I will never forget the day when one of my best friends rolled up her sleeve and showed me the cuts on her arm. I was in shock. I didn’t know what to say or how to react. I felt like crying but I didn’t know if it was appropriate to let her see that.

I had, of course, heard about people who cut themselves. But I had never met one, so I had never dived deep into the issue. I used to think of it as something distant. Something that someone somewhere did, but far away from me and completely out of the reach of my help. It had to happen to someone whom I loved so that I finally opened my eyes.

I hope no one who you know struggles with self-harm. No one deserves this. But if you do know or if you ever meet someone in that situation, I’d like you to know how to act. I’d like you to know what to say and what to do to help. That’s why I am writing this article, so you don’t feel as paralyzed and powerless as I did.

Understanding why people cut

As in any other situation, the first step you need to take to be able to help is to learn more about the matter. Before speaking to the person, try your best to understand what they are going through.

There are several reasons that can lead people to engage in self-harm. But what needs to be clear is that cutting is a physical manifestation of intense psychological suffering.

A common misconception is that people who do that are seeking for attention. That couldn’t be further from the truth. In fact, most people who cut try to hide it from others. They will wear long sleeves in the summer to hide their wrists. Or they will do it on their thighs or their stomachs — body parts that are easier to hide. They do that because they are ashamed of the cuts and the scars. They don’t want anyone to know they do that to themselves.

Self-preservation is a basic instinct of every living being. Animals will avoid fighting with others that are bigger and stronger than they are. Even plants, in their immobility, will do their best to survive. They reach out for the sunlight and use some amazing techniques to keep predators away.

It takes a lot to make someone go against their own nature and hurt themselves. I can’t stress the level of pain, the anguish that is necessary to lead someone to do that.

That’s the kind of suffering that only mental illnesses can cause. I will dare to say that 100% of the people who engage in self-harm are struggling with a mental illness. Typically, it will be depression. But it could also be others, such as anxiety or a bipolar disorder, or PTSD, to name only a few.

Those illnesses can cause some very distressful feelings, and the person tries to escape by cutting themselves. They do it because they are searching for alleviation from:

• anger
• frustration
• restlessness
• sadness
• apathy
• the need to see blood/scars to feel alive
• the feeling that one’s not real
• the feeling that one’s losing control of one’s own life

…among other disturbing sensations. The impulse to get rid of them is so strong that one would do anything it takes to see them going away. Including hurting themselves, often against their own conscious will.

There’s no better way to understand this than hearing it in the words of people who have been through it. If you want to do that, you can check out this great video from WatchCut’s Youtube channel.

Be careful about how you approach the issue

Unless you have an intimate relationship with the person, don’t ask about the cuts directly. They are probably ashamed of it and trying to hide it from you, so they won’t like it if you point it out.

Instead, ask a more general question about their wellbeing. A simple “Are you ok? I noticed you seem a bit down lately. Is anything wrong?” will do. Make sure you show them you’re truly concerned, and not just curious. Be persistent, but kind. With time, when they feel comfortable, they’re going to open up to you about it.

Never say anything that inflicts guilt on them

According to my friend’s psychologist, a lot of the time, self-harm is nothing less than a way the person has found to punish themselves. That means the person feels guilty for something, even if that is an unconscious process.

Mental illnesses often come along with a lot of guilt. We feel like we are a burden for others for being this or that way. We didn’t want to do this or that, but we can’t control it. Then we blame ourselves for being “too weak” to control our minds.

To sum it up: the person doesn’t need anyone making them feel more guilty than they already do. Please weight your words so you don’t say anything that might cause them to feel like that.

A few of the things you should avoid saying are:

• “Why do you do this to yourself?”
• “Just stop it!”/ “You need to stop it now.”
• “Those scars are going to stay forever. Is that what you want?”
• “Are you proud of the way your arm/leg/stomach looks now?”

Listen. Listen. Then listen some more.

Do your best to understand why the person started self-harming in the first place. Remember that it’s all a symptom of an underlying psychological suffering. Be mindful, ask questions when you don’t understand something. Suspend judgment and try to put yourself in their shoes to understand what their situation feels like. A good rule of thumb to keep in mind is: talk 20% of the time, listen 80% of it.

