In The Know Zone

helping a self injurer

Editor's Note: the content of this Web article may be triggering for those who self-injure.

Helping a loved one

The support of an understanding, patient supportive loved one or friend can be of immeasurable value to someone battling SI.  Here are some ways you can help:

Short Term

  • Recognize that ultimatums NEVER work. You cannot dictate an end to a behavior that is a means of survival—however maladaptive it may be.
  • Don't take it personally.  It isn't done to hurt you.
  • Educate yourself.  This is a complex, long-term problem.  The more you know, the more you can help at each stage.
  • Show that you see and care about the person in pain behind the self-injury.
  • Show concern for the injuries themselves. Those who self-injure are usually deeply distressed, ashamed and vulnerable. Offer compassion and respect.
  • Make it clear that it's okay to talk to you about self-injury. If you feel upset by the injuries, say so, while making clear that you can deal with your feelings and don't blame her for them
  • Let her know you respect her efforts to survive, even though it involves hurting herself
  • Acknowledge how frightening it may be for her to think of living without self-injury. Reassure her that you will not try to deprive her prematurely of her way of coping.


  • Help her make sense of her self-injury. Ask when the SI started, and what was happening then. Explore how it has helped her survive.
  • Gently encourage the person to use the urge to self-injure as a signal of important but buried experiences, feelings and needs. When she feels ready, help her learn to express these things in other ways. (See the self-help section above.)
  • Support her efforts keep herself safe and to reduce her self-injury - if she wishes to. Suggest ways to reduce risks from the practice, like washing implements used to cut, avoiding alcohol if she thinks she is likely to self-injure; taking better care of injuries; reducing severity or frequency of injuries even a little.
  • Don't see stopping self-injury as the only goal. The self-injurer may make great progress, yet still need self-injury as a coping method for some time. Self-injury may also worsen for a while when difficult issues or feelings are being explored, or when old patterns are being changed. Encourage her and yourself by acknowledging each small step as a major achievement.
  • Take care of yourself.  Supporting someone through SI is very hard work. And it won't help at all if you burn out. Be sure your needs are being met.[43]


[43] Adapted from Secret Shame: Help for Families and Friends, available at: Accessed 9/22/2004 and  Helpful Responses to Self-Injury, The Bristol Crisis Center for Women, available at Accessed 1/11/2005


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