Feelings you may have

Upon learning of another's self injury you may feel a large variety of emotions: shock and denial, anger and frustration, empathy and sadness, and guilt.

▪ Shock and denial

Since self injury is often carefully hidden you might have been shocked to learn that a loved one is hurting themselves. You might not have noticed any of the signs connected to self injury such as the refusal to wear short-sleeved shirts, or shorts. Or the frequent "accidents" that there were always excuses for. But remember this, self injury is a secretive behaviour and is usually done when the person is alone and the injuries are usually hidden. But, also some family members or friends ignore or deny many of the signs. So, that when you do find out about the self injury you are shocked.

Denial is closely related to shock. It is often necessary for all of us to use denial to survive in this world where so much misery exists. If we were unable to deny or lessen the huge amount of starvation, wars, poverty, etc. we would probably be in a state of constant depression. But in the case of self injury, denial is detrimental and can deeply hurt your loved one who self injures. Self injury show's how much emotional pain an individual is in and to deny the self injury is to deny the presence of that pain. Denial may make that loved one feel that you are uninterested, are unwilling to help, or simply just do not understand. Therefore it is very important that you do not deny the reality of the self injuring behaviour of a loved one and its implications. This may be very difficult for you to do but it is absolutely essential to respond to the self injuring so that you may be able to help the person who hurts themselves.

▪ Anger and frustration

Anger is a common response upon learning of a loved one's self injuring. First, the anger may come from the many lies that quite often surround self injury. Many people who self injure lie about their behaviour to feel less ashamed or to ward of other's feelings of anger, disgust, or rejection. But when the lies are found out these are often the feelings that result. You may feel angry or disgusted because you were lied to. You may not understand the reason that the self injurer lied and therefore may feel even more angry. The lies indicate distrust, and this implied lack of trust and openness between you and the self injurer may anger or even hurt you.

You might feel that the self injuring behaviour is unnecessary, which might also anger you. It may be very frustrating to watch someone else hurt themselves. You might feel the need to scold the person or force them to stop self injuring. This frustration comes about from your inability to control other's behaviours. No matter how much you may dislike what the self injurer does, and no matter how much you might try to control what they do, you simply cannot.

Self injury is different from most other behaviours because the results are physically visible. This may cause you to feel your own helplessness in changing the self injurers behaviour. Realizing your helplessness in this situation may also cause you to feel anger and frustration.

▪ Empathy, sympathy and sadness

Understanding how much another person hurts emotionally is good and bad. It allows you to help them. But it also may cause deep psychological pain within you.

Empathy is the ability to understand the perspective and situation of another. When you are empathetic you are able to enter the emotional world of another. You take perspective and see the world through the eyes of that person. Of course it is impossible for you to feel exactly what another feels and to experience what they experience. But empathy may help you to gain understanding of the self injurers situation.

Self injurers feel a lot of emotional pain. Understanding this pain is very helpful when you are supporting and assisting the self injurer. But there is a negative part to empathy, that is the loss of detachment or "separate perspective" When you are looking into and experiencing another person's inner world it does affect you. As a human being you are often unable to stop this, so as a result you might feel some of the sadness and pain of the self injurer. So, empathy might result in sadness.

You might feel sad for the person who self injurers. This sadness you feel for another is sympathy. When we feel sympathetic towards another person, we see them as someone worth our pity, which can be a condescending view. Empathy is a helpful emotion, but sympathy is not. Sympathy puts the self injurer in an inferior position. When we feel sympathy we presume to understand how they feel and how they see their situation. A self injurer might see their self injury as a positive behaviour that helps them survive. But from a sympathetic stance their self injury might look like a negative behaviour. So, basically sympathy and the sadness that may come with it are not useful rather, it blocks understanding and "objectifies the person for whom you feel pity."

