Self-harm: understanding and support

Discovering that someone you love is hurting themselves on purpose can be deeply distressing. It helps to understand what self-harm usually is, and isn't, so you can respond in a way that actually helps.

What it is

Self-harm is when someone deliberately hurts their own body, often as a way to cope with overwhelming emotional pain, numbness, or distress they don't know how else to manage. It can take many forms, including cutting, burning, scratching, hitting oneself, or other deliberate injury. Importantly, self-harm is usually not the same as a suicide attempt, though the two can sometimes overlap and both deserve to be taken seriously. For many people, self-harm functions as a release valve for feelings that feel too big to hold, a way to feel something when they feel numb, or a form of self-punishment. It's a sign that someone is struggling, not a bid for attention.

Signs to notice

• Unexplained cuts, burns, bruises or scars, often in places that are easy to cover, like arms or thighs.
• Wearing long sleeves or trousers even in hot weather.
• Finding sharp objects, lighters or other tools in unusual places.
• Withdrawal, secrecy, or reluctance to change in front of others or go swimming.
• Increased irritability, low mood or emotional overwhelm before the self-harm is discovered.
• Direct statements about wanting to hurt themselves, which should always be taken seriously.

What helps

• Respond with calm concern rather than shock, anger or panic. A reaction of horror can push someone to hide it further.
• Avoid ultimatums or punishment. Self-harm is a coping mechanism, and removing it without offering another way to cope with the underlying pain rarely works.
• Ask gently what they're using it to cope with, rather than focusing only on the behaviour itself.
• Encourage professional support, and offer to help them find or attend it.
• Support the development of alternative coping strategies over time, such as grounding techniques, creative outlets or physical movement, ideally guided by a professional.
• Keep communication open. Let them know they can come to you without fear of judgement.
• Take care of your own emotional response too. Supporting someone through this can be draining, and you deserve support as well.

When to reach out for help

Any self-harm is worth taking seriously and should be met with professional support, even if it seems "minor." Seek urgent help if the injuries are severe, if the person expresses a wish to die, if the frequency or severity is increasing, or if self-harm is combined with substance use or hopelessness.

Getting help in South Africa

Cleared Mind's EAP counsellors can support both the person self-harming and the people around them with understanding, practical guidance and ongoing care. SADAG's Mental Health Line on 011 234 4837 also offers support and referrals.

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If you or someone else is in immediate danger, reach out now. SADAG Suicide Crisis Helpline (24h): 0800 567 567 or SMS 31393. SAPS 10111, ambulance 10177, GBV Command Centre 0800 428 428.