Illustration by Dinda Lehrmann.

Illustration by Dinda Lehrmann.

I’ve had the odd privilege of seeing self-harm from a few different perspectives—as a therapist I worked with clients who were self-harming, and as a teen, many of my friends hurt themselves. Regardless of how you started self-harming—by accident, after reading about it, or with intention—I’m approaching this with the idea that you can stop. Because you can stop. I’ve learned that self-harm is, at its most basic, a coping mechanism, not a suicide attempt. That said, if you have hurt yourself in an attempt to end your life, or have a strong desire to end your own life and a plan to do it, please tell an adult you trust, or call the National Suicide Prevention Lifeline: 1 (800) 273-8255.

We all have coping mechanisms and we needn’t feel ashamed of them, but we can also find healthier ways of dealing with negative emotions and general mindfuckness. Hurting yourself physically to help yourself emotionally is not a fair trade, and there are ways to help yourself emotionally that don’t involve physical pain.

We have needs. Our physical needs are for water and nutrients. Our emotional needs are just as important, but sometimes we neglect those, or they change so fast that we don’t realize that what we used to need isn’t what we need anymore. If you are self-harming, see if you can figure out what emotional need self-harm meets for you. Does it make you feel more focused? Less anguished? Less stressed? More alive? More in your body? What was there afterward that wasn’t there before, feeling-wise? Understanding this without judgment or shame is important, because those needs absolutely deserve to be met. You just need another solution.

While some people are able to stop the habit of self-harming on their own, for most people, it’s quite difficult. Maybe you want to stop but don’t know how. Perhaps the initial release of self-harm feels good and you don’t want to lose that, even if you end up feeling worse later. Asking for help with anything can be hard, and even harder in this situation since bodies are private and personal, and shame around our bodies can be so much of a thing, too. Perhaps you do want to tell someone but are afraid because self-harm is often misunderstood and you don’t want to freak people out. An adult can help you find coping skills for your pain and stress, and will sometimes have more access to resources than someone your own age. You aren’t a burden, and you deserve to be in touch with someone whose priority is making sure you’re are OK. You don’t have to go through this experience alone.

When figuring out who to approach, run through the adults in your life: parents or guardians, teachers, siblings, a friend’s sibling. When I was younger, I decided I could trust adults when they listened to me and didn’t talk down to me. Who makes you feel heard? Who makes you feel like your thoughts and opinions are important and aren’t annoyances? Once you have that person in mind, go to them. Tell them that you have been self-harming. Your opener could go something like this:

Hi, I want to talk to you about something hard for me. I have been self-harming and I want to stop. I am doing this because it’s helping me cope with negative emotions/the swarm of shit inside me/stuff I can’t cope with. I am not doing this because I want to die. I need help coping.

Or:

I need to tell you something because I need outside help. I have been self-harming. I am not suicidal, but I want to stop.

You don’t have to be suicidal in order to warrant help, or love, or attention. You just have to be human. If you are in college, you can go to your Student Mental Health Clinic or Student Health Services to ask for a referral to a therapist. You can also ask your regular doctor, or talk to the counselor at your school. There is no national database of free or low-cost therapy if you don’t have health insurance benefits, but the National Alliance on Mental Illness, NAMI, has a state-by-state website that lists a ton of resources.

If you aren’t quite ready to approach an adult, talk to someone, even if they can’t get you “professional help.” Pick a time when you and your pal are alone and in an undisturbed place, and approach the conversation however you feel most comfortable. Keep it simple: Ask if your friend would be willing to be on your team with fighting this. Sometimes, the loneliness of having a secret that feels shameful is the worst part, and talking to someone else about it will help you to feel less alone. Talk about the emotions that lead you to self-harm. Get comfortable using words instead of your body to express these feelings, even if you’re not making a lot of sense at first.

If you want, you can develop a shorthand with a friend. Agree on a safe word, an emoji, a GIF, whatever, ahead of time, so that when you feel like you want to self-harm, you can instead send a signal out to your trusted confidant. Then you and your friend can just connect—it doesn’t have to be a dramatic, sappy conversation—about why the world is unfair or why OINTB isn’t on for another few months. Self-harm operates and flourishes in secrecy, but a system like this lets someone else in on your feelings so you don’t have to bear them on your own.

The people you approach might not be fully aware of what self-harm is, or they may think it’s something that only happens to you. If that’s the case, direct them here or here for more information. Showing them that self-harm is a well-studied and discussed phenomenon in the psychological community will keep you from having to justify that what you’re experiencing is a “real thing,” and will answer a lot of questions that you may not want to answer, or may not know the answers to. Your experience won’t be exactly like anyone else’s, but those resources can at least provide some context.

Adults, especially those that work with people under 18, have a “duty to report to the authorities” if you are suicidal, which is why it’s important to make it clear that you are not suicidal, just in need of help to figure out your emotions. The adult you tell may react with shock, fear, or pity. Forgive them for this if you can; these are somewhat natural reactions to seeing someone you care about injured. Give them a moment to process how they are feeling, and know that it’s not on you to convince them everything is OK. It’s not OK: that’s why you are asking for help. This is a good time to present them with the resources above, to remind them that you are a person they care about, or to just stay silent and let them deal for a moment.

If they treat you with disgust or dismiss you, it’s a sign that they are not equipped with the tools to help you. That’s on them, not you. It may hurt you to have someone treat you this way, and being hurt is a completely appropriate reaction, but remind yourself that it’s their problem if they don’t understand, not yours. You are worth more than that. Move on to the next adult, or the next therapist.

When you sit down with a therapist, look out for those same feelings I mentioned earlier, of feeling heard and valued, rather than condescended to. Ask the therapist about the “limits of confidentiality,” especially if you are under 18, so that you know what information will stay inside the room, and what might have to leave the room.

Once you feel that you can trust your therapist, talk to them about how you feel before and after you self-harm. Don’t hold anything back if you can help it, just describe your thoughts and feelings and behaviors as best you can. Show them the scars if you like, or don’t. Take yourself seriously, by which I mean, don’t pretend like your self-harm isn’t a big deal. You cared enough about yourself to reach out for help, and you deserve help, so don’t pull back by downplaying what’s going on with you.

Learning new coping mechanisms is a really gorgeous way to watch the storm inside subside, or to watch the desert inside suddenly swarm with life—you will surprise yourself with how much you are capable of. Those changes can’t happen long term with self-harm, but they can with some tools that therapy can give you.

Also know that once you seek help, you are not expected to be suddenly 100 percent cured. There is no 100 percent, not for anyone. We are all just doing the best we can at any point in time. You may seek help, start learning and enjoying some new skills, and still backslide into self-harm when things get stressful. You may weirdly miss self-harming, or miss the identity it gave you, if only to yourself. This is all OK. Getting better is difficult, in any capacity—it’s a journey of steps backward and forward. But it’s also exhilarating.

Self-harm isn’t disgusting or uncommon or anything else you might have been told. It’s a form of communication, and once you start on your body, it’s time to continue with your mouth, or your words on paper, or any other means you have of communicating. You can develop an amazing support system, you can get an amazing therapist, and you can change change your behavior. You are powerful. Keep finding new ways to use that power. ♦