Being a good listener is already a huge help.

Encourage them to seek help

Accept the fact that unless you are a mental health professional, you’re not going to be able to provide all the help that that person needs. But you can help them getting access to that help.

Sometimes, the most difficult step to take is to gather the courage that’s necessary to admit one needs to see a professional. Talk to the person and try to convince them to take that step. If you can, offer to go with them in the first appointment with the therapist or psychiatrist. Maybe your presence is all that they need to take action.

Another problem with mental illnesses, particularly depression and the bipolar disorder, is that they have a way of convincing the person that he or she is not worth it. Those illnesses make the person believe that any effort to get out of that situation is pointless. Worse, the person who self-harms often believes that they deserve it as if they needed to be punished for something.

Help them fight against that mentality. Tell them that they do not deserve to feel that way and they don’t need to keep on feeling it. Help them see value in themselves by showing how much you appreciate their presence in your life. By doing this, you will slowly convince them to seek the help they need.

Attention: sometimes, it’s better not to wait

Of course, you must not pressure the person to seek help. Encouraging is one thing, forcing someone to do something is completely different.

But there are two situations in which you might need to take action yourself, instead of waiting for them to have that attitude:

1) If the person is underage and/or unable to get help for themselves, consider talking to someone who can do that for them. You may talk to a school counselor or a teacher, for example. If you’re a close friend of their family, even reaching out for one of their parents may be a good option. You should first encourage the person to talk to those people themselves, but if they are too hesitant and you’re worried, it might be time for you to do it.

2) If the person is in suicidal risk, they’re in a delicate situation where their life is in danger. At this point, you must take immediate action and talk to someone as quick as possible. Don’t leave the person alone at any moment. Try to get a support web to assist you in this and seek professional help as soon as you can. The person might be upset at you for getting other people involved, but their life is more important now.

Support them during recovery

Even after seeking professional help, it takes time and a lot of effort to stop self-harming. The act becomes a type of addiction, and as any kind of addiction, it takes determination to quit. The problem is, when someone is mentally ill, it’s sometimes difficult to find such determination.

This is when the person is going to need you the most. Don’t abandon them after they have seen a doctor. Stand by their side and continue to remind them every day of why this fight is worth it. Remind them how they don’t deserve to suffer anymore and how better days are coming for them.

You can also help them find alternatives for self-harming. Buddy Project has a great list of them on their website. With many of those, you can help them even if you’re not able to be present all the time.

Emergency help: when they have JUST cut

A few weeks ago, another friend called me after she had just cut herself and was still bleeding. I was very scared then, but I had to calm myself down to be able to help her.

Here’s what to do in that situation:

1) Make sure they are safe

You’re going to have to be very careful and sensitive now. The person is likely to be very nervous and scared. As calmly and gently as possible, ask how hurt they are.

Try to understand if their injury is more serious than a “normal” cut and if they’re in danger. If you sense that might be the case, even if they do not tell you so, call 911 and/or your local suicide hotline immediately.

It’s always best to be too careful than to not to be careful enough.

2) Do your best to help them calm down

As I said above, they’re probably going to be very nervous and scared. They might be feeling even worse than they were before cutting. People use cutting as an escapism mechanism, as a way to feel better, but such effect only lasts about 5-10 minutes. After that, they tend to feel worse than they did before.

If you can, go to the place where the person is. Being present is always an enormous help, even if you don’t do anything but being there.

If that’s not possible, then stay on the line and just talk to them. Ask them if they want to talk about what led them to do that. If they do, then be the best listener that you can. If not, try to talk about things that they like to distract them. Maybe you can try to make them laugh if you’re good at that. Stay with them as long as you can — they need the support now more than in any other time. They’re going to remember your help later and be thankful.

Final thoughts

Dealing with self-harm is never easy, not for the person who’s in that situation, neither for those around. You’ll often wish you could do more for them. Sometimes, you’re going to feel frustrated that you can’t. But know that if you’re doing all that you can, that’s already a huge difference in their life.

Do you know anyone who self-harms? Have you ever been in that situation yourself? Do you have any other tips to share on how to deal with it? We want to hear you! Please share your thoughts in the comment section below!