Self-harm is a term that refers to any deliberate act of hurting oneself, such as cutting, burning, scratching, or hitting. The person who self-harms does not want to die but to cope with their emotional pain, suffering, or trauma. According to the World Health Organization, self-harm is one of the leading causes of death among 15-29-year-olds, affecting millions worldwide.
Self-harm can be a challenging and complex issue to deal with, both for the person who self-harms and for the counselor who tries to help them. Counseling someone who self-harms requires sensitivity, compassion, and skill. In this blog post, we will share some do’s and don’ts of counseling someone who self-harms based on the latest research and best practices.
The Do’s of Counselling Someone Who Self-Harms
- Do listen empathically and validate their feelings. Self-harm is often a way of expressing or regulating overwhelming or unbearable emotions. The person who self-harms may feel alone, ashamed, guilty, or hopeless. As a counselor, your role is listening to their story without judgment or interruption and acknowledging and validating their feelings. Let them know you are concerned and will stand by them.
- Do ask open-ended questions and explore their triggers and coping strategies. Self-harm is not a random or irrational behavior but a learned and chronic response to certain situations or stimuli. By asking open-ended questions, you can help the person who self-harms to identify and understand their triggers and coping strategies. For example, you can ask: “What was going on for you when you felt the urge to self-harm?” or “How did self-harm help you in that moment?” It can help them understand why and how they do it.
- To assist them in recognizing and using their abilities and supports. Self-harm can erode the person’s self-esteem and confidence and make them feel powerless and hopeless. By providing online relationship counseling as a counselor, you can help them recognize and build on their strengths and resources that can benefit their relationship. These are their talents, interests, values, goals, relationships, and support networks. You can also help them discover and develop coping skills that are healthier and more effective than self-harm for themselves and their partner, such as relaxation techniques, distraction methods, positive affirmations, or creative outlets.
- Do provide psychoeducation and information on self-harm and its consequences. Self-harm can have severe physical and psychological consequences, such as infections, scars, nerve damage, blood loss, or emotional distress. The dangers of self-harm may not be known or taken seriously by those who do it. As a counselor, you can provide accurate and factual information on self-harm and its consequences and dispel any myths or misconceptions they may have. You can also educate them on how to care for their wounds and seek medical attention if needed.
- Do collaborate with them on a safety plan and a treatment plan. Self-harm can be addictive and hard to stop, especially if it has become a long-term habit. As a counselor, you can work with the person who self-harms to create a safety plan and a treatment plan that are realistic and achievable. A safety plan is a set of steps they can follow when they feel the urge to self-harm, such as calling a helpline, contacting a friend, or using a coping skill. A treatment plan is a set of goals and actions that they can take to address the underlying issues that lead them to self-harm, such as seeking therapy, taking medication, or joining a support group.
The Don’ts of Counselling Someone Who Self-Harms
- Don’t judge, criticize, or blame them for their behavior. The person who self-harms does not do it because they are weak, needy, or dishonest. They do it because they have learned to deal with their emotional hurt in this way. Judging, criticizing, or blaming them for their behavior will only make them feel worse about themselves and less likely to trust you or seek help.
- Don’t react with shock, disgust, or anger. Self-harm can be shocking and disturbing to witness or hear about, especially if you are unfamiliar with it or have personal feelings about it. However, reacting with shock, disgust, or anger will only make the person who self-harms feel ashamed, rejected, or misunderstood. Try to remain calm and composed when dealing with self-harm cases, and focus on the person’s feelings rather than their actions.
- Don’t try to fix, rescue, or control them. Self-harm is not something that you can fix or cure by yourself. You cannot fix or heal the person who hurts themselves. That is not your job or duty. Trying to fix, rescue, or control them will only make them feel dependent, helpless, or resentful. Instead, respect their autonomy and agency and empower them to make choices and decisions.
- Don’t ignore or minimize their self-harm or their underlying issues. Self-harm is not a trivial or harmless behavior that can be ignored or dismissed. It is a serious and complex problem that indicates high emotional distress and suffering. Ignoring or minimizing their self-harm or underlying issues will only make them feel invalidated, invisible, or unimportant. Acknowledge and address their self-harm and underlying issues, and refer them to appropriate services or professionals if needed.
- Please don’t force them to stop or promise to keep it a secret. Self-harm is not something that you can force someone to stop or quit. It is a personal and voluntary decision the person must make for themselves. Forcing them to stop or promise to keep it a secret will only make them feel pressured, coerced, or betrayed. Respect their readiness and willingness to change, and support them at their own pace and stage. However, if there is a risk of severe harm or suicide, you must report it and seek help.
If you are counselling someone who self-harms, you may face some challenges, but also experience some rewards. For example, you may be able to find affordable online counseling services that can enhance your work with them. It requires patience, empathy, and skill to help those who self-harm overcome their emotional pain and find healthier coping methods. By following the dos and don’ts of counseling someone who self-harms, you can provide effective and compassionate support and guidance to the person who self-harms and help them to heal and recover.