Help For Families

As a parent or concerned loved one of a self-injurer, you may have experienced feelings of shock, denial, anger, frustration, empathy, sadness, and or guilt. These are normal reactions to a very scary and sad problem. As you might be aware, self-injury (SI) helps people feel better and cope during difficult times. SI also helps by giving them a way to physically express and release their tension and emotional pain when words and relationships have not worked or are not available.

Your family member or friend has an opportunity to participate in a program which has been designed to promote communication, honesty, verbal expression of feelings and most of all safety. Your continued participation in your daughters or family members life will most certainly promote enhanced relationships, trust and honest communication.

Someone you care about is in pain, and they are telling you in the best way that they know how. The following is a poem written by a self-injurer that provides insight into the world of a self-injurer.

How will you know I’m hurting
If you cannot see my pain?
To wear it on my body
Tells what words cannot explain.
- C. Blount

Your family member or person you are concerned about has entrusted you with information about his or her self-injury, or maybe you've seen it unwittingly. However you found out, it is important to pay attention to self-injury in a helpful way. Here are some guidelines for dealing with self-injury (SI) in a friend or family member.

Don't take it personally

Self-injurious behavior is more about the person who does it than about the people around him/her. The person you're concerned about is probably not cutting, burning, hitting, or scratching just to make you feel bad or guilty. Even if it feels like a manipulation, it probably isn't intended as one. People generally do not self-injure to to annoy others, however, there is a point to the behavior a way to communicate to self and others that something is terribly wrong.

Read

Get as much information as you can about self-injury in general. Find books that present the voice of self-injurers talking about what they do and why -- it lets you inside the mind of people who SI.  The book at the top of our reading list is Bodily Harm, by Karen Conterio and Wendy Lader, PhD. The directors of S.A.F.E. Alternatives wrote this book which should be required reading for therapists, families and self-injurers as it is comprehensive, thoughtful and offers insights not found elsewhere.

Understand your feelings

Be honest with yourself about how self-injury makes you feel. Don't pretend that it's okay if it's not -- many people find self-injury repulsive, frightening, or provoking (Favazza, 1996; Alderman, 1997). If you need help managing the feelings brought up in you by self-injury, find someone to talk with.  Model what it is like to have scary or unreal feelings and to seek out support.  We can not do it alone is the message we want to convey. Find a therapist to share your concerns and feelings with however, it is important to not say things like "My therapist says you should..." Therapy is a tool for self-understanding, not for getting others to change.

Be supportive without reinforcing the behavior

It's important that the person you are caring about  know that you can separate or distinguish who they are from what they do, and that you can care about them despite their behavior. Be available as much as you can be. Set aside your personal feelings of fear or revulsion about the behavior and focus on what's going on with the person.

Some good ways of showing support include

• Talk about self-injury. Let people know that you're willing to talk, and then follow the other person's lead. Tell the person that if you don't bring the subject up, it's because you're respecting their space, not because of aversion.
• Make the initial approach. "I know that sometimes you hurt yourself and I'd like to understand it. People do it for so many reasons; if you could help me understand yours, I'd be grateful." Don't push it after that; if the person says they'd rather not talk about it, accept this gracefully and drop the subject, perhaps reminding them that you're willing to listen if they ever do want to talk about it.
• Be available. You can't be supportive of someone if you can't be reached.
• Set reasonable limits. "I cannot handle talking to you while you are actually cutting yourself because I care about you greatly and it hurts too much to see you doing that" is a reasonable statement, for example. "I will stop caring about you if you cut yourself" isn't reasonable if your goal is to keep the relationship intact.
• Make it clear from your behavior that the person doesn't need to self-injure in order to get displays of love and caring from you. Be free with loving, caring gestures, even if they aren't returned always (or even often). Don't withdraw your love from the person. The way to avoid reinforcing SI is to be consistently caring, so that helping the person take care of themselves after they injure is nothing special or extraordinary.
• Provide distractions if necessary. Sometimes just being distracted (taken to a movie, on a walk, out for ice cream; talked to about things that have nothing to do with self-injury) can work wonders. If someone you work with is feeling depressed, you can sometimes help by bringing something pleasant and diverting into their lives. This doesn't mean that you should ignore their feelings; you can acknowledge that they feel lousy and still do something nice and distracting. (This is NOT the same as trying to cajole them out of a mood or telling them to just get over it -- it's an attempt to break a negative cycle by injecting something positive. It could be as simple as bringing the person a flower. Don't expect your efforts to be a permanent cure, though; this is a simple improve-the-moment technique.)
• Try hard not to ask, "Is there anything I can do?" Find things that you can do and ask, "Can I?" People who feel really bad often can't think of anything that might make them feel better; asking if you can take them to a movie or wash those (month-old) clothes (if done nonjudgmental) can be helpful. Spontaneous acts of kindness ("I saw this flower at the store and knew you'd love to have it") work wonders.
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