Self-Harm Chats
Self-harm is the deliberate injuring of one's own body as a means to deal with some form of emotional distress.
Self-harm is a symptom, not an illness itself, and therefore, points to a deeper emotional struggle and is not the problem itself. When chatting about self-harm, it is helpful to focus the conversation on the emotions and situation the member is experiencing, not the physical injuries.
NOTE: The relationship someone has with self-harm is very complex and often goes through many different stages throughout their struggle with self-harm. Not everyone is ready to recover.
When someone tells you they self-harm:
What you might say:
'It sounds like things are really hard right now. Are you safe?'
'I just want to clarify really quickly, are you harming yourself right now?'
Note: If they are in immediate danger, or are actively harming themselves, then this is a crisis chat which we are not trained to take. We need to refer them to 7cups.com/crisis link and politely end the chat. Read more here.
Once you know they are not in immediate danger, talk about what makes them feel this way. Focus the conversation on what they are thinking, feeling, and going through. Make sure they feel heard. Listen to understand. Reflect what you hear, ask for more detail when appropriate, and ask questions that help them clarify their emotions, continue their story, and reflect on what might be the root feelings and causes of these urges, thoughts, and beliefs about themselves. Phrases such as following can help:
'It sounds like you're going through a really hard time. I'm glad you came on here to talk today.'
'That's a really painful place to be in. Do you know what sort of things might be making you feel this way?'
'I'm sorry to hear things are so difficult right now. Would you like to talk about what's been going on?'
'It's not stupid to feel like this.'
'Sometimes we feel bad without having any external reason, but that doesn't mean our feelings aren't real and hard to deal with. What is it like for you to feel this way?'
'You mentioned you hurt yourself earlier today. I just want to check in - have you done anything to take care of your injuries?'
Phrases to avoid:
'You need to ____.' Or 'You have to tell someone.'
As hard as it is when you know someone is wanting to hurt themselves, remember we aren't here to give advice or tell people what to do.
'I know how you feel. I used to ____.'
This early in a conversation it might be wise not to make this comparison yet. Use this phrase sparingly, and only after they've really explained something. It also helps to soften this with a bit of personal detail when you say you know how they feel, that way it truly makes a connection and doesn't risk sounding like you might be making assumptions about their feelings and situation. If used too often, this can make it sound like you're generalizing their situation and not really hearing them.
'Promise me you won't hurt yourself.'
Promises can, occasionally, help someone in the short term, but many people find them unhelpful and they don't serve as a long-term solution. You are also a stranger online and unlikely to be a significant reason for them to not harm. For many, these demands are uncomfortable to deny, easy to break, pointless, and feel like the other person doesn't understand how difficult these urges are. Use this with caution.
'Please don't cut.'
With some members, most likely the ones you've talked to before, you may possibly find this useful. But it is unlikely. It is also not a very effective use of your time. The member came on to express themselves and maybe brainstorm alternatives, not have someone beg them to not harm.
'Isn't there someone you care about? When you hurt yourself, you're saying you don't care about them.'
Self-harm is personal and rarely has anything to do with wanting to hurt another person. Not caring for your own body does NOT directly correlate to not caring about someone else. Yes, self-harm hurts relationships and those around you, but it is typically not about that, it's just a side effect.
'You're beautiful.' Or 'You're ruining your body.'
Comments about their body/beauty can often bring shame to the member. It also fails to acknowledge the complex emotions and thoughts behind self-harm and does nothing to empathize with their struggles.
'You need to think positively.'
This is true, but also unrealistic and unhelpful. It tends to come across as a command when said this way and can seem to make light of the emotional struggles they are currently facing, which are deep, complex, and typically long term.
'You don't need to hurt yourself.' Or 'It'll get better.'
Possibly true, but it doesn't reflect what the member is telling you or show that you are understanding the distress they are experiencing right now.
'Hurting yourself won't fix anything.' Or 'Hurting yourself will only make things worse.'
This is just not true. Self-harm, while maladaptive and with negative consequences, DOES help. If it had no benefits it would not have been used as a coping skill in the first place.
'You need to get rid of all your sharps.'
Getting rid of tools is a part of recovery but 1) they may not be ready to recover and 2) it is NOT something that is easy to do. You may at some point find it a good idea to ASK if they might be willing to consider moving their tools somewhere else, giving them to a friend, or throwing them away, but be sure to be understanding and accepting if they are not ready to do that yet. Self-harm is a coping skill they are relying on to survive right now, and unless they have many healthy coping skills they are currently practicing and using regularly, it is likely to be almost unthinkable for them to get rid of their sharps.
