If someone you love is hurt by Self-Injury you may feel lost. Maybe they did not tell you, but you noticed it yourself, so you're wondering if you should face them – and how. Or maybe they're open to you, but you're still not sure how to help properly.
Self-injury is usually best understood as an unhealthy coping mechanism for emotional distress, according to . National Alliance for Mental Health (NAMI). People often harm themselves to release intense feelings they do not have to express in another way NAMI . Other potential causes of self-harm include attempting to break emotional deafness, avoid harassing memories, signal help, punish oneself, or exercise a sense of control, as in US. National Library of Medicine .
Since every self-injury scenario (and friendship) is a little different, it is difficult to give appropriate advice for all cases. How you handle it depends on the situation. Mental health experts still have some suggestions on how you might possibly turn to this conversation and not.
Before you say anything, choose a good time for both of you.
"They want to beat as long as the iron is cold", Elaina Zendegui Psy.D., assistant professor of psychiatry at the Icahn School of Medicine at Sinai, tells SELF. This means that you do not jumpstart your friend right after the job starts, or on a day when he is clearly in a bad mood.
You also want to know where you are. 19659008] so that you can be as supportive as possible. "Make sure you're actually in a room where you can talk about it, because it can be very annoying," says Zendegui.
While your first instinct is to respond to your friend's self-injury or details of shock, horror, or sadness, do your best to remain non-judgmental and unresponsive (or at least not over-reactive), Psychologist Joan Freeman MA, Founder of Non-Profit Centers for Suicide and Self-Injury Pieta House in Ireland and Solace House in New York City, tells SELF.
Here are suggestions on what to say:
1. "I noticed some stains on your arm and I'm worried because I'm taking care of you. Are you hurt? "
If your friend has not told you that they hurt themselves, but you have reason to believe that they are something, open yourself up with something simple and straightforward. "Describe what you noticed and why you think there is a problem, express your concerns and ask them directly," says Zendegui.
You may be wondering if they are really hurt. You can try a more open question to see if they volunteer the information, such as: B. "What's going on?"
It's possible that your friend is lying or withdrawing from the question and giving someone the chance to talk about themselves. Pamela Cantor, MD, developmental psychologist and clinical psychologist in Massachusetts and former president of the American Association of Suicidology, says Pamela SELF. "It could release a scary secret," says Dr. Cantor.
Meghan S., 29, who herself has been injured for about two years during her college studies, tells SELF that "it was somehow." a relief, "when a close friend asked if she hurt herself. "I think part of me wanted someone to ask if I'm okay," she says.
. 2 "I can see that you are in great pain. Do you want to tell me what's going on? "
" You can confirm that the pain they feel is genuine without confirming [self-harm] themselves, "says Zendegui. Alternatively, try the following: "I do not know what you're going through, but I can tell you it's very hard for you right now."
Then invite her to talk about the causes of her pain, says Dr , Cantor. Listen until you're done with the sharing – do not jump in for advice, or try to relate it to your own experiences.
. 3 "What gives you the urge to hurt yourself?"
If your friend has signaled that he is open for conversation, you can ask more questions to understand what he is going through, says Zendegui. 19659021] Focus your questions on the emotional triggers of self-harm and the implications that follow. "They want to identify the feelings that are happening around the plot and not judge the plot itself," says Freeman.
Questions like, "Have you noticed what feelings cause you to hurt yourself?", "How can you feel like it?" And "How long does the relief?" Cantor: Not only will you learn more about your friend's experiences, but also give you the opportunity to discuss the process in ways that he may not have done before.
4. "I'll do anything, what I can, but I can not help you alone Can we help you something? "
You can also try something like," Have you thought about speaking to someone? "
Self-Injury is a complex one Problem often associated with other behavioral and mental illness problems such as dangerous substance use and depression according to NAMI .To stop the behavior and create new B It is usually necessary to seek the help of a mental health expert. Therefore, it should be paramount to guide a friend to a doctor.
