If you love someone who engages in self-harm behaviors, you may feel scared, helpless, or unsure of what to say. You want to help, but worry about saying the wrong thing or making things worse. These feelings are common and understandable.
Self-harm is an emotionally charged and often misunderstood behavior. With empathy, compassion, and consistency, loved ones hold a meaningful role in supporting recovery and healing.
What Is Self-Harm?
Self-harm refers to the intentional injury of one’s own body as a way of coping with emotional pain, distress, or overwhelm (National Institute for Health and Care Excellence [NICE], 2022). It is important to note that self-harm does not always mean someone wants to die.
While considered an inherently risky behavior, self harm is more commonly rooted in an attempt to manage emotions that feeling overwhelming in times when no other coping strategies feels effective. For many, self-harm may:
- Provide a sense of separation from overwhelming emotions
- Externalize feelings that feel invalidated internally
- Offer temporary relief from emotional overwhelm through physical expression
Shifting our understanding of self-harm from being “attention-seeking” or “manipulative” or even just “wrong” to being an alternative coping response—when more adaptive responses are unavailable—is crucial in providing empathy and effective support during treatment.
Therapy and Supports
Therapy is an essential component of recovery from self-injurious behaviors, but it is not the only piece of the therapeutic process. While therapists provide structured support for an hour or two each week, loved ones play a vital role in the everyday moments when urges may arise.
Supportive relationships can:
- Reduce feelings of shame through understanding and shared acceptance
- Help regulate emotions
- Reinforce coping strategies and interventions learned in therapy
Loved ones often serve as “emotion coaches” to help to create an environment for healing—one where emotions can be felt safely and can be supported to respond more adaptively. This role is not meant to “fix the problem”, but to create an environment where safety, care, and connection are provided.
Emotion Coaches and Their Role
Emotion coaches are individuals who play an active role in the persons life with intention of helping to navigate intense emotions and help guide loved ones through those feelings without avoiding or dismissing emotions.
This begins with validation, rather than reacting from fear.
Validation may sound like:
- “I can understand how this feels overwhelming.”
- “It makes sense that you’re feeling this way right now.”
- “Thank you for coming to me. I can sit with you through this urge.”
Validation does not mean agreeing with or endorsing self-harm behaviors. Instead, it communicates understanding of the emotional pain being experienced.
Helpful Tip: It is also important to avoid using the word “but” in responses, as it can unintentionally invalidate feelings. Instead, try statements such as:
- “Your feelings matter to me, and I want to help you get through this.”
- “I care about you deeply, and I’m concerned about your safety.”
Statements like this highlight and support understanding while also recognizing this is an unsafe behavior.
We Are Not Here to Fix
Many loved ones often feel pressure to find solutions or stop the behavior immediately. While safety matters and is important, focusing solely on stopping the behavior can unintentionally suppress the emotional experience and increase feelings of shame or invalidation.
Often, what helps most is providing space to listen and validate emotions- simply being present.
Support can look like:
- Allowing emotions to exist without trying to change them
- Showing understanding and presence by sitting with them through the urge
Statements such as “You shouldn’t feel this way,” though often well-intentioned, can increase feelings of shame. Presence and understanding are often far more powerful than trying to fix the problem.
Try instead:
- “How can I be helpful to you in this moment?”
- “I am here to listen to whatever it is that you are feeling”
- “Maybe we can try some deep breathing”
Support as a Loved One, Not as a Therapist
Taking on the role of an emotion coach can feel intimidating. However, your role is not to replace the therapist, but to be a steady and comforting presence.
Steady support includes:
- Encouraging connection with their therapist
- Setting healthy boundaries
- Providing reminders of coping skills established in the therapeutic space
- Recognizing when you, as a support person, need support yourself
It is important to acknowledge that supporting someone who self-harms can bring up fear, anxiety, or uncertainty. Seeking support for yourself as an emotion coach is not a failure- it is a necessity.
Remembering This Is a Process
Recovery from self-harm is not linear. It includes progress, setbacks, stuck points, and moments of intense emotion. Healing is not defined by perfect abstinence, but by consistency—consistency in treatment AND consistency in support.
Therapeutically, recovery involves strengthening emotional awareness, building internal insight, developing safety plans supported by coping strategies, and repairing interpersonal ruptures that may have occurred. Each time an individual reaches out for support, engages honestly in therapy, or shares vulnerable experiences is a sign of progress.
Setbacks or continued engagement in self-harm are not failures. Instead, they provide opportunities to identify unmet needs and adjust support in ways that are more adaptively responsive.
When individuals are met with patience, validation, and availability, their nervous systems learn that intense emotions can be tolerated and survived—without causing harm.
Note:
If a person is actively engaging in self-harm or feels unable to keep themselves safe, immediate support is essential. Reaching out to crisis services such as calling or texting 988 provides immediate, confidential support from trained professionals. Individuals should also be encouraged to contact their therapist or mental health provider as soon as possible.
If there is imminent risk or injuries requiring medical attention, presenting to the nearest emergency room is the appropriate step. Seeking urgent help is not a failure or an overreaction—it is an essential act of care and safety.
Written by Marisa White, LPC, NCC
About TLC Wellness
TLC Wellness is dedicated to serving individuals of all ages and addressing a diverse spectrum of mental health needs. The mission is to provide compassionate and effective therapy services, tailored to each person’s unique circumstances, to promote healing, resilience, and holistic well-being within the community. By utilizing proven modalities such as cognitive behavioral therapy, exposure and response prevention, acceptance and commitment therapy tools, and family systems/relational models, TLC Wellness strives to empower individuals on their journey toward a more authentic and fulfilling life.