Self-harm is when you hurt or harm yourself intentionally.

People self-harm in different ways and it can be a minor or high-risk action or behaviour which causes harm.

“We often think of self-harm in terms of cutting, scratching or burning,” says Natalie, who is a therapist working with children, young people and families.

“But we can see other forms of self-harm that involve unhealthy choices or behaviours, such as risk-taking activities, destructive relationships, food, alcohol and drug abuse.

“I think that it’s important to understand the wider context of self-harm as this can be vital in understanding the individual.”

Why do people self-harm?

People have their own reasons for self-harming but it can be a way of coping with feelings that they find overwhelming.

It could be difficulties at home, school or work. They may be feeling sad, lonely or guilty, or struggling with anxiety, depression or trauma.

Self-harm can be a means to manage “uncontrollable emotions”, says Natalie.

“There are often complex feelings to be unravelled when helping people understand their self-harming behaviour.

“I see many instances of self-harm being used as a way to manage anxiety, or to provide a form of relief for intense internalised feelings."

People who self-harm are often seeking to communicate their emotional pain to the outside world, and are unable to do this in a healthy way.

“Self-harm can be a way to manage anger and uncontrollable emotions," says Natalie. Many of my clients have described this as necessary and helpful. It's a safety behaviour that enables them to manage in their day-to-day lives.”

How to tell someone you self-harm

This is often very hard and may not be necessary. The harm may be witnessed rather than someone talking about their actions.

Natalie says: “This is important to acknowledge as we know a lot of self-harm is about the communication of distress.

“If you’re suffering and want to talk to someone then there are many different ways to access the support that you think might be best for you.”

If someone you know is self-harming then ask about their feelings and if they need to feel safe, Natalie adds.

“These things will hopefully open a dialogue into some form of help or distress relief.”

How to deal with self-harm

If you’re self-harming, or someone you know is self-harming, help is out there. If needed, seek immediate medical attention.

Speak to a GP or a health professional who can help you find support, including counselling and psychotherapy.

“There are wonderful and experienced therapists available via BACP who can offer the safe space that people often need to navigate through periods of self-harm,” says Natalie.

Self-harm can be frightening and difficult to deal with and people are often unsure how to approach or help family or friends who are harming.

Natalie recommends the most important things to do are:

  1. Try not to panic. This is often the most natural response, but it rarely helps and can often end up causing more distress for everyone involved.
  2. Listen. In most self-harming cases I’ve worked with, the clients feedback that the best help and support came from someone listening to their feelings about their self-harm, and giving them the space to talk about their experiences.
  3. Try not to judge. Self-harm can be viewed as a negative behaviour and often people are subjected to further distress through the responses of those around them. Patience and understanding will enable people to feel able to share their distress rather than feel ashamed.

How can counselling and psychotherapy help?

Natalie says that therapy can help the person understand the issues around their self-harming and enable them to find healthier ways to manage them.

She says it can also help parents, or other family and friends, to understand the behaviours.

“Through therapy we can start to explore the feelings around the self-harm and try to name some of the experiences the person will be feeling,” says Natalie.

“It’s through this process that we’ll hope to provide relief from the immediate distress and then to increase self-understanding of the underlying issues for the damaging behaviours.

“In understanding these, we’d hope to find healthier ways for the client to manage their feelings.

“Therapy can often be helpful for parents of self-harming young people too, to help them to understand the behaviour and the feelings that are at behind it.”

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