Eventually:
The conversation may come to a point where they have explained themselves and their situation fully and the discussion turns towards what they want to do about it. Here is where you may offer resources.
Phrases to Avoid:
'You should do ____'
'Doing _____ will help.'
'You need to do something instead of harming.'
As hard as it is, remember to not give advice or tell them what you think they should do.
What you might say:
'What sort of things have you done before to help you cope when you feel so____?'
'I know you were really angry tonight when you felt like you had to hurt yourself, but it also sounds like part of you doesn't want to hurt yourself. Are there any other ways you've tried to deal with your anger before?'
'I know you said you've been struggling with self-harm for several years now. Is there anything you've found that's helped you not hurt yourself before?'
'Do you think it might help to brainstorm a few things you could try instead of harming yourself tonight?'
'It seems like you've been wanting to harm yourself today because of all the anxiety and stress you've been facing. Have you found any other things helpful when dealing with anxiety?'
'Have you ever heard of ___?'
'Would you like me to share a resource with you?'
'You mentioned you've seen a counselor before. Did you guys ever talk about your anxiety? Did they have any advice?'
Remember, you're there to Listen and help them think things through. Give resources as you discuss this if they are open to that, and be understanding if they tell you ____ won't work, or they don't want to try ___.
Other things that might come up:
Member: I think I want to tell _____, but I'm so scared. I don't know what to do.
Phrases to Avoid:
'You should tell her.'
'It'll be fine.'
'She's your mom, she'll love you no matter what.'
'If they aren't nice about it, they shouldn't be your friend anyway.'
Advice should be avoided. Also, try to avoid making assumptions about their situation, family, or friends. Ask questions and let them find those realities themselves. Giving simple reassurances can also run the risk of making the member feel like you don't really understand their personal situation.
What you might say:
'That's a really big decision. It could certainly be helpful to have someone who knows and can support you, but it's also a really scary thing to tell someone something so private. Do you know what sort of things you're most worried about happening if you tell ____?'
'It makes sense to be scared and anxious about such a big decision. When I have really big decisions I sometimes find it helpful to weigh the pros and cons. What sort of good things do you think might happen if you tell them?'
'It sounds like you're ready to tell her, and from what you've said earlier it sounds like she'd be really supportive. But, the act of telling her can still be really scary. Have you thought about how you want to tell her?'
Member: I'm just so torn. I know I should do something else, but I really just don't care and I want to hurt myself.
Phrases to Avoid:
'You just need to distract yourself.'
'You know that harming is bad.'
People who self-harm typically already feel great shame and pressure from themselves and society to stop harming. It is not likely to be very helpful for you to remind them so bluntly about that.
What you might say:
'Self-harm is something you've relied upon for a long time. It makes sense how it's hard to give it up.'
'That sounds like a confusing place to be in. Sometimes it helps me when I weigh all sides of a decision. Like, what would be good about not harming? What would be bad about not harming? What would be good about harming? And what would be bad about harming?'
'Sometimes, for me, I feel really anxious about the idea of NEVER harming again. I've found it helpful to think in shorter terms like, do I need to harm tonight, or can I wait? Or, what if I wait 15 minutes and then decide whether or not I really want to harm? It can give me more time to make up my mind, and remind me that it's always my choice what I decide to do. Do you think that applies to your situation today?'
It's important to recognize that it is NOT your choice whether they harm or not. It is THEIRS. It's really really hard to watch someone struggle with such self-destructive thoughts and behaviors, but ultimately they have to decide this on their own. You can help them think it out, but never tell them what to do or what not to do. Give them a safe and open space to think through various aspects of their choices and to examine the motivations behind their desires.
Resources
Healthy Alternatives & Coping Skills –
✅ Creative Expression could be an easy starting place. Self-harm is often used to express, validate, and let out emotions. Do they journal, write, draw, doodle, dance, paint, play music…?
✅ Are they struggling with an intense and overwhelming emotion like anxiety or anger that seems to demand immediate and rash action? Try deep breathing techniques, visualization, mindfulness, and/or meditation.
http://www.pocketmindfulness.com/6-mindfulness-exercises-you-can-try-today/
https://www.7cups.com/exercises/mindfulness/?showlist=1
✅ Going and sitting with another person can help you keep yourself in control. They don't have to know why you're upset – or even that you're not feeling good – you just need to refrain from being in a private place where harming is easy and accessible. They can even take their computer with them and continue to chat with you while they sit in the kitchen, living-room, lounge, wherever around other people.
✅ https://www.7cups.com/self-harm/
✅ Self Harm Recovery Growth Path
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