Self-harm is a very real issue for some of us who struggle with depression. Much like any mental illness, it not only affects the patient but our loved ones, too. For the well-being of both patient and loved ones, communication is vital; most importantly, understanding the reasons behind the urges and how to respond appropriately.
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In my most recent episode of self-harm urges, I reached out for help and was blessed to have several people who understood and responded appropriately. Sadly, others were not so helpful, although their intentions were good. For those of us struggling with depression and self-harm urges, it’s important to try and recognize these good intentions whenever we can; although the depressed mind is not always so supportive of this line of thinking. Equally, no matter how good the intentions are, it does not take away the sting of poorly chosen words.
In my experience, it is those who have suffered from the same urges and hurdles who know how to respond. The average person, who has never experienced that compulsion, is often confounded and doesn’t know how to respond appropriately. This often creates a barrier between those with self-harm urges and our loved ones. That is what inspired me to write this article.
I hope to bridge that gap in understanding, to help people understand their loved one’s urge to harm themselves, what responses are helpful, what responses are not and why.
The first thing you need to understand is that we don’t want to hurt ourselves. Perhaps that sounds odd when talking about self-harm, but this is not an action that someone takes without a reason. In fact, self-harm is not the root problem; it’s a symptom of a deeper problem. Not understanding this is often what leads to the most harmful responses from other people.
When facing urges such as self-harm, it is absolutely vital to reach out for help. However, the wrong kind of responses can increase the risk and make it more difficult to reach out in the future. The most common statements may seem like simple truths, but when they show that the urge is not understood, this can lead to worsening feelings of isolation and worthlessness.
Someone may seem perfectly fine, then reach out and tell you that they are having these dark thoughts; understand that no matter how well they seem to be doing, this means they’re not doing well. Responding by telling someone that they’re actually doing really well may seem like encouragement to you, but it’s invalidation to them.
Equally, avoid generic suggestions such as, “Think positive thoughts.” While positive thinking is vital to anybody’s well-being, it does not cure depression; even the most positive people in the world are not immune. They’re also probably doing that already to give themselves the best chance and your remark can make them feel judged as a failure and all their efforts dismissed.
It is often simple phrases that cause the most harm during times of vulnerability. For example, “You shouldn’t feel like that,” may have been meant as a plea for the person you love not to cause injury to themselves, but instead, it may make them feel invalidated. We feel the way we feel; there is no should or shouldn’t about it. Obviously, the result we want is safety and for no harm to come from these urges, but if someone is reaching out to you instead of hurting themselves, they already know this and you have an opportunity to meet them where they’re at. Judging the urge as a feeling they shouldn’t have often silenced them, preventing them from being able to tell you what the real problem is.
Another common mistake people say is; “Hurting yourself won’t make things better.” When people say this, they are looking at a well (or at least, uninjured) person and thinking that harming themselves will cause a problem that didn’t need to be there. To them, there is a world of pain and suffering trapped inside them and they need to let it out.
Hurting themselves is a coping mechanism that helps them feel better; it is an unhealthy coping mechanism, which is why we want to prevent it and find an alternative, but understanding the reason they want to self-harm and how it makes them feel better is the key to supporting them.
From my personal experience, when I feel that I want to cut myself, it’s like all the emotional pain that is tearing me up inside has filled me. The pain is right under my skin. The dirtiness from being raped seeped into my body, it infected me, it’s right there beneath my skin and I want it out. It’s like lancing a boil to get rid of the infection; I want to be clean again, but no amount of soap can wash this away. Bleeding it out makes me feel like I am removing some of the dirtiness from my body. Superficial wounds on my arms are nothing compared to the deep gashes on my heart. That is a very different mindset to the person looking at me as if the cuts are the problem; they are only the symptom.
For those of us who follow Christianity, there are other statements that may be true and helpful in Sunday School lessons, but harmful as one-to-one responses with somebody who has the urge to harm themselves.
“Your body is a temple for the Holy Spirit,” becomes, “You are not worthy to have the gift of the Holy Spirit.”
“Your body is on loan from God,” becomes, “You are not worthy to receive good things.”
Depression is a liar; but it’s very convincing.
To the depressed mind that is desperate to release the pain, these statements become judgments that fortify those damaging beliefs. Though these statements are said in love and truth, they often fail to address the message that is most needed.
“You are loved,” “I love you,” “God loves you.” These are statements that remind a person why they shouldn’t harm themselves, without passing judgment on them for feeling that way.
“I know you are hurting,” “I’m here for you,” “Call me whenever you feel like this,” are all statements that acknowledge the deeper issue, without minimizing it as if the self-harm were the true problem. But these statements can be dangerous when not followed up with action. If you’re going to say these things, ask yourself if you’re willing and able to make time.
Can you sit for an hour with someone as they cry, even though there are no magic words you can say to make things better?
Responding to someone with self-harming tendencies, suicidal ideations or any other form of depression, is not just about words. You need to back it up with actions.
“There is nothing I can do to make it better,” is not true. You might not see any improvements as you sit with them, but if you leave you also won’t see how much worse things get. You won’t always see the results you want, but your presence is the biggest help you can give.
Of course, there are times when nothing can be done, when things are busy when you can’t get there. These things can’t be helped sometimes. But to the person in distress, their need does not go away just because you can’t fulfill it. Your willingness but the inability to help does not negate what they’re going through.
It’s important to understand that their reaction to this may look like anger but it is actually frustration. They reached out because they needed help; that help is still needed, even when it’s not available. At this time, recognizing their frustration is the difference between being supportive rather than making them feel guilty. The guilt of having these feelings is more than enough; increasing the guilt, increases the risk.
If you can’t get there, seek further help; call another mutual friend or call the emergency services. Get somebody there who can sit with them through their darkest hour. Check-in on them later – check-in several times over the next few days. If somebody is in that dark place, it’s not going to vanish overnight.
By the time you know that somebody is in that dark place, by the time they are seriously at risk of harming themselves or ending their life, this struggle has been going on for weeks, months or years. You may have only just found out about it, but it is not a new situation. You’re just arriving late to the deadliest battle of their life.
Respond with kindness.
Respond with patience.
Most of all, choose your words carefully.
For more content from NJ Gatehouse, visit her blog.
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