Self-harm is one of the most misunderstood subjects in mental health because it is frightening to think about, many of us avoid the topic or fold it into stereotypes. Yet behind the behaviour is a person who is trying to cope with feelings that feel unbearable, uncontrollable, or numb. When we replace judgement with curiosity and care, we create safer ground for honesty and for change.

What self-harm is (and is not)

Self-harm means deliberately hurting yourself. Cutting and burning are widely known, but it can also include hitting yourself, interfering with wound-healing, misusing alcohol or other substances, or taking unnecessary risks. For many people it works, in the short term, to regulate emotion, discharge tension, or feel something when everything feels empty. It is rarely about “attention”, and it does not automatically mean someone wants to die. Many people who self-harm want to live; they are trying to survive intense feelings with the tools they currently have.

Why people self-harm

No single story explains it. Common threads include:

• Release – turning invisible distress into a pain you can see.
• Regulation – using sensation to bring emotions back within bounds.
• Numbness – proving you can still feel something.
• Control – when life feels chaotic, the act can feel predictable.
• Communication – showing how bad things feel when words fail.
• Self-punishment – driven by shame or harsh self-criticism.

These reasons do not excuse harm, but they explain why stopping is hard:

“the behaviour ‘works’ for a moment, then guilt, secrecy, and shame make the next urge more likely.”

Myths that make things worse

• “If I ignore it, it will stop.” Silence breeds secrecy. Gentle, consistent check-ins help people feel less alone.
• “Talking about it puts ideas in their head.” Sensitive, non-graphic conversations reduce risk and increase help-seeking.
• “You can make them stop.” Ultimatums increase shame and secrecy. Support works better than control.

How to start the conversation

Choose a quiet moment. Lead with care, name what you have noticed, and pause:

“I have seen some bandages lately and I am concerned.” Listen more than you speak. Validate feelings “That sounds incredibly heavy” before discussing options.

Avoid jumping to advice or problem-solving. Ask what helps in the moment and what support they would like from you.

If you do not know what to say, say that honestly and stay present. Presence beats perfect words.

Support that actually helps

• Stay calm. Visible shock or panic can increase shame.
• Acknowledge the function. “I can see this helps you cope. Let’s also find safer ways.”
• Collaborate on a plan. Encourage a GP appointment, counselling, or a helpline chat; offer to sit with them while they call.
• Reduce access to means where safe and agreed, keeping trust at the centre.
• Check in consistently. Short, regular messages communicate care better than a single intense conversation.
• Look after yourself. Supporting someone is emotionally taxing; seek supervision or your own support if you can.

Safer alternatives for intense moments

Alternatives are not cures, but they can create a pause between urge and action. People find different tools helpful at different times. Options include grounding with cool water on wrists or a flannel on the neck, paced breathing (inhale four, exhale six), brisk movement, scribbling or tearing paper, holding something textured, journaling the urge for two minutes, or building a small “care box” with reminders of reasons to stay safe. If the urge eases for even a minute, that gap is progress.

After-care matters

If someone has self-harmed, compassionate after-care lowers risk and builds trust. Encourage wound care and medical attention where needed. Avoid interrogations or lectures. Focus on what was happening before the urge, what – if anything – helped, and what might help next time. Reassure them that slips do not erase progress. Recovery is a path with bends, not a straight line.

If you live with self-harm

You are not broken, weak, or attention-seeking. You have been coping the best you can with the tools you had. And you deserve new tools. Start by naming what the urge is asking for: relief, comfort, control, connection? Then experiment with ways to meet that need more safely; breathing for relief, a weighted blanket for comfort, a simple plan for control, or a message to a trusted person for connection. Keep a short log of triggers, feelings, and what helped. Share it with a professional if you can; patterns often point to practical next steps, like therapy, medication review, or specific skills for emotion regulation.

Building a support team

Recovery is easier with others. A GP can discuss treatment options and rule out physical contributors such as sleep problems or pain. Talking therapies build skills for emotion regulation, self-compassion, and problem-solving. Schools and workplaces can offer small adjustments like flexible deadlines, private check-ins, or quiet spaces. Friends and family can provide steady, non-judgemental presence and practical help with meals or appointments. No single person has to be everything; think of support like a small team with different roles.

For parents, partners, and friends

It is normal to feel scared or helpless. Those feelings need outlets too, perhaps through your own counselling or a carers’ group. When you are with your loved one, keep your stance simple:

“I care about you. I want to understand. I am here to figure this out together.”

Avoid monitoring without consent or prying into every moment; these erode trust. Agree on two or three practical ways you can help; lifts to appointments, checking the “care box” is stocked, sending a text at tricky times, and review together what is working.

When risk feels higher

If someone talks about wanting to die, has injuries that need medical attention, or cannot stay safe in the moment, seek urgent help.

In the UK you can contact:

• NHS 111,
• go to A&E,
• call 999,
• text SHOUT to 85258, or
• ring Samaritans 116 123.

Stay with the person if you can, or on the phone if you are apart.

“I am here; we will take this one step at a time” can change a persons life.

A hopeful note

People move beyond self-harm every day. Urges can fade. Skills can grow. The space once taken by secrecy can fill with connection and pride. Progress is not measured only by never having urges again; it is measured by how quickly you reach for support, how kindly you speak to yourself, and how many safe minutes you can build into hard days. One safer choice is a beginning, not a small thing.

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Share this piece with a colleague, friend, or family member. Use it to start a conversation about how you might check in on each other, and what support would be most helpful on tough days.

This is a conversation for us all – people struggling and those who want to help and support.

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