• Dr Helen Care

5 Steps to Supporting someone who wants to Self-Harm

Someone has told you they are thinking about hurting themselves, or that they have already done it.

Calm hand-drawn poster saying BREATHE - You've Got This.
You Can Make The Difference - You've Got This!

You may be feeling scared, lonely or confused. Here are some ideas about what to do now.

I’m going to break this down into 5 steps:

  1. Keep calm

  2. Don’t judge

  3. Hold the line

  4. Be practical

  5. Don’t do it on your own

Keep Calm

1 - Keep calm

I’m a clinical psychologist and I’m trained in dealing with this, but it still makes me feel upset and sometimes annoyed when someone tells me they have hurt themselves. This is someone you care about, and it isn’t what you want for them. Cutting or hurting oneself is sadly quite common, and it is important that you stay calm. There are lots of reasons why people feel they might hurt themselves. It isn’t always something catastrophic, they may just be overwhelmed by some difficult feelings. Showing them that you can stay calm will help them stay calm too. They are more likely to feel able to talk to you if you can stay in control.

2 - Don’t judge

This may not be what you want them to do, but remember that whatever is telling them this might be a good idea, will also be telling them that they are on their own. The fact that they have either come to tell you about, or you have been sensitive enough to notice that there might be a problem, is great news. They are no longer facing this on their own. Their 'Rubbish Feelings' will immediately be easier to tackle when there are two or more of you working against them. Try to listen to what they are telling you. They may find it hard to put into words to start with. Give them time, and ask some gentle open questions like “what are you feeling at the moment?” “When did you first notice you were feeling like that?” “Was there anything happening that made that feeling worse?” “Is there anything you want to tell me about?” Reassure them that they don’t have to tell you everything, but that you will listen if they do.

Rubbish bin with scrunched up paper ready to throw away
Negative emotions are very strong

3 - Hold the line

This means acknowledging the feelings and still telling them to stop: “I understand how awful this feels right now. The rubbish feeling is making you feel like you can’t cope. But it isn’t OK to hurt yourself. “

4 - Be practical

As hard as it feels, being practical and thinking through logical steps will help the person feel contained, feel like they have some strategies, and help them to stay safe.

Ask: “What will help you stay safe?” Think about trigger points so they don’t have things that might remind them of how it feels to hurt.

Ask “What makes that rubbish feeling feel stronger? Would you feel safer if you had someone with you? Which rooms feel safer to be in right now?

If they have already cut or hurt themselves, make it safe. Check – has the bleeding stopped? have they cleaned the cut or burn or scratch? is it covered so it won’t get dirt in it? Does it need medical attention, like stitching?

Emojis and speech bubbles spelling out TALK
They need to talk - and so do you

5 - Don’t do it on your own

It can feel as if you can’t possibly share the information. But it is important that you try not to deal with it on your own. Feeling rubbish can make someone feel ashamed. Show them that it is OK to talk about it, with people who are trustworthy and safe. Don’t promise them you won’t tell, but you can promise you won’t tell anyone without letting them know. Try to find out who it would be OK to talk to – can I tell your teacher/your doctor/the school nurse? At the very least, make sure you have someone you feel you can talk to even if you don’t give them all the details or the name of the person you are worried about. This is a lot to deal with on your own, so get support.


You are taking an important step in showing that person who may have thought about hurting themselves that they aren’t on their own, you are willing to listen and they do have a choice about hurting themselves. They don’t have to listen to that rubbish feeling. No matter what else you do or don’t feel able to do, just being there for the person is a great start.

You could also play them the 'Before you Self-Harm take 5 mins to BREATHE' podcast at www.aconfidentstart.com/podcast.

Thanks for caring and good luck.

Dr Helen Care


Sources of Help for Preventing Self-Harm

For young people

Childline 0800 1111


NSPCC www.nspcc.org.uk

PAPYRUS (Young suicide prevention society).

HOPElineUK 0800 068 4141

(Mon to Fri,10am to 5pm & 7 to 10pm. Weekends 2 to 5pm)


Young Minds https://youngminds.org.uk

NHS https://www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/camhs-information-for-children-and-young-people/

17 views0 comments