People who self harm do so for all kinds of reasons. From the outside, there is often no way of knowing what’s going on. It may be tempting to think that stopping the self harm is a good thing to do that will improve the situation, but this isn’t always the size of it.
Sometimes people self harm as a way to not kill themselves. It may be a survival skill that enables them not to do something far worse. For some people, it is a way to vent otherwise unbearable emotions – and in the short term that can also be a suicide-avoidance strategy. For people who are numb, it can be a way of feeling something, and feeling can be a lot better than not feeling – extreme numbness makes some people feel suicidal. It can be an act of reclaiming control over body and self.
While it may not be optimal, it may be necessary in the short term and just trying to get someone to stop won’t deal with the underlying issues and may put them at risk in other ways. It probably isn’t a cry for help, although it can be. It probably isn’t attention seeking – although just occasionally, that’s part of it. Most usually the self harming person is someone in great distress, although there was a boyfriend in my distant past who used it for emotional control of others, which was grim. These are unusual things, and it is better, safer and kinder to start from the assumption that a self-harming person is in a lot of distress.
Not all self harm is obvious. It can be about not eating. In fact, if you starve yourself and lose weight the odds are that people will emotionally reward you. It can take the form of alcohol abuse or drug abuse. Self harm can be about intentional acts of self-sabotage. For the person who has internalised worthlessness and who is full of self hatred, self harm can be about delivering the punishment you’ve been taught to expect. It isn’t always obvious to the people doing it what it is for and how it is supposed to work.
There are no easy answers to helping someone who is self harming. Don’t disempower them – whatever is going on, making them feel powerless is going to make everything worse. Don’t assume you know better than them what is going on. Don’t let your discomfort over what they are doing be the most important thing – the distress prompting the self harming needs to be the most important thing. If you’ve no experience of this kind of thing, don’t imagine you already have the tools to help someone who is doing it – educate yourself and get support. Be kind and be patient and don’t get cross with them – that isn’t going to fix anything. Don’t make your feelings about the self harm their responsibility – the odds are that guilt and shame are already part of what’s making them hurt themselves.