.
"I couldn't do that--it would hurt too much."
Actually, many self-injurers feel little or no pain when they self-injure.1 The body makes endorphins, a natural painkiller, causing the self-injurer to feel less pain than a person would normally feel from such injuries. Note that at other times--when receiving stitches, or from an accidental injury--self-injurers are certainly capable of feeling pain, just like anyone else.
"That's so gross."
So are most problems. We're not trying to justify self-injury--self-injurers tend to agree that it's unhealthy and generally not a good thing to do.2 On the other hand, even though self-injury is not good, one should acknowledge that the self-injurer has come up with a way to deal with life when there seemed to be no other way. Try to respect the fact that your friend is dealing with some difficult issues, and that, for now, this is her way to cope.
"You're just doing it for attention."
If your friend were purposefully showing her scars in order to try to get someone to change his or her behavior, one could make a case that she is doing it partially for attention. Most self-injurers, however, keep their scars carefully hidden and avoid telling others about their self-injury, behavior indicating that attention is low on their list of priorities.3 Jan Sutton characterizes self-injury as "attention-needing" rather than "attention-seeking," meaning that self-injurers are not trying to seek attention by their behavior but rather that they are in desperate need of it.4
What to Do
First of all, educate yourself about self-injury. I can't stress enough how important it is to learn about what your friend's dealing with. The info page on this site is a good starting point, and the book reviews page and links page will guide you to additional resources. If she's a Christian, you might also encourage her to read some of this site's Christian resources.
Show her that you care. Send her a card in the mail when she's not expecting it, or put a kind note in her locker, or do something else to remind her that you do care about her. Sometimes the Lord works it out so that your gesture of kindness comes right when your friend really needs a reminder that someone cares.
Show her what Christ's love is like. You can't threaten a person out of self-injury, but sometimes you can love a person out of self-injury.
Let life proceed normally, as much as possible. If you're her family member or roommate, don't watch her all the time. Be sensitive to her desire for privacy, and let her have some semblance of a normal life.
Encourage her to get into counseling. You don't have to fix all her problems herself, and you may hurt your relationship if you try.
At least 60% of self-injurers have been abused.5 If your friend is one of them, learn about flashbacks. If you're with her when she starts having vivid, emotional memories of the abuse, you can help her to ground herself--to get back to the present. Help her remember to splash cold water on her face, or stamp her feet on the ground, or do something else that involves sensation. This can help her to realize that even though the memories are vivid, those events are in the past.
Understand that change takes time. If someone has been self-injuring for three years, it's unlikely (although not impossible) that she'll stop overnight. Stopping isn't just ending the behavior; it's replacing it with other things, which is much more difficult.
What Not to Do
Don't call it "self-mutilation." Although this is the term used in much of the literature, many self-injurers find this term derogatory and insulting. "Self-injury" and "self-harm" are better terms to use, or you might take your cue from the way your friend refers to it.
Don't threaten or give ultimatums. The fact is, you can't threaten someone out of self-injury. The threats will create more stress, which will increase the person's desire to self-injure. If they do manage to avoid self-injuring, they may use another unhealthy coping skill instead: anorexia, bulimia, alcohol, or drugs, for instance. Threats rarely produce lasting and healthy change in a person.
Don't avoid your friend, or act like who she is has changed. Even though your friend is using an unhealthy coping skill, there are a lot of things about her that are still the same. Don't act like she's turned into some sort of alien, or like her self-injury is the only thing about her that matters.
Don't go berserk. As hard as it is to do, the best thing you can do is react (somewhat) calmly.
Don't make her show her scars, especially if you already know that she's self-injuring. Body privacy is very important to self-injurers, and forcing someone to show her scarred forearms may humiliate her as much as a strip-search would. If she doesn't want to wear short sleeves or a swimsuit, don't pressure her to do so--it may be easier for her not to self-injure when her scars are covered. (In fact, since clothing is a real concern for many self-injurers, I've assembled some links of long-sleeved clothing and swimwear on the links page.)
Don't avoid the topic of self-injury. No, you don't need to talk about it all the time, but you should be willing to listen to her if she brings it up. Let her know that you're comfortable with talk about self-injury. (Reading some informational materials, such as this site's info page, will help you become more comfortable with the subject.)
- Karen Conterio, Wendy Lader, and Jennifer K. Bloom, Bodily Harm: The Breakthrough Healing Program for Self-Injurers (New York: Hyperion, 1998), 55.
- This conclusion comes from the author's own experience and from her experience interacting with self-injurers.
- See, for instance, the stories in Deb Martinson's quote archive at http://www.palace.net/~llama/psych/quot.html
- Jan Sutton, Healing the Hurt Within: Understand and Relieve the Suffering Behind Self-Destructive Behavior (Oxford: Pathways, 1999), 20.
- Armando R. Favazza, Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry, 2nd ed. (Baltimore, MD: Johns Hopkins University Press, 1996), 266; Marilee Strong, A Bright Red Scream: Self-Mutilation and the Language of Pain (New York: Penguin, 1998), 64.
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