How can I Help a Friend who Self-Injures?

Jackie Goodman & Janis Whitlock
February 12, 2013 — 1,215 views  
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I think my friend may be injuring him/herself but I am not sure. How should I bring it up?

Suspecting, but not being sure, that your friend is injuring him/herself is a difficult situation to be in. Friends often worry about raising a clearly uncomfortable topic, risking their friend’s anger or defensiveness, or somehow violating a friend’s trust. However, it is important to remember that you may be instrumental in helping your friend get the help he/she needs. Remember, ignoring it won’t help at all. Here are a few things to keep in mind:

Don’t be afraid to talk. Studies show that individuals who self-injure wish that someone would raise the subject – even though it is uncomfortable. Even if your friend reacts angrily or defensively at first, it is important to keep doors to communication open.

Set aside a time for a private meeting with your friend. Do not approach your friend in a social situation (such as at school) or in a place that will have a lot of distractions.

Show “respectful curiosity” by inviting your friend to speak freely about his or her experiences. You can do this by asking questions such as “how does injuring help you feel better?”, “are there things that really trigger you to injure?” Not only does this allow your friend to talk about his or her relationship with self-injury while you fully listen, it can help you understand what he/she is going through and about the role self-injury plays in your friend’s life.

Share your concern with your friend by sharing what you have noticed and telling him/her that you are concerned. Let your friend know you want him/her to talk to you so you can help. Share your memories of specific times when you felt concerned about your friend’s self-injury.

•  Understand that you can’t cause your friend to begin self-injuring by raising the subject. Ifyou bring it up and your friend isn’t self-injuring,he or she won’t start just because you said something about it. Remind your friend thatif he/she ever has a problem in the future, youwill be there to help.

Let them know that you won’t judge them.

It’s also important to not show pity, as this can be demeaning, too. Be empathetic and open – listen and try to understand.

Don’t promise to keep secrets about your friend’s self-injury, or promise not to tell anyone who would assist your friend in getting treatment. Making a promise such as this could put you in a difficult position.

• If your friend still will not talk to you, let him/her know that whenever he/she is ready, he/she can come to you for support. Encourage your friend to talk to someone else if he/she doesn’t feel comfortable talking with you.

How do I best help my friend?

Be there to talk with your friend when he/she needs it.

You want your friend to know that you support him/her. The more clearly you define the ways in which you are willing to help your friend, the more helpful and consistent you will be. You will also find that maintaining clear, consistent and predictable boundaries in terms of your availability will enable you to avoid feeling overwhelmed or manipulated.

Educate yourself about self-injury. The more you know, the better equipped you will be to help your friend. You’ve already taken this step by coming to our website! Please check out some of the other pages and resources available from http://www.crpsib.com

Encourage your friend to speak with a parent, teacher, mental health professional or another trusted adult. You can offer to go with your friend to get help or talk to someone for him/her.

Help your friend find alternatives to self-injury. You can find some really useful ones or go to:http://www.crpsib.com/factsheet_coping_alternatives.asp

Support positive steps. Anything your friend does towards getting help should be positively reinforced such as, “I’m glad that you went and spoke to someone.”

Carry on normal activities. Don’t let this revelation about your friend change how you interact – that will only serve to turn him/her off to getting help.

What if my friend asks me not to tell anyone or rejects my help?

Your friend may ask you to keep his or her self-injury asecret. Let them know that this is very difficult for you todo and that it is much more important for him or her toget help. Tell your friend that he/she deserves to feel better.Sometimes people may be embarrassed that they self injure,and that is why they don’t want anyone to know.Let your friend know that there are people who can helpin a non-judgmental way. If your friend rejects your help,remember you are not a failure! Be patient. Sometimespeople aren’t ready to get help. You cannot force someone

to stop. Help your friend understand how important it is that he/she gets help and encourage he/she to talk to someone.

What if my friend becomes angry with me or stops talking to me?

Fear of betraying a confidence or trust and of angering or losing a friend is a common barrier to getting help for a friend. It is really important to know that although your friend may get mad at you, his/her safety is more important than privacy or anger with you. In every interview we have conducted in which a person told a trusted adult about a friend’s self-injury, the person self-injuring was ultimately glad – even if he or she was angry at the friend at first.

What do I do if my friend is living with his or her parents or legal guardians?

If your friend is still living with parents or legal guardians, consider talking to one of his or her parents about your concerns. If you don’t feel comfortable telling his/her parents, go to a trusted adult (maybe someone at school) and ask that person for help for your friend. Let this adult know that they should try and handle this with the utmost discretion.

What do I do if my friend is living on his or her own?

If your friend is living independently, at college for instance, consult a trusted RA (Resident Assistant), staff, or faculty member on campus about what to do. Remember, even if you don't want to share your friend’s secret, you can still talk to a mental health professional about how it is affecting you – knowing that your friend self-injures can be difficult. If you think the situation is serious (life threatening or otherwise), get your friend help immediately. You are NOT betraying your friend if you’re getting him or her the help they really need.

If I get help for my friend, what can I expect?

Many institutions follow a set protocol for handling issues like this. One example of this is that followed by Cornell’s Gannett Health Services: A student seeking help for a friend would first be met by a member of the staff to discuss concerns and answer questions. This would be followed by an inquiry into whether the self-injuring friend gave any indication of being suicidal. REMEMBER, self-injury itself is not an indication of suicidal tendencies. If your friend is suicidal, staff would want to be more proactive in finding services to help them immediately. If not, the staff would discuss ways that you could talk to your friend about your concerns and encourage your friend to seek help on his/her own.

What shouldn’t I do when helping my friend?

Don’t take the behavior personally.

Don’t give your friend an ultimatum. You need to support your friend, not make him or her feel like you are pressuring them. For example, DON’T say: “If you don’t stop cutting yourself, I won’t be your friend anymore.”

Avoid placing shame, blame, or guilt on your friend regarding his or her actions or attitudes. Do not useaccusatory “you” statements like, “You just need to stopcutting.” Or, “You areacting irresponsibly.”Instead, use “I” statements.For example:“I’m concerned that you will seriously injure yourself.”

Avoid giving simple solutions. For example, "If you'd just stop, then everything would be fine!"

Don’t tease him or her. Take your friend seriously and respect his or her feelings.

Don’t accidentally reinforce the behavior. Some people believe that self-injuring has a certain mystique. Don't let your friend buy into the notion that the behavior is a sign of strength, rebellion, punk chic, or simply a part of his or her personal identity.

Don’t get upset if your friend doesn’t want to approach things your way.

How involved should I get?

• Helping a friend who is going through something as difficult as self-injury can take a toll on you. Don't take on the burden as your own, or feel responsible for someone else's behavior.

• Be honest about your limits with helping your friend; it is important that you can realize when you’re overextending yourself. Make sure you have some “me” time. Be sure to care for yourself and don't allow yourself to be drained or pulled down by your friend's situation.

• If you feel as if the situation is getting too intense or overwhelming, take a break. Explain to your friend that you want to be able to help him or her in the best way possible, so right now you need to take care of yourself first.

• Wanting to take a break doesn’t mean that you are a bad friend.

Jackie Goodman & Janis Whitlock