Starting the Conversation

Having conversations about mental health can be difficult, and self-harm can be especially difficult to talk about. It is a very personal and emotional topic for both the person who is self-harming and for the people who are trying to support them. You might feel like you don’t know how to go about supporting your loved one, or even how to start the conversation. We have put together this resource to give you some tips on how to start a conversation about self-harm.

If we suspect or learn that a loved one is self-harming, it can be stressful and difficult to come to terms with. We are often worried that we will make the situation worse by asking. However, people who self-harm often report that they do not mind being asked, if the person asking is sensitive and is trying to understand. Avoiding the subject might cause your loved one to believe that they cannot talk to you about their self-harm and this could increase feelings of stress, guilt and loneliness. Instead, let your loved one know that you are willing to talk about it. When starting a conversation about self-harm, it is important to follow your loved on’es lead. Respect their space and let them know that they can start a conversation about it when they feel ready.

When starting a conversation about self-harm, it is helpful to pick a time when you know that you will have plenty of time to talk. Self-harm can be very hard to talk about, so having enough time will give your loved one space to think and will make the conversation easier. We can’t always control when a loved one might want to speak to us about self-harm, and sometimes they might ask to speak to you at a time when you can’t give them enough of your time. Your loved one might open up about their self-harm in a way that doesn’t allow time for a full conversation as a way to keep themselves safe. It’s completely natural to feel like you should drop everything to have this conversation in the moment, but that is not always practical or appropriate. In cases like this, it’s important to assure your loved one that you are interested in what they have to say, but you want to make sure that you have time to give them the attention they deserve. You can then arrange a time that suits you both to have a conversation. This will help your loved one to know that you care and want to dedicate time to them.

It’s important to create a safe space for your loved one to talk to you about self-harm. It is helpful to try and find a space that is private and where you will not be disturbed. The space can be at home, the car, out for a walk, or anywhere else that your loved one might feel safe and comfortable. Involving your loved one in choosing where would make them feel comfortable will reassure them that you are serious about listening to them and their needs.

It’s important in a conversation about self-harm that we are there to listen. This is a chance for the person you love to open up about what is happening in their life at the moment. You might be the first person they have spoken to about self-harm, so it is important for them to feel heard. Listening to their reasoning can also help you put things into perspective and be more understanding towards them. When we are talking to people about self-harm we often, understandably, want to ask a lot of questions. Try not to jump in and take control, or ask too many questions. Instead, let the person talk, and they will most likely cover your questions anyway. Ask them what they need from you, and listen to their needs.

During a conversation about self-harm you might experience a range of emotions, such as shock, denial, anger, frustration and potentially even guilt. However, being confrontational, judgemental or overly emotional might make the situation worse. It is important to try to remain calm. Try and imagine what your loved one might feel like opening up to you about their self-harm. They are trying to cope with their feelings and this time needs to be about them and not about yourself. This does not mean that you have to internalise your feelings and thoughts, so please make sure you have appropriate support networks in place to help you cope with the situation.

Having long, face-to-face conversations about self-harm can be very difficult for some people. It can be helpful to talk to your loved one about other ways that they can communicate with you. You might want to text each other, leave notes for each other, voice note each other or send emails or letters. This allows time for both sides to read or listen to the messages and reflect on them before sending a response. It can also feel less intimidating to your loved one as it sometimes is easier to write down how we are feeling. It can also help you as a family member or friend, as you do not have to worry about your initial reaction. Another alternative is to go for a drive. This means that the conversation is not directly face to face as you will have to focus on the road, but still gives the closeness of both you and your loved one being in the same space.

When having conversations about self-harm, we often want to fix things right away. Remember that self-harm is an emotionally sensitive subject and your loved one might not feel comfortable, or be able to open up right away. They might not know why they self-harm, what triggers their self-harm or what they want to do about their self-harm. Good communication is important but it is equally as important to know when to step away and give the person some space. This will help them to make sense of their thoughts and allow them to reflect on what has been happening. Remember that this is just the first conversation on the recovery journey, so don’t get disheartened when things aren’t fixed straight away.

Wanting a loved one to stop self-harming is extremely natural and many people do stop self-harming with the right support. However, this can take time as it usually requires a “trial and error” process for the person to find which ways of coping work for them and which ones do not. Although it may be difficult for us to know that someone we care about is harming themselves, it is important to remember that the self-harm is a coping strategy for them. Taking their coping strategy away will not solve the problem, it will only take away their way of coping with what is happening in their life. This might increase feelings of guilt and lead to more distress for your loved one.

This might be support for your loved one or for yourself. Some people find it easier to open up to someone who is not involved in their daily life. Make sure to talk about this option with your loved one and confirm that they are happy to take this step. This does not mean that they are never going to talk to you about their self-harm and feelings, but it might offer them a safe space to talk about it for the first time. You might also wish to seek support for yourself. Supporting someone who self-harms can be overwhelming and it is important to look after yourself as well. It might feel “wrong” to do this as you might feel you have to focus all your attention on the other person, but it is absolutely okay and necessary to look after your own wellbeing too. See our Looking After Yourself resource for more tips on managing your own wellbeing.

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