How to Support a Loved One Who Is Self-Harming

nicolemarzt
Sep 19
3 min read

Discovering that a loved one self-harms can be both confusing and painful. You may rightfully feel worried, upset, or afraid. You might also feel desperate to "fix" things. These reactions are normal, but how you show up in the hours and days after disclosure matters deeply.

Here are some gentle guidelines to consider.

Educate Yourself on Self-Harm

Self-harm is usually a coping strategy for unbearable emotional distress, dissociation, or a desire to feel “real.” Despite the misconceptions, it is rarely about attention seeking. Understanding this reduces stigma and helps you respond with compassion rather than frustration.

Here are some important key points to keep in mind:

Nonsuicidal self-injury usually regulates intense emotional pain or creates a sense of control
It is different from suicidal intent, though it can co-occur with suicidal thoughts
It often coexists with many mental health conditions, including depression, PTSD, borderline personality features, substance use, or overwhelming stress
The sensation of physical pain can become a form of self-soothing or grounding over one's own body, even though it carries medical risks
People are often hesitant to seek professional support for self-harm due to fears of stigmatization or the risk of involuntary hospitalization

Hold Space: Validate Negative Feelings and Diffuse Shame

When someone discloses self-harm, the most important thing is to stay calm. If you react negatively or start lecturing, you risk the other person shutting down.

Open body language and warmth invite a sense of trust. If this is your first time hearing about self-harm, you can respond simply by saying:

"Thank you so much for telling me. I'm glad you can trust me."
"I am here for you, and you're not alone."
"I care about you, and I want to help keep you safe."

Avoid lecturing or trying to fix the problem right away. Your job isn't about giving solutions, and it's okay to be honest and say something like, "I want to be here for you. I'm not sure of the right thing to say or do, but I love you."

Know Your Own Needs and Limitations

Self-harm disclosures can feel terrifying for friends and family members, and you may be tempted to do everything in your power to keep your loved one safe.

However, nobody else's recovery can be your sole responsibility. You can offer compassion and a nonjudgmental presence, but it's equally important for your loved one to look after their emotional well-being. Self-care matters, and you should strive to:

Set clear boundaries about what you can and cannot provide
Seek your own therapy or emotional support during this time
Avoid making promises you can’t keep, especially around secrecy with imminent danger
Take breaks when needed so you can remain present and effective

Problem-Solve to Reduce Immediate Risk

Short-term safety is always a priority, and limiting access to dangerous means may be crucial at this time. Your intention should be more about sensitivity and compassion rather than control.

Everyone has a right to dignity, but you can work together to mitigate acute risk by:

Identifying triggers and typical warning signs (time of day, places, feelings).
Agreeing on safe storage or temporary removal of sharp objects
Co-create a list of alternative coping mechanisms that can be used to manage difficult emotions or negative thoughts, including relaxation techniques, grounding exercises, or tapping into their support system
Decide who will be available to stay with them during high-risk moments and how to reach that person quickly

If your loved one refuses safety steps and you believe there is imminent danger, tell them you are worried and that you may need to involve emergency services. Be clear and compassionate before making that call.

Support Long-Term Care and Recovery

Short-term safety is essential, but a genuine recovery entails ongoing support that addresses the root causes of self-harm behaviors, including trauma, depression, anxiety, or other mental health concerns.

Treatment may be multifacted and can include:

Trauma-focused therapies, including EMDR, DBT, or somatic therapies
Psychiatric medication to support mood regulation or impulse control
Specific skills training focused on distress tolerance and emotion regulation
Family or peer support groups

Treating Self-Harm and Other Mental Health Concerns at Resurface Group

When people self-harm, they are physically expressing emotional overwhelm. Focus first on safety. Then, focus on how you can connect your loved one to compassionate treatment and support. Take care of yourself as well- it is hard to show up well for others if you are not resourced.

At Resurface Group, our mental health professionals help young adults and their families strengthen their mental health and develop effective coping skills. We provide integrated psychiatric and holistic care along with safety planning, family support services, and social skills programs. We are in-network with most major insurance plans and also offer both in-person and virtual services for your convenience.