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The truth about self-harm

And tips for how you can help a loved one


By Emily Bulthuis, MSW, LICSW
July 27, 2017

     


Self-harm, especially among adolescents and young adults, is much more common than many people realize. About 15 percent of teens have reported some form of self-injury. And while many people equate self-harm with cutting, it expands beyond this. Head-banging, ingesting something harmful or even scratching one’s own skin repeatedly are all forms of self-harm.

A common misconception about self-harm is that it is an attempt at suicide. But generally, it is not. This is an important reminder that I give parents and family members of those who may be engaged in self-harming behaviors. Self-harm is a serious concern, though. And it is almost always linked to some form of emotional pain.

It can be hard for someone who has never self-harmed to understand why some people do it. But it’s important to acquaint yourself with some of the reasons behind it. This is especially important if you want to help someone may be struggling with self-harm. Here are some of the most common questions I get from loved ones and how I answer them:

What is self-harm?

Self-harm is a behavior where one inflicts harm to themselves in a purposeful manner. Self-harm itself is not a mental illness. But it can be linked to a mental health concern. It shows a lack of other coping skills to handle stressors that one may experience.

Why would someone hurt themselves on purpose?

If a person struggles with this behavior, any stressor that overwhelms their ability to cope could be a trigger for self-harm. It typically stems from a very strong or overwhelming emotion. It could be related to relationships, work, school or finances. What causes someone to feel stress is subjective. But no matter the stressor, it is something the person may not know how to deal with. This is when self-harm is sometimes used as an extreme coping mechanism.

 

What should I do or say to help someone doing self-harm?

If you think self-harm may be an issue for someone you care about, start by asking how they’re doing. This may sound simple, but showing interest and concern for someone can be meaningful. This is especially the case if they feel alone.

Self-harm can be a sign of other emotional problems or life stressors. Be prepared to listen non-judgmentally to what a person may have to say. You may not agree with what they consider a stressor, or their interpretation of that stressor. But it is important to remember that you can still respect their experience. Use validating comments like, “That sounds really hard” or “I hear you.” Always express hope for the person, especially about their ability to recover and feel better. You can gently suggest that they talk to a professional. Our organization has care teams who can help at:

Can someone who self-harms get better?

Yes. Like with other health issues, treatment can help. This starts with a visit to a licensed mental health professional. This could be a psychologist. It could be a clinical social worker. Or it could be a marriage and family therapist. A professional like this will work with the individual to create a tailored treatment plan based on their specific needs.

Treatment typically includes therapy. It can help people learn new and healthier ways of coping with strong emotions. And it can help build personal insight. This way, they more easily understand their behaviors and their emotional experience. Medicine may be recommended to help someone manage symptoms of a mental health issue. This is needed if that is contributing to the self-harming behavior.

Talking about self-harm and other mental health concerns can be a hard conversation to start. And mostly, that’s due to stigma. But, it’s a key first step for someone to seek help.

Our organization works to end stigma through our ongoing campaign Make It OK. On this website, you can learn what to say and not to say. You can hear people tell their real-life stories. And you can find ways to help.

About Emily Bulthuis, MSW, LICSW

Emily Bulthuis is a Licensed Clinical Social Worker who provides individual therapy to adults. She works in Park Nicollet’s Behavioral Health department. Emily earned her undergraduate and master’s degrees from the University of St. Thomas. Emily enjoys partnering with her patients to support them in improving their quality of life and emotional well-being. Her specialties include co-occurring mental and chemical health disorders. She also works with family members of those struggling with mental health matters. In her free time, Emily enjoys listening to podcasts, cycling and spending time with her family and black lab, Lucky.

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