Self-Injury Behaviour – Tips for Families and Caregivers

Why would someone injure themselves through cuts, burns, or hitting?

From the outside, it can be shocking and incomprehensible why someone would self-injure. From the inside, it is a way of coping with deep emotional distress that the person does not know how to tolerate, manage, or change. The self-injurer is usually not suicidal and generally tries to keep their behaviour secret.

If you have learned that a teen or adult is using self-injury to cope, you may be wondering why this is happening and how you can help. Whatever the person’s reason – whether it’s to gain control, stay in reality, escape from painful emotions, or punish themselves – what this person needs is for you to see, accept, and support them as a person in distress, not to see them as a “cutter.” Teens who self-injure often say, “I don’t tell my parents ’cause they’ll freak out!”

So what can you do? Don’t freak out, ignore the acts, or panic. Instead, stay calm, give first aid when necessary, show you care and listen if they want to talk. Encourage them to get help, be persistent in initiating communication, and get your own support. It is important to get professional help since not only the self-injury but also the underlying causes and lack of coping skills need to be considered. If you are concerned that someone might be self-injuring, get information for yourself about self-injury and then take initiative and ask them. You are letting them know you care, and this will not put the idea in their heads if it isn’t there already.

What can you do to help?

• Give focused attention (turn off the TV and ignore your cell phone)
• Listen in order to understand their feelings, without minimizing or problem-solving (“So you feel really overwhelmed and unable to cope – tell me more about that”)
• Show interest in them as a person, not just checking on whether they are self-injuring (“Tell me about your day,” or “What do you like about that music?”)
• Be persistent in creating opportunities to talk and offering enjoyable activities
• Validate their emotions by accepting how they feel, rather than telling them to stop feeling sad or saying that what they care about isn’t a big deal or shouldn’t matter
• Model adaptive ways to cope with emotions and stress (“I am feeling down, so I am calling a friend to chat,” or “I need to set limits and say ‘No’”)
• Tell them that you believe they will find more constructive ways to deal with these very real and difficult emotions
• When needed, provide first aid or a drive to the doctor or emergency room
• Encourage them to seek professional support—and get it for yourself!

Self-injury behaviour often requires professional intervention, but supportive involvement of family and other caregivers is also important.

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