How to Talk to Someone Who Self-Harms: Dos and Don’ts

Key Takeaways

• Approach conversations about self-harm with empathy and without judgment to create a safe space for open dialogue and trust building.
• Avoid minimizing their pain or demanding they stop immediately, as this can push them away and worsen feelings of isolation.
• Listen actively and validate their emotions while gently encouraging them to find healthier coping strategies at their own pace.
• Recognize warning signs that indicate professional intervention is needed, such as escalating behaviors or expressions of hopelessness.
• A Mission For Michael provides specialized mental health care with evidence-based therapies like DBT and EMDR to help individuals develop healthier coping mechanisms.

Understanding Self-Harm and Why Communication Matters

Self-harm affects millions of teens. Research indicates that approximately 17% of adolescents report some form of self-injury, yet many struggle to know how to respond when someone they care about engages in these behaviors. These conversations require sensitivity, compassion, and understanding. 

When approached correctly, your support can be a lifeline for someone struggling with emotional pain. This guide covers the key dos and don’ts of talking to someone who self-harms, helping you provide meaningful support while avoiding common pitfalls.

What Is Self-Harm and Why Do People Do It?

Self-harm involves deliberately causing physical pain to cope with overwhelming emotional distress. Common forms include cutting, burning, scratching, or hitting oneself. People engage in self-harm for various reasons: to release unbearable tension, to feel emotionally numb, to punish themselves, or to communicate pain they cannot express verbally.

Self-harm is not typically a suicide attempt, though it does increase suicide risk. It often serves as a maladaptive coping mechanism for underlying mental health conditions such as depression, anxiety, PTSD, or borderline personality disorder. Understanding this context helps frame conversations with empathy rather than panic or judgment.

Self-harm is a coping mechanism for overwhelming emotional pain, not attention-seeking behavior, and often signals underlying mental health conditions that require professional treatment.

The Dos: How to Support Someone Who Self-Harms

• Do Create a Safe, Non-Judgmental Space

The foundation of any helpful conversation is creating an environment where the person feels safe sharing without fear of judgment, punishment, or overreaction. Choose a private, comfortable setting and ensure you have adequate time for an unhurried conversation. Express your concern calmly and let them know you care about their well-being.

Use open body language and maintain appropriate eye contact. Your tone and demeanor should communicate acceptance and support. Keep in mind that opening up about self-harm requires immense vulnerability, and how you respond in those first moments can determine the outcome of future conversations.

• Do Listen Actively and Validate Their Feelings

Active listening means giving your full attention without planning your response while they speak. Let them share at their own pace without interrupting. Acknowledge the emotional pain they are experiencing, even if you cannot fully understand it. Statements like “That sounds incredibly difficult” or “I can see you are really struggling” validate their experience without condoning the action.

Validation does not mean agreeing that self-harm is a good solution. It means recognizing that their pain is real and deserving of compassion. This distinction is vital for maintaining trust while gently guiding them toward healthier alternatives.

• Do Express Concern Without Ultimatums

Share your feelings honestly but constructively. Use “I” statements such as “I feel worried when I see you hurting yourself” rather than “You are making me upset.” This approach focuses on your emotional response without making them feel blamed or guilty, which can worsen their distress.

Avoid issuing ultimatums like “If you don’t stop, I’ll tell your parents” or “Stop or we can’t be friends anymore.” These threats typically backfire by damaging trust and increasing isolation. Instead, express your desire to help them find healthier ways to cope with their pain.

• Do Encourage Professional Support

Gently suggest professional help from a therapist who specializes in self-harm. Frame this as an addition to your support, not a replacement. Evidence-based therapies such as Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Eye Movement Desensitization and Reprocessing (EMDR) have proven highly effective in addressing the underlying causes of self-harm and developing healthier coping strategies.

Offer to help them research treatment options or accompany them to an initial appointment if they feel comfortable with that. Professional treatment addresses the root causes of self-harm rather than just the behavior itself.

• Do Learn About Self-Harm and Available Resources

Educate yourself about self-harm, its causes, and effective treatments. Understanding the complexity of self-harm helps you provide more informed support. Familiarize yourself with crisis resources and warning signs that indicate immediate professional intervention is needed.

Creating a non-judgmental space, actively listening without interrupting, and encouraging professional support are essential steps in helping someone who self-harms feel understood and supported.

The Critical Don’ts: What to Avoid in These Conversations

• Don’t React With Shock, Anger, or Judgment

Your initial reaction sets the tone for everything that follows. Visible shock, anger, or disgust can cause immense shame and prevent the person from opening up again. Avoid statements like “How could you do this?” or “That’s so stupid.” Even if you feel upset, take a moment to compose yourself before responding.

Remember that self-harm is a symptom of deeper emotional pain, not attention-seeking behavior or manipulation. Responding with judgment closes doors that may be difficult to reopen.

• Don’t Minimize Their Pain or Compare Struggles

Never diminish their experience with statements like “Others have it worse” or “You have nothing to be upset about.” Pain is subjective, and comparing suffering invalidates their very real distress. Similarly, avoid toxic positivity such as “Just think positive thoughts” or “Everything will be fine,” which dismisses the complexity of their situation.

Each person’s pain deserves acknowledgment regardless of external circumstances. What feels manageable to you might be overwhelming to someone else, especially when struggling with mental health challenges.