▪ Guilt

Guilt is the feeling of remorse stemming from a perceived wrongdoing. When we do something that goes against our morals and values, our conscience supplies us with adequate measures of guilt. Self injury in a loved one may make you feel guilty. For example, you might feel that something you did caused your friend or relative to hurt themselves. Maybe you're afraid you weren't a good parent, partner, or friend. Maybe you feel that you didn't offer enough love, support, attention, or affection. Or maybe you feel you weren't around enough or didn't listen enough. Guilt is often useful but in this case you might feel guilt that isn't necessary, appropriate, or useful.

You do not have the power to make anyone do anything. Your behaviours or actions certainly may influence the perceptions, beliefs, behaviours, and emotions of the self injurer or anyone for that matter, but this is not force. Whatever you did or did not do you did not force the person to injure themselves. People always have a choice for what they do, even under the most extreme situations.

This guilt you may feel is a normal reaction to learning of a loved one's self injury but it is not particularly helpful. It is more helpful to surpass these feelings or remorse and regret and focus your energy in a more positive and useful direction. Talk with the friend or family member who self injures and ask how you might help them. Wallowing in your guilt will only make you feel depressed and unable to act. You need to offer help to the self injurer rather than apologies.

Thoughts you may have

Accompanying the feelings you might have because of another's self injuring behaviour, are thoughts that reinforce and support these feelings. There are a large variety of thoughts that often come when you learn that someone you love is self injuring, such as:

• "It's all my fault."

• "You're crazy."

• "You're doing this to manipulate me."

• "I can fix this."

• "This changes our whole relationship."

• "You're not who I thought you were."

When you look at these thoughts you might see that they are wrong, and could negatively influence your feelings. Also, imagine if you said any of these things to your loved one who self injurers They would be terribly hurt or upset. Be aware of your thoughts so that you can stop them from contributing to a negative emotional response that might hurt the relationship between you and the SI'er.

What to do and what not to do

As a friend or a relative of a self injurer you probably want to help them, to ease their emotional pain. But, without the right knowledge this "helping" could hurt more than it helps the self injurer. This section has some ideas on what you should do and what you shouldn't do while trying to help someone who self injures.

▪ Do talk about self injury, within reason

As has been mentioned before self injury is an isolated and secretive behaviour. Whether or not you discuss it, it exists. Ignoring self-injury does not make it go away. It may actually cause more damage, because, first of all, ignoring self injury actually may help reinforce the feeling of shame surrounding the behaviour. Many people who self injure feel that what they do is so shameful that talking about it is a taboo. So, basically, the secrecy and feelings of shame are strengthened. Second, it can add to the factors that lead to self injury. When communication is weak, there may be an increase in feelings of isolation and alienation, feelings that often precede an act of self injury. Therefore, by not talking about self injury, you might actually increase the chances of your friend or family member hurting themselves again.

Talking about self injury is important. That may be a good start to helping a person who hurts themselves. You can remove the shame and secrecy associated with self injury and you encourage communication between you and the self injurer. You help create change just by talking.

Something that might stop you is that you might not know what to say. Even though you might not know what to discuss, just be acknowledging that you want to talk opens up communication channels. Here are some questions and topics you might want to address:

• "How long have you been hurting yourself?"

• "Why do you hurt yourself?"

• "How do you hurt yourself?"

• "When and where do you usually hurt yourself?"

• "How often do you injure yourself?"

• "How did you learn to hurt yourself?"

• "What is it like for you to talk with me about hurting yourself?"

• "Does it hurt when you injure yourself?"

• "How open are you about your self-injurious behaviours?"

• "Do you want to change your self injuring behaviours?"

• "How can I help you with your self injury?"

▪ But don't

Don't keep asking questions if the self injurer does not wish to talk about their self injury. This is intrusive and unwelcome. This may cause even further alienation, make them feel even more alone and isolated. The self injurer may eventually open up to you but this will be when and where they want to. Just, make sure they know that you are willing to talk and to listen to them and that you will try to be understanding and not judgemental. Until then, don't pressure them.

