Self-Harm and How to Support a Loved One Who Struggles With These Urges

Woman battling self-harm

Self-harm can be identified as using self-injuring techniques to cope with negative feelings and events. Self-harming behavior is also defined as actions that are done with intent to harm oneself. This is typically due to lack of other self-soothing coping skills, or an inability to express feelings in a healthier way.

Individuals may self-harm or self-injure repeatedly and increase in frequency as the behavior continues [1, 2]. Often, it is difficult to stop self-harming behavior, but recovery is possible.

Self-injury behaviors include, but are not limited to, cutting, skin picking or scratching, burning, hitting, wound interference, nail biting down to skin, and head banging [3].

Supporting Those Who Self-Harm

Helping those who self-harm can be tricky. It is important to help keep the loved one busy, especially during times they are most likely to self-injure. Keeping them away from the area and tools they use to self-injure can also be helpful so there are lessened triggers. Distraction can be powerful and help delay urges to self-harm.

Helping create a list of healthy self-soothing behaviors and support for different uncomfortable emotions can also be beneficial. For example, when feeling angry, squeeze ice, rip up newspaper, use clay or Play-Doh to keep hands busy [1]. Other ideas include taking a warm bath, playing with your pet or friend’s pet, doing something for someone else, or listening to music.

Negative thoughts can also be difficult to combat, but helping challenge unhealthy patterns can be supportive to a loved one who is struggling. If you find that a loved one is having difficulty with thoughts or speech that is negative, help them change their thoughts to something positive from that day or in their life. Help them see what are the facts about their statement versus which is an opinion.

Reframing is also valuable by saying, “I am doing what I need to do to take care of myself, I will work on doing ____next time.” Positive affirmations and coping statements are also a great tool.

Being able to go over and create some together can help a support person know what to say if the loved one contacts them when having strong urges. Working out a support plan for when urges are high, as well as a contact sheet for who can they call if one person does not pick up.

Being able to ask open-ended questions or make comments like those below can help an individual feel supported, not judged, and compassionate toward a support person:

  • How are things going for you?
  • What are you feeling?
  • It seems that you have been stressed lately.
  • I am concerned that maybe you feel discouraged.

It is important to remember that self-injury behaviors are not an attempt at suicide, but a way to release the pain that they are otherwise unable to express. If you are concerned that a loved one may be unsafe or suicidal, please take them to the nearest emergency room or call 911.

I am a Parent: What Can I Do?

It can feel overwhelming at first when you are trying to support a loved one who struggles with self-harm urges. Self-injury is typically a very personal act, and there are many methods, as mentioned above, that a person will use to self-harm.

Mother and daughter discussing self-harmSelf-injury covers various behaviors, but all have a key element which is the intent to harm oneself not as a way to commit suicide, but rather a way to cope and survive [4].

Try to avoid ultimatums with self-harm behavior. These can push away your loved one and may cause the perception that the supportive person does not understand, nor is listening to what the loved one is trying to convey.

If you are a parent, it can be hard not to panic when you learn of your child’s self-harm behaviors. Be available to talk to your child in a safe space, and remember that self-injury is a learned behavior and habit-forming.

Work to give your child structured space and privacy, as well as encourage them to talk with you or a profession. Remember to reinforce that the behavior is something you want to help stop and that you love your child unconditionally and will support them.

When a Friend Opens Up About Self-Harm

If you are under the age of 18 and supporting a friend struggling with self-injury, encourage the individual to speak to an adult or counselor at school [4, 5]. You can offer to go with them if they are afraid to talk to an adult alone about their behaviors.

If your friend is unwilling to speak to someone about it, you need to let a trusted adult know if you are concerned they are in danger, especially if they might be suicidal. Remind your friend that telling an adult can be difficult, but it can help them get the help they need.

If you are over 18, be there to listen. Remain calm and patient, even if you are unsure why a loved one is engaging in those behaviors. Let your friend know that they are not alone, and encourage them to share this with another trusted adult, or get involved with a professional counselor and/or group support.

In conclusion, it is important to keep a non-judgmental and empathetic stance when supporting a loved one with self-harm urges. Being able to support the person by providing healthy self-soothing skills, distraction techniques and grounding tools can help ward off urges becoming behaviors.


[1] Retrieved (n.d.) April 25, 2017, from
[2] Retrieved (n.d.) April 25, 2017, from
[3] Retrieved (n.d.) April 25, 2017, from
[4] Retrieved (n.d.) April 25, 2017, from
[5] Retrieved (n.d.) April 25, 2017, from

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is an Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 7, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on May 7, 2017.
Published on

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.