How can I support a person who wants to self-harm?
May 12, 2010 9:10 AM Subscribe
My girlfriend tells me she's getting the urge to self-harm, something she last did years ago. Read on for vital info before replying, but the question is: what can I do to help?
We've agreed that she's going to see a therapist. She saw one some time ago and made a huge amount of progress, but her treatment was cut short.
We've moved in together recently, and she talks now about being unable to vent her sometimes irrational anger in front of me (she wants to break expensive things). Instead, she says, she turns it inside, where it becomes a desire to harm herself.
The situation is under control and I don't think she will harm herself. But the question is how I can provide support for her. We hug a lot but sometimes when the desire to harm is strong she doesn't like me being near her or touching her. We do of course talk about it, which is why I know everything I've mentioned here (and I also know the core causes of her issues, although knowing this doesn't seem to help her very much).
We've agreed that she's going to see a therapist. She saw one some time ago and made a huge amount of progress, but her treatment was cut short.
We've moved in together recently, and she talks now about being unable to vent her sometimes irrational anger in front of me (she wants to break expensive things). Instead, she says, she turns it inside, where it becomes a desire to harm herself.
The situation is under control and I don't think she will harm herself. But the question is how I can provide support for her. We hug a lot but sometimes when the desire to harm is strong she doesn't like me being near her or touching her. We do of course talk about it, which is why I know everything I've mentioned here (and I also know the core causes of her issues, although knowing this doesn't seem to help her very much).
The situation is under control and I don't think she will harm herself.
No. No it is not. Unless you're observing her 24/7, this situation is not under control in the least. She needs to be in therapy yesterday. Like Think_Long said, research, call, make appointments.
posted by griphus at 9:20 AM on May 12, 2010
No. No it is not. Unless you're observing her 24/7, this situation is not under control in the least. She needs to be in therapy yesterday. Like Think_Long said, research, call, make appointments.
posted by griphus at 9:20 AM on May 12, 2010
Therapy. Today.
As someone with lots of stuff but no self harming, I do want to thank you for being supportive and open about this. It can be really hard to reach out for help. For her, and for you. Thanks, on her behalf, for giving her a safe place to be honest and vulnerable.
Offer to go with her to therapy if that is ever something she wants. Help her find, create, and enjoy healthy ways to self soothe and distract. The practice of these things during small issues will help her immensely during even harder times, which are sure to come in the future, since life is like an ocean, with emotions coming and going like waves.
(if she's not sure how to navigate all the many options for therapy, I really get a lot from my DBT, with a weekly group component for trauma survivors. members of the group with history of self harm have shared that some specific skills have helped curb that behavior.)
Again, thank you for being there for her.
posted by bilabial at 9:34 AM on May 12, 2010
As someone with lots of stuff but no self harming, I do want to thank you for being supportive and open about this. It can be really hard to reach out for help. For her, and for you. Thanks, on her behalf, for giving her a safe place to be honest and vulnerable.
Offer to go with her to therapy if that is ever something she wants. Help her find, create, and enjoy healthy ways to self soothe and distract. The practice of these things during small issues will help her immensely during even harder times, which are sure to come in the future, since life is like an ocean, with emotions coming and going like waves.
(if she's not sure how to navigate all the many options for therapy, I really get a lot from my DBT, with a weekly group component for trauma survivors. members of the group with history of self harm have shared that some specific skills have helped curb that behavior.)
Again, thank you for being there for her.
posted by bilabial at 9:34 AM on May 12, 2010
Yes, definitely have her schedule an immediate appointment with a therapist.
Additionally, it sounds like moving in together might have been a stressor for her, so maybe you could talk that out? Are you messier, or neater, than she is? Does she need some time to herself? Are finances stressing her out? Don't pry or blame or judge, obviously (not that you would), but try to let her know she can talk to you. She needs to feel safe and secure enough to express herself instead of keeping it bottled up.
posted by JenMarie at 9:38 AM on May 12, 2010
Additionally, it sounds like moving in together might have been a stressor for her, so maybe you could talk that out? Are you messier, or neater, than she is? Does she need some time to herself? Are finances stressing her out? Don't pry or blame or judge, obviously (not that you would), but try to let her know she can talk to you. She needs to feel safe and secure enough to express herself instead of keeping it bottled up.
posted by JenMarie at 9:38 AM on May 12, 2010
Self-harmers usually have a favorite tool - a boxcutter or equivalent, often a specific one. Find out what her self-harm tool of choice is (if she's serious about wanting to resist she'll tell you what it is) and make sure there isn't one in the house, and remove it if there is - really remove it, take it away and throw it out somewhere away from the house and don't tell her where. If it's something easy to buy (cheap boxcutters can be found at the grocery store), then check incoming bags for them (with her permission).
If she's serious she will agree to the above. If she doesn't, if she hedges on telling you what she wants to cut with or doesn't let you unpack the groceries, then you need to go to the emergency room psych IMMEDIATELY - it means she doesn't really want to control it and she should get professional help ASAP.