▪ Do be supportive

Talking is one way to show support, but there are many other ways to show it as well. A good way to determine how to offer support is to ask directly. That way, you know what kind of support to offer that is helpful. Also, being supportive is to keep your negative reactions to yourself. Making judgements or hurtful responses conflict with support. To help the loved one who self injures you must put aside your negative thoughts and feelings for the moment. This is crucial if you want to help the self injurer. You can only provide support by being supportive. That is not to say that you aren't going to have negative thoughts or emotions but that you must hide them. At a time when the self injurer is emotionally healthy and you are not offering help you may, without being emotionally hurtful, express your thoughts and feelings.

▪ Do be available, within limits

Most people who hurt themselves will do so when they are alone, so the more time you spend with the self injurer the less chances they'll have to self injure. This is not saying that it will eliminate the behaviour all together. Offering your company and support can decrease the chances of self injury.

For many people who hurt themselves it is difficult to express or even recognize what they need. So, it is helpful to volunteer the ways in which you are willing to help. This way your friend will know when and in what ways they can rely on your aid.

Forming boundaries may be necessary for you in any situation with a self injurer. Boundaries are the limits you place on yourself and others in relationships, ground rules in effect. They help you know what you can expect from others and what others can expect from you. Some self injurers have trouble with boundaries, possibly due to events such as trauma and abuse, so as a result they might break your boundaries because of this you might need to set and maintain clear and consistent limits with them. For example, if you are not willing to take crisis calls after midnight, then tell them. This way they know what to expect and what help is available to them. That way you help form a clear and consistent relationship.

▪ Don't discourage self injury

Telling an individual to not injure him or herself is both aversive and condescending. Self injury is a way of coping for some people, a final attempt to relieve emotional pain. Many self injurers wouldn't hurt themselves if there was another way. And even though there are negative effects they keep on doing it, which shows that often it is necessary for their survival. By making even the most casual of comments indicating that you want the self injurer to stop their behaviour you risk damaging your relationship with them and any communication you might have. Your friend or relative will continue to hurt themselves as long as they feel it's necessary whatever you say will not stop this. But the amount of secrecy and shame surrounding their behaviour will grow.

Also, some people who self injure actually hurt themselves even more in reaction to demands that they stop their behaviour. By imposing your limits on another, you create the potential for failure. Thus, some who self injure will increase their self injuring behaviours in order to feel as if they have a choice about it and control over these actions.

▪ Do recognise the severity of the persons distress

Most people don't hurt themselves out of curiosity to feel what it's like. They do it because they are in emotional pain and it is the only way they feel they can cope. This may be difficult for you to understand, but it is important for you to recognize the extreme amount of emotional pain that self injurers are in.

One reason that some people self inure is that they want to change internal pain to something external that they can treat. Wounds can be symbols for pain and suffering. It's important to acknowledge the messages sent by scars and wounds. How much you understand your friend or relative's pain and how much you empathize appropriately will make communication with them better. Don't be afraid to talk about the subject of emotional pain. This way the self injurer can talk about their internal suffering, rather than express it through hurting themselves.

▪ Do get help with your own reactions

Sometimes the behaviour of others affects us so profoundly that we have to get help to deal with our own reactions. Getting help, possibly through therapy, could help you deal with your often disturbing or overwhelming responses to a loved one's self injury. You might find getting help for someone's else's problem strange but remember this the behaviours of others can have a profound effect on you. This effect is further strengthened by the mysteriousness, secrecy, and misconceptions about self inflicted violence. Therefore, getting help through therapy can help educate you on self injury as well as helping you understand and change your reactions. Since learning of a friends or family member's self injury is often very emotionally disturbing you can get help for this.

Asking for help may be a very hard thing for you to do. Remember that the self injurer had the same problem so do what they did ask for help if you need or want it. Look for a trained professional, ask friends for support, talk with a religious counsellor if you wish. Getting support for yourself helps you and the self injurer. The more you are able to handle your own reactions, the better you will be able to help your friend or family member who self injurers.