"If you offer listening, support and care, the best way to help is to bring your friend to a responsible professional," says Dr. Cantor. This can also help to put boundaries between you and your friend, which can be important if you feel overwhelmed, says Zendegui.
Suppose your friend seems to be resistant to the therapy . Mention people in your life or in the life of your friend who have gone to therapy (as long as they are open so they do not invade their privacy). You can say something like, "I know the therapy was really helpful when you had trouble," says Zendegui.
Because the idea of indefinite therapy can be intimidating, you can also try Zendegui, call the "foot under the door" technique and suggest that your friend call someone to see what he can offer, or an initial consultation performs. You do not have to commit yourself to life, just for this first step.
If your friend seems to be disheartened at the prospect of finding an affordable therapist whom he can trust, you can help him with these tips . Do not ignore your own mental and emotional performance.
. 5 "It's okay if you do not want to talk about it now. I am always here. "
Your friend may not be willing to engage in a long conversation or commit to getting help from the bat. Respect that, says Zendegui, and ask for an open invitation to talk anytime. You can always bring it up gently again later. It could take weeks or months and several trials, says Zendegui. It's also possible that your friend will never be ready to open up, she adds. This can be frustrating and disturbing, but you can not force it.
In Meghan's case, she appreciated her friend's constant offer to revisit the subject later. "I do not think we ever talked about it again," she says. "But it was a relief to tell someone, and probably it's good for me to have to say aloud [it]."
The only exception to the advice to let your friend be, is when you think that your self-harm is a sign that you want to end your life. While self-harm is not usually a suicide attempt, the habit increases the risk that a person will attempt suicide if they do not receive help, according to US. National Library of Medicine .
If you are worried about your friend's life, call the 24/7 National Suicide Prevention Hotline at 1-800-273-8255 or use the 24/7 Crisis text Line at 741-741. You may also want to take your friend to the emergency room or call his family, depending on the circumstances. Learn More About what to do if you think a friend has suicidal thoughts.
Here are some things that can not be said:
1. "Can I see?"
Avoid voyeurism, says Freeman. Although you are curious about the details, they are not relevant if you get help from your friend. You also risk reacting negatively to what your girlfriend shows you, which can stigmatize.
Meghan had this experience with another friend who asked about detecting her injuries after her injury, after she had learned what was going on, but then she was angry when she saw it committed. "I did not blame her for her reaction, but it definitely hurt my feelings," Meghan says. "You are ashamed and appreciate yourself."
2. "Things are not so bad."
Do not try to convince your friend that his feelings are unjustified or that his behavior is not "rational." Glass half full is not here.
Your friend is probably in tremendous pain, and the last thing you want to do is refute it, says Zendegui. "This can really reduce their experience and make them feel worse," she explains, "and even harm your relationship with them."
. 3 "If you do not stop, I can not be your friend anymore."
Do not give your boyfriend an ultimatum, says Zendegui. Leaving self-harm requires much more than willpower, explains NAMI . There is a good chance that issuing an ultimatum will actually make matters worse.
The prospect of losing your friendship (or other consequences) can only make your friend feel isolated, trapped, misunderstood and powerless. Moreover, threatening to lose the only coping mechanism that your friend currently has, as unhealthy as it may be, could potentially make mental health  even more difficult.
how much you can do.
No matter what, your friend can reject or reject what you say, Dr. Cantor. You feel that you have failed or that the situation is hopeless, but that does not mean that your words have no effect. These changes are often cumulative and take time. "[They] may not immediately change the behavior [their] but you planted the seed," Dr. Cantor.
Meghan, for example, injured herself for at least six months after her friend first brought it up to her, she says. She finally stopped with the help of her mother and a therapist . But her friend, who spoke to her, "was like a baby, Baby Step [toward]", she explains.
It is reasonable to be nervous during this conversation. Try to rehearse what you will say before, says Zendegui. It is also a good idea to be prepared for supportive nonverbal communication. She adds, "They can be ready with eye contact and reflect some of their body language – their expression, their attitude – to meet them where they are."