• Don’t Make It About You

While your concern is valid, avoid centering the conversation on how their self-harm makes you feel. Statements like “You’re hurting me by doing this” or “Think about how this affects your family” add guilt to an already overwhelming emotional burden. This guilt rarely motivates positive change and often increases shame and isolation.

Maintain appropriate boundaries while keeping the focus on understanding their experience and finding paths toward healing.

• Don’t Demand Immediate Cessation

Ordering someone to “just stop” or demanding promises they will never self-harm again sets unrealistic expectations. Self-harm is a coping mechanism, and removing it without replacing it with healthier alternatives leaves the person without tools to manage their distress. Recovery is a process that takes time and professional support.

Instead, acknowledge that change is difficult and express hope that they can develop better coping strategies with proper support. Celebrate small steps forward rather than demanding perfection.

• Don’t Keep Harmful Secrets

If the person is in immediate danger or their behavior is escalating, you may need to involve trusted adults or professionals—even if they asked you to keep it secret. Explain that you care too much about their safety to remain silent when they need help beyond what you can provide.

Approach this thoughtfully and, when possible, involve them in deciding who to tell and how. The goal is to ensure their safety while preserving as much trust as possible.

When to Seek Immediate Professional Help

Certain situations require immediate professional intervention. Seek help right away if the person:

• Expresses suicidal thoughts or has a suicide plan
• Causes severe injuries requiring medical attention
• Shows signs of escalating self-harm frequency or severity
• Exhibits symptoms of severe depression, such as extended hopelessness or withdrawal
• Experiences psychotic symptoms like hallucinations or delusions

If self-harm is accompanied by psychosis, professional evaluation is necessary. Psychosis can be a sign of a more complex mental health diagnosis that may benefit from medication paired with therapy for comprehensive treatment. non-medication approaches such as CBT and supportive therapy can also help individuals manage psychotic symptoms, but professional assessment ensures appropriate care.

How Professional Treatment Addresses Self-Harm

Professional treatment offers structured, evidence-based approaches to address both self-harm behaviors and their underlying causes. DBT, specifically designed to help individuals regulate emotions and develop healthier coping mechanisms, teaches skills for distress tolerance, emotional regulation, interpersonal effectiveness, and mindfulness. CBT helps identify and change negative thought patterns that contribute to self-harm, while EMDR effectively processes trauma that often underlies these behaviors.

Residential and outpatient programs provide comprehensive care with individual therapy, group support, psychiatric evaluation when needed, and family involvement. These structured environments allow individuals to focus on healing while learning sustainable coping strategies they can use long-term.

Why A Mission For Michael Offers Comprehensive Self-Harm Treatment

A Mission For Michael’s residential and outpatient programs provide specialized care with evidence-based therapies like DBT and EMDR to help individuals develop healthier coping mechanisms in a supportive, home-like environment.

At A Mission For Michael, we understand the complexity of self-harm and the underlying mental health conditions that often drive these behaviors. Since 2010, we have provided specialized care across California, Washington, Virginia, and Minnesota, helping individuals develop healthier ways to cope with emotional pain.

Our evidence-based approach includes DBT, CBT, EMDR, and holistic therapies that address both the behavior and its root causes. We offer flexible treatment levels, including residential programs, partial hospitalization, intensive outpatient care, and virtual online therapy, allowing us to meet each person where they are in their recovery process.

With a 2:1 staff-to-client ratio, our licensed clinical professionals provide personalized attention in comfortable, home-like environments. We specialize in treating complex psychiatric conditions, including depression, anxiety, PTSD, and borderline personality disorder, conditions frequently associated with self-harm behaviors. Our facilities are accredited by The Joint Commission and the California Department of Health Care Services, ensuring the highest standards of care and safety.

We accept most major insurance plans and provide financial guidance to make treatment accessible. Our compassionate team understands that recovery is a journey, not a destination, and we walk alongside each client every step of the way.

Frequently Asked Questions (FAQs)

How do I start a conversation about self-harm with someone I’m worried about?

Choose a private moment and express your concern gently using specific observations rather than accusations. You might say, “I’ve noticed some marks on your arms, and I’m concerned about you. 

Would you be willing to talk about what’s going on?” Approach with compassion and be prepared to listen without immediate solutions.

What if the person denies self-harming even though I see clear signs?

Respect their response while leaving the door open for future conversations. You can say, “I’m here whenever you want to talk about anything.” 

Avoid pushing too hard initially, as denial may indicate they are not ready to discuss it. Continue offering support and watch for opportunities to revisit the conversation when they feel safer.

Can talking about self-harm make someone more likely to do it?

Research shows that asking about self-harm does not increase the behavior. In fact, discussing it openly in a supportive way often provides relief and can reduce isolation. 

The key is approaching the conversation with genuine concern and without sensationalizing the behavior.

How long does recovery from self-harm typically take?

Recovery timelines vary greatly depending on individual circumstances, the presence of underlying mental health conditions, treatment engagement, and personal support systems. 

Some people show improvement within months of beginning therapy, while others require longer-term support. Progress is rarely linear, and setbacks are a normal part of recovery.

What makes A Mission For Michael effective in treating self-harm behaviors?

At A Mission For Michael, we combine specialized expertise in complex mental health conditions with evidence-based therapies specifically designed to address self-harm. Our DBT program teaches concrete skills for managing emotions without self-injury, while our trauma-focused therapies like EMDR address underlying causes. 

With our 2:1 staff-to-client ratio and multiple levels of care, we provide intensive, personalized support that helps individuals develop lasting, healthier coping mechanisms in a safe, compassionate environment.