As an ex-self-harmer, I can say that not having the means to hand makes it much easier to get through the impulse and let it pass without acting. It's one less thing to fight.
posted by Billegible at 9:48 AM on May 12, 2010
If she's serious she will agree to the above. If she doesn't, if she hedges on telling you what she wants to cut with or doesn't let you unpack the groceries, then you need to go to the emergency room psych IMMEDIATELY - it means she doesn't really want to control it and she should get professional help ASAP.
As an ex-self-harmer, I can say that not having the means to hand makes it much easier to get through the impulse and let it pass without acting. It's one less thing to fight.
posted by Billegible at 9:48 AM on May 12, 2010
Everying Billegible said, plus you might try some little DBT methods to cope with the urge (holding an ice cube is one that has worked well for people I've known) until you can get her to her first appointment.
What she needs from you is going to depend on who she is, though. Can you have a conversation with her about what she thinks you could do to help her? I mean, maybe she needs someone to make the call to the therapist in the first place. Maybe she needs to be distracted. (I had a boyfriend once who would take me to play Skee-Ball when I was in a bad place. It was wonderful.) Maybe she just needs to talk. Or to be left alone.
There are a ton of things that can help with that moment of intense emotion, by the way. Deep breathing, bubble baths, going for a run, turning the radio up loud and cleaning house. Sometimes just having someone to say, "Hey, do you want to take a bath now?" is super-helpful.
posted by brina at 10:28 AM on May 12, 2010
What she needs from you is going to depend on who she is, though. Can you have a conversation with her about what she thinks you could do to help her? I mean, maybe she needs someone to make the call to the therapist in the first place. Maybe she needs to be distracted. (I had a boyfriend once who would take me to play Skee-Ball when I was in a bad place. It was wonderful.) Maybe she just needs to talk. Or to be left alone.
There are a ton of things that can help with that moment of intense emotion, by the way. Deep breathing, bubble baths, going for a run, turning the radio up loud and cleaning house. Sometimes just having someone to say, "Hey, do you want to take a bath now?" is super-helpful.
posted by brina at 10:28 AM on May 12, 2010
Based on my experiences, it's important not to overreact. That means that you don't take it upon yourself to "fix" her yourself either by taking away her tools or by "forcing" her to go to an emergency room unless she expresses a desire to cause herself serious harm.
Of the self-injurers I knew/know, very few would have reacted at all positively to having their primary (if they had one) way of hurting themselves taken away. It just takes away their control over the one thing they feel like they have control over: getting to inflict pain/injury on themselves.
Just be supportive of her, don't freak out if you discover wounds or she tells you about it. Probably the best thing you can do is help her understand that you'll be there through this and after she is able to stop harming herself.
Self-harm can be a useful tool for some people to avoid attempting suicide or other worse destructive behavior. Don't make them choose between attempting to get around you to harm themselves or doing something worse.
posted by skynxnex at 10:43 AM on May 12, 2010 [2 favorites]
Of the self-injurers I knew/know, very few would have reacted at all positively to having their primary (if they had one) way of hurting themselves taken away. It just takes away their control over the one thing they feel like they have control over: getting to inflict pain/injury on themselves.
Just be supportive of her, don't freak out if you discover wounds or she tells you about it. Probably the best thing you can do is help her understand that you'll be there through this and after she is able to stop harming herself.
Self-harm can be a useful tool for some people to avoid attempting suicide or other worse destructive behavior. Don't make them choose between attempting to get around you to harm themselves or doing something worse.
posted by skynxnex at 10:43 AM on May 12, 2010 [2 favorites]
Self-harmers usually have a favorite tool - a boxcutter or equivalent, often a specific one. Find out what her self-harm tool of choice is (if she's serious about wanting to resist she'll tell you what it is) and make sure there isn't one in the house, and remove it if there is - really remove it, take it away and throw it out somewhere away from the house and don't tell her where. If it's something easy to buy (cheap boxcutters can be found at the grocery store), then check incoming bags for them (with her permission).
Just to offer an alternative perspective, while my preferred tool was a scalpel, I've used a boxcutter, swiss army knife, broken glass, compass, scissors, steak knife, ceremonial dagger and even pencil sharpener blade. Once scalpels became unavailable I would use anything I could get my hands on. You can't remove everything sharp in your home (assuming she's a cutter - if she does something else it might be easier to remove things she can hurt herself with)
If her issue is anger/frustration - would it be possible, at least in the short-term to get her some things that its ok to break? I'm assuming the 'breaking' is more important than the 'expensive'.
posted by missmagenta at 10:49 AM on May 12, 2010
Just to offer an alternative perspective, while my preferred tool was a scalpel, I've used a boxcutter, swiss army knife, broken glass, compass, scissors, steak knife, ceremonial dagger and even pencil sharpener blade. Once scalpels became unavailable I would use anything I could get my hands on. You can't remove everything sharp in your home (assuming she's a cutter - if she does something else it might be easier to remove things she can hurt herself with)
If her issue is anger/frustration - would it be possible, at least in the short-term to get her some things that its ok to break? I'm assuming the 'breaking' is more important than the 'expensive'.
