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The next section is aimed at helping a friend who self-injures. However, there are some tips that family members might also find useful, so please keep reading – remember nothing ventured, nothing lost.

Helping a friend who self-injures

It can be difficult for an outside observer to understand the non-verbal language of self-injury, and broaching the subject with someone you suspect of engaging in the practice is tough, especially if there is a strong emotional tie between you. Nevertheless, it is important to resist any temptation to pretend the problem might not exist and remain silent. Ultimately, you may be doing your friend an enormous favour by bringing the subject out in the open. The sooner the problem is addressed, the greater the chance of nipping self-injury in the bud.

Approaching the subject

Give thought to your timing. Approach the subject when you are somewhere quiet with your friend and you have plenty of time together to talk without interruptions. Alternatively, you could put the ball in your friend’s court by saying something like:

‘There’s something important I would like to discuss with you. When would be a convenient time?’

Choose your words cautiously

Approach the topic tentatively, sensitively, and avoid being too intrusive. Say something along the lines of, ‘It’s really difficult for me to say this, and I could be wrong, but I’ve noticed some scars on your arms recently and can’t help wondering if you have been hurting yourself . . .’

Be prepared for denial

In divulging your belief to your friend that he or she is self-injuring, you are taking a risk with no guarantee of a positive reaction to your disclosure. It may go one of two ways. On the one hand, your friend could feel vulnerable, ashamed, or embarrassed at what might be a tightly guarded secret being exposed. She or he may react by denying the truth or by blaming the injuries on an over-zealous cat or accident. Conversely, knowing the truth is out and that he or she is no longer alone with such a painful secret could bring a huge sigh of relief.

Don’t take things to heart

If you are convinced that your suspicions are correct, yet your friend denies or ‘bends’ the truth, try not to take it personally. The shock of having one’s protective coat of armour pierced often leads to a defensive reaction or a need to shield oneself more strongly from the possibility of further pain.

Offer the gift of listening

Allow time and space for the dust to settle. It could be that your friend will welcome the opportunity to talk once he or she has had time to reflect on your disclosure. Reassure your friend that you are willing to be there in the future by saying something like, ‘What I’ve said might have come as a bit of a surprise to you, and perhaps you would prefer to leave the matter there for the time being. However, I want you to know how much I appreciate our friendship and that I am here to listen if it would help to talk at another time.’

Set clear limits

If your friend does own up to self-injury, beware promising more than you can provide. Realistic gifts of help come packaged as support, a shoulder to cry on, an empathic ear to listen, encouragement to seek professional help, and information gathering. Promising to keep your friend’s self-injury a secret between you can place you in a precarious position, and no such assurance should be made without careful thought to the potential consequences. For example, what if you become concerned because your friend’s self-injury is getting more frequent or more serious – would keeping the secret be in the best interest of your friend? It’s much better to be honest and clear at the start about what you can realistically offer, rather than risk your friend feeling betrayed or let down by you later.

Don’ts and Do’s: A Summary

• Don’t avoid the issue of self-injury. Do give your friend permission to talk about it if he or she is willing.
• Don’t blurt out your suspicion at an inappropriate time or in an unsuitable place. Do plan the time and place carefully.
• Don’t condemn, chastise, or criticise your friend. Do show caring, concern, and compassion.
• Don’t risk drowning in tricky waters by pledging to keep your friend’s self-injury an absolute secret. Do protect yourself and your friendship by being genuine about how far you are prepared to go.
• Don’t give up at the first hurdle. If your friend seems reluctant to discuss the issue initially, do make it clear that your offer of support remains open.
• Don’t pressure your friend to stop self-injury. Do accept that the behaviour is playing an important function in your friend’s life and that he or she may not be ready to stop or may need to learn healthier coping skills before being able to let go of self-injury.
• Don’t focus entirely on the wounds and scars; the surface symptoms. Do recognise that your friend’s outward behaviour is a manifestation of internal anguish.
• Don’t put pressure on yourself by trying to resolve your friend’s problems. Do encourage your friend to seek professional help from a doctor, therapist, or counsellor.
• Don’t ignore your own needs. Being a good friend to someone in emotional turmoil can be stressful. Do take care of yourself and do seek support for yourself if necessary.

And finally, do consider these wise words from Ralph Waldo Emerson (1803–1882):

‘The only way to have a friend is to be one . . .
A friend is a person with whom I may be sincere.
Before him I may think aloud.’

The value of true friendship

This extract is from a conversation between a woman who disclosed self-injuring to a friend (the only friend that knows about her self-injury). She is asking her friend whether she did the right thing telling her, and seeking her opinion on how knowing affected her. It demonstrates clearly what can be achieved with courage, honesty and open communication.

• MD to friend: After telling you about my SI, how did it make you feel? What did it make you think?
• Friend: Looking back it may seem strange that hearing about SI [self-injury] didn’t startle me or affect me in any great way. I felt quite impressed at the courage it took to tell me – and I was glad I was considered a good enough friend, the type of person who could be confided in. I felt a bond grow right there and then. A part few others knew. I felt an immediate responsibility – it wasn’t overwhelming or heavy, I just had more knowledge. It was my obligation to be aware, to be there when needed. I didn’t think any less of you as a person – maybe I even felt more. Suddenly you were this strong women who needed my help. I wanted you to know that it wasn’t horrible or abnormal or strange. It was just a way of communicating. I did, however, want you to stop. I wanted to do all in my power to try and ensure you self-injured as little as possible.
• MD to friend: What do you think my SI behaviour communicates?
• Friend: A lack of esteem. An inability to talk about problems; a need to cover them up; a need to look strong and independent. It shows a deeply hurt soul. A troubled part. A punishment of self. It’s a controlling method. A silent release that burdens no one, except yourself. I said first that it showed a lack of self-esteem, yet I think it goes further than that – almost to self-loathing and disgust.
• MD to friend: Do you think I was right to tell you?
• Friend: Definitely. Our friendship is deeper now, stronger. I can ‘be there’ and try to understand. I think talking about it is essential – essential to understanding that you aren’t considered weird or anything because of your SI. It’s a part of you, but the more that I know, the more help and love there is.
• MD to friend: Do you think your knowledge of my SI has changed our relationship? If so, in what way?
• Friend: Some relationships can go on for years without really forcing people to share private things about themselves. I think that it’s only through this sharing, this daring to look at each others weaknesses that we truly get to know others and ourselves. You could do things or think thoughts for years and think they’re unique to you, that you are weird or disgusting or whatever, yet half the population could be prone to the same behaviour. Our friendship is stronger. It is open to communication. Past can be discussed as easily (well, not easily – but openly!) as present. Secrets are spilled from both sides and the joint healing begins.
• MD (concluding remarks): I always thought that I was such a burden on my friend, that I was contaminating her in some way with everything . . . I know not everyone is this understanding and I know that I am very privileged to meet someone like her.