Help! My Loved One is Harming Themselves
What is self-harm? Self-harm, or “self-injurious behavior,” is an intentional act often causing physical pain or destruction to one’s own body typically because of intense emotions.
Why do people self-harm? There are many reasons someone may engage in self-harm. Often a person may feel that it is a way to cope to with intense feelings or relieve numbness. Sometimes people say the pain is distracting or it is a way to punish yourself if you are feeling guilty or remorseful, it forces you to feel something when you are having difficulty feeling any strong emotions. Sometimes people are unaware that they are self-harming until later (this sometimes looks like scratching, picking at nails or skin, pulling out hair).
Does the act of self-harm mean the person wants to die? No. Self-harm and suicidal thinking are not directly correlated. While both can exist and it is not uncommon for some people with limited coping skills, to use self-harm as a means to manage overwhelming feeling but they do not necessarily think about ending their life. It is important to consult with your loved one’s therapist and be clear and direct when asking about suicidal thinking versus self-harm.
Is self-harm dangerous? Yes, although it can be managed and terminated with appropriate treatment. You may hear clinical terms such as “superficial self-harm,” which refers to minimal skin breakage not requiring any medical attention (bandages, sutures, medical glue). It is important to remember that self-harm, like other maladaptive coping strategies (substance use, aggression and running away), can escalate quickly and should be brought to the attention of mental health and medical professionals when discovered.
What is the treatment? Treatment for self-harm behaviors begins with an assessment by a clinician either in a PCP office, crisis center, or therapy office. They need to first understand the persons level of risk, if the self-harm needs any medical attention, and if the person can remain safe with family support at home (this is where we come in!). Therapists will work with your loved one and family to create a safety and skills plan to mitigate the risk of recurring self-harm. Best practice would indicate a DBT informed approach to explore the reasons behind self-harm, accessible alternative coping strategies, and access to coaching calls for preventative measures and implementing the skills plan successfully.
Everyone is different which is why our therapists take a client-centered approach to best suit their individual needs. Self-harm is frightening but not helpless. If you or a loved one is struggling with self-harm, please reach out for a consultation.