posted by missmagenta at 10:49 AM on May 12, 2010
You've already gotten excellent advise and I would like to congratulate you for being supportive on this situation. You mention that one of the ways to vent her anger is to break things, can you (along with her therapists) also find way to release this anger via other activities such as kickboxing (maybe hitting a bag) or maybe yoga (which is supposed to be a calming experience)
posted by The1andonly at 10:53 AM on May 12, 2010
posted by The1andonly at 10:53 AM on May 12, 2010
I know I'm a broken record about this, but one of the best ways to be supportive of your girlfriend is to
1) take care of yourself (possibly including therapy for yourself- this is stressful!). Have hobbies of your own. Have a life of your own.
2) be her boyfriend and not her dad or therapist or anything else. It just gums up the relationship.
posted by small_ruminant at 11:09 AM on May 12, 2010
1) take care of yourself (possibly including therapy for yourself- this is stressful!). Have hobbies of your own. Have a life of your own.
2) be her boyfriend and not her dad or therapist or anything else. It just gums up the relationship.
posted by small_ruminant at 11:09 AM on May 12, 2010
Other activities to relieve stressors:
--buy dishes at Goodwill and break them (inside or on top of a sheet, maybe, or throwing at a wall)
--BATTING CAGES. Love the batting cages. It feels really good to connect with something like that, not just let energy release with something like running.
posted by Madamina at 11:14 AM on May 12, 2010
--buy dishes at Goodwill and break them (inside or on top of a sheet, maybe, or throwing at a wall)
--BATTING CAGES. Love the batting cages. It feels really good to connect with something like that, not just let energy release with something like running.
posted by Madamina at 11:14 AM on May 12, 2010
Tattooing could be an alternative. If the point of her self-harming is to experience relief through pain, getting a tattoo was pretty satisfying to me as an alternative to cutting. Felt about the same, and the result is prettier and more socially acceptable. Maybe book her in for getting a small tattoo and see if she likes it, then go for more. Not a cheap solution but then again I doubt therapy and medicine is cheap either.
posted by lizbunny at 11:46 AM on May 12, 2010 [1 favorite]
posted by lizbunny at 11:46 AM on May 12, 2010 [1 favorite]
It's a good sign that she is TALKING to you about the urges. Talking is a coping tool other than self-harm, so please continue to provide a safe, welcoming space for it. Be very careful not to introduce any kind of guilt or shame or reason for her to be embarrassed by talking to you about it. You are already doing something very valuable by being a good person for her to talk to, which helps her keep from internalizing the anger.
And, as others have said, she would likely benefit greatly from seeing a therapist. It's also not a great coping tool to break expensive stuff either, and it's been found in study after study that anger is INCREASED after using physical aggression as an "outlet". It's a little bit of a fine line, but there are a lot of ways that therapists work with anger and self-harm specifically. Best of luck.
posted by so_gracefully at 2:46 PM on May 12, 2010
And, as others have said, she would likely benefit greatly from seeing a therapist. It's also not a great coping tool to break expensive stuff either, and it's been found in study after study that anger is INCREASED after using physical aggression as an "outlet". It's a little bit of a fine line, but there are a lot of ways that therapists work with anger and self-harm specifically. Best of luck.
posted by so_gracefully at 2:46 PM on May 12, 2010
Therapy helped. Not having any razors in the house. The other anachronism being honest about how it affected him helped. I've had one relapse in the past 8 years and that was a sign that I need to control my drinking better as well. Find out what the emotional triggers are - not just 'angry' or 'sad'. For me any feeling of ostracism or alienation would trigger unhelpful thought processes. Lack of control as well. The relapse had all three plus something close to alcohol poisoning.
Concrete things I did: I had a list of non-maladaptive coping strategies (breathing exercises, tea ceremonies, passages to read, songs to listen to) and a list of not great but acceptable ones (smoking, breaking shit, chocolate, alcohol). I had a list of crisis behaviours that would necessitate drastic action like the ER (excessive alcohol, trying to find razors/sharp implements).
posted by geek anachronism at 3:57 PM on May 12, 2010
Concrete things I did: I had a list of non-maladaptive coping strategies (breathing exercises, tea ceremonies, passages to read, songs to listen to) and a list of not great but acceptable ones (smoking, breaking shit, chocolate, alcohol). I had a list of crisis behaviours that would necessitate drastic action like the ER (excessive alcohol, trying to find razors/sharp implements).
posted by geek anachronism at 3:57 PM on May 12, 2010
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Not good enough.
When you say you've "agreed that she's gong to see a therapist", have you just verbally agreed - or did you and her do some research and actually make some calls?
posted by Think_Long at 9:12 AM on May 12, 2010