Discovering that someone you care about is self-injuring can be distressing and knowing how best to help and provide effective support is not easy. This chapter offers guidance to family members on strategies that may help, and direction on what to avoid. It also addresses the important issue of self-care. Further, it provides suggestions on helping a friend who self-injures. Finally, guidance is given to teenagers who might be considering self-injury as a way of coping with their difficulties. The useful resources section at the end of the chapter provides pointers to information that in addition to being of potential interest to family and friends, might possibly be helpful to students, teachers, school staff, and health care professionals.

Guidance For Family Members

As previously mentioned self-injury generally has a profound effect on family members and can arouse strong emotions. Sometimes an attitude of ‘take no notice – she’s only doing it for attention’, or ‘it’s no big deal, or it’s just a passing phase – she’ll soon grow out of it’ is adopted, which only adds fuel to the fire. It’s unlikely that anyone who takes this attitude will pick this book up, which is a shame because self-injury is a serious issue and people don’t do it for the fun of it. Another way that people cope with the knowledge that someone they care about is self-injuring is by denying its existence – they adopt the attitude ‘what I don’t see can’t hurt me’, or ‘I know that you are doing it but I don’t want to hear about it’. This stance may stem from feelings of fear, helplessness or powerlessness.

My hope is that this book might find its way into the hands of people who hold this attitude, because loved ones need support and understanding to help them recover. On the contrary, discovering that someone you care about is self-injuring throws many people into a state of turmoil, confusion, or fear, and worrying thoughts start going round and round in their minds – thoughts such as ‘what if she really is trying to kill herself?’, ‘what if he does it again?’, ‘what if I say the wrong thing?, ‘it must be my fault . . .’, ‘what on earth can I do to help?’ My hunch is that if you are reading this chapter, you fit into this category and are probably struggling to know what to do for the best to help your loved one. First, be assured you are not alone. The following comments from family members explain how they felt on discovering that their nearest and dearest were hurting themselves:

• ‘I felt very sad and like it was my fault. I felt helpless.’
• ‘I was shocked, horrified and terrified. It took me completely by surprise.’
• ‘[I was] upset. I didn’t quite understand how somebody could hurt themselves . . . but I knew to take it very seriously.’
• ‘I could not understand why our seemingly well adjusted girl, would hurt herself. She did not show any of the traditional signs of depression or emotional maladjustment.’
• ‘[I felt] terribly frightened as I was not aware at the time it was an injuring phenomenon, which in itself is serious, but really thought she was trying to commit suicide.’

Perhaps you can identify with some of these feelings.

How To React And Safety Issues

If you discover your daughter, son, partner, or a parent is self-injuring (parents self-injure too) first and foremost, try to remain calm – even though you are unlikely to feel calm. Try to understand that your loved one is hurting emotionally and that this is his or her only way of expressing that hurt. It’s also important to recognise that even though the wounds are self-inflicted, he or she is likely to be in a state of shock if the incident is recent. Pressing for explanations, or giving your loved one the third degree immediately following a self-injury episode is unwise as he or she may not be in the right place mentally to be able to explain, or might not be aware of what triggered the episode.

Getting angry, shouting, or being judgemental, is also likely to exacerbate the situation rather than defuse it. Priority to wound care is a must – if the wounds are fairly minor and clean, provide a sterile gauze bandage or plaster, and a dose of ‘tender love and care’. If the wounds are deeper, or won’t stop bleeding, they probably need stitching and should be seen sooner rather than later by a health care professional. Don’t hesitate to call an ambulance if necessary, or seek advice from your GP if you are uncertain about the best course of action to take.