What can you do to help a friend or family member who is a self-injurer?

It is very hard to realize that someone you care about is physically harming herself or himself. Your concern may come out in frustration and even comments that can drive the person farther away. Some things that might be helpful are:

• understand that self-harming behavior is an attempt to maintain a certain amount of control, and that it is a way of self-soothing let her or him know that you care and that you will listen
• encourage expression of emotions, including anger
• spend time doing enjoyable activities together
• offer to help find a therapist or support group
• do not tell the person to stop the behavior or make judgmental comments - people who feel worthless and powerless are even more likely to self-injure
• if you are the parent of a self-injuring child, prepare yourself to address your family's difficulties with expression of feelings, as this is a common factor in self-injury - this is not about blame, but about a learning process that will help the entire family

How can a self-injuring person stop this behavior?

Self-injury is a behavior that becomes compulsive and addictive. Like any other addiction, even though other people think the person should stop, most addicts have a hard time just saying no to their behavior - even while realizing it is unhealthy.

There are several things to do to help yourself:

• acknowledge that this IS a problem, that you are hurting on the inside, and that you need professional assistance to stop injuring yourself.
• realize that this is not about being bad or stupid - this is about recognizing that a behavior that somehow was helping you handle your feelings has become as big a problem as the one it was trying to solve in the first place.
• find one person you trust - maybe a friend, teacher, minister, counselor, or relative - and say that you need to talk about something serious that is bothering you.
• get help in identifying what "triggers" your self-harming behaviors and ask for help in developing ways to either avoid or address those triggers recognize that self-injury is an attempt to self-sooth, and that you need to develop other, better ways to calm and sooth yourself
• try some substitute activities when you feel like hurting yourself - there are some examples here, and many more that can be found online (links are provided below): if cutting is a way to deal with anger that you cannot express openly, try taking those feelings out on something else - running, dancing fast, screaming, punching a pillow, throwing something, ripping something apart
• if cutting is a way to feel something when you feel numb inside, try holding ice or a package of frozen food, taking a very hot or very cold shower, chewing something with a very strong taste (like chili peppers, raw ginger root, or a grapefruit peel), or snapping a rubber band hard on your wrist
• if cutting is a way to calm yourself, try taking a bubble bath, doing deep breathing, writing in a journal, drawing, or doing some yoga if cutting involves your having to see blood, try drawing a red ink line where you would usually cut yourself, in combination with other suggestions above

How is self-injury treated?

One danger connected with self-injury is that it tends to become an addictive behavior, a habit that is difficult to break even when the individual wants to stop. As with other addictions, qualified professional help us almost always necessary. It is important to find a therapist who understands this behavior and is not upset or repulsed by it. Some of the online resources below offer links for referrals to therapists experienced with self-injury.

Cognitive-behavioral therapy may be used to help the person learn to recognize and address triggering feelings in healthier ways. Because a history of abuse or incest may be at the core of an individual's self-injuring behavior, post-traumatic stress therapies may be helpful. Interpersonal therapy is also the main treatment for the underlying issues of low self-worth that allowed this behavior to develop. Hypnosis or other self-relaxation techniques are helpful in reducing the stress and tension that often precede injuring incidents. Group therapy may be helpful in decreasing the shame associated with self-harm, and in supporting healthy expression of emotions. Family therapy may be useful, both in addressing any history of family stress related to the behavior, and also in helping family members learn to communicate more directly and non-judgmentally with each other. In some situations, an antidepressant or anti-anxiety medication may be used to reduce the initial impulsive response to stress, while other coping strategies are developed. A recent treatment involves an in-patient hospitalization program, with a multi-disciplinary team approach.

About the Author

Listen to Arthur Buchanan on the Mike Litman Show!

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With Much Love, Arthur Buchanan

President/CEO Out of Darkness & Into the Light 43 Oakwood Ave. Suite 1012 Huron Ohio, 44839 www.out-of-darkness.com 567-219-0994 (cell)

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