Not every person experiencing an eating disorder will self-harm, however, a high risk of self-harm is reported among people with eating disorders.
What is self-harm? Self-harm can take many forms, including cutting, burning, punching, and picking at skin or sores. Generally speaking, it refers to someone deliberately inflicting pain to their body as a means of coping with difficult emotions.
Why do people self-harm? Without directly asking, it can be hard to know why our loved one self-harms. This is because the reasons vary from person to person, and some people may not even understand why they self-harm.
The most frequently reported factors that young people identify as to why they self-harm include:
- A way to relieve or control stress or strong emotions that sometimes come with feeling isolated, hopeless, overwhelmed, or frustrated
- a way to show they need help
- a response to feelings of guilt or shame
- a coexisting symptom of their depression or anxiety.
What are signs that someone is self-harming? Self-harm can be hard to recognise because it typically occurs on body parts that aren’t easily noticeable to other people.
The following signs may indicate that someone could be self-harming. However, the only way to be certain is to voice your concerns and ask them directly.
Behaviour
- avoiding leisure activities, such as swimming
- hiding objects such as blades, knives, or lighters
- increased use of bandages or antiseptic
- less inclined to socialise with family or friends
- decline in performance at school or the workplace.
Emotions
- fluctuating mood
- bouts of irritability occurring more frequently and lasting for longer periods of time
- appearing sad or hopeless
- low self-worth or high levels of guilt
- less inclined to care about their physical appearance.
Physical signs
- injuries on their body that they cannot provide a logical explanation for
- injuries on their body that they are unwilling to explain.
What actions can I take? It can be devastating seeing someone you love hurt themselves and not be able to fix the emotional and physical pain they’re in. However, it’s important to know that in the moment the very best thing you can do is take steps to:
- create a safe space for your loved one to talk about their thoughts
- talk openly about other ways they might cope with their thoughts, ranging from short-term coping strategies to seeking long-term professional support
- brainstorm with them things that may help their general health and wellbeing.
If you believe your loved one needs urgent medical assistance – including due to serious lesions on their body, or due to suicidal feelings – it is paramount that you:
- Phone 000 for an ambulance, or
- Travel with them to an emergency department.
Talk about it with them.
If you feel comfortable, open up the conversation
Examples of how to talk about self-harm, as suggested by the Raising Children Network:
- “I noticed the scars on your arm. I hope it’s ok to say that? Can you tell me about the times when you hurt yourself?”
- “I can see that you’re very upset. You might be scared. I’m scared too. Together we can work this out.”
- “The fact that you’re self-harming tells me you’re very upset. You might not like that I’ve found out. I’m not going to ask you a lot of questions but I do want to help – when you’re ready.”
Suggestions on setting up a safe environment for a conversation:
- Talk in a private setting, preferably not at a time when other life stressors are happening in your life or theirs.
- Begin by telling them why you are concerned, then what you have noticed on their body or their change in demeanour; lastly gently and directly asking if they’re engaging in self-harm.
- Refrain from interrupting – prioritise calm and lack of judgement throughout the conversation.
- If they have confirmed they are self-harming, it can be helpful to understand their triggers and means used. This can be done by asking questions around why, how frequently, and what they use to self-harm.
Make it clear that they have the option to talk only if they feel comfortable. If they don’t want to talk, encourage them to seek support from a mental health professional such as your local GP, a psychologist, counsellor, other family member, or crisis support service via text or phone call. Tell your loved one you are there to support them in any way they need or want even if just to take them to appointments, to hang out with, distract etc. Remind them that you know you can’t fix how they feel, however, you are a good listener!
If they are currently seeking support from a mental health professional, ask if they have a safety plan set up? There may be potential coping strategies they can use to help manage any difficult emotions. If you know the safety plan, you may try to encourage them to engage in any existing coping strategies.
If you don’t know how to open up a conversation with your loved one, there are other people you can reach out to for guidance. A crisis-support service via text message or phone call can give you short-term support such as immediate safety-planning if you are fearful for your loved one’s life, as well as resources you can access in your local community for long-term support such as local mental health services. Your family GP can give you information about creating a Mental Health Treatment Plan for yourself and/or your loved one.
Short-term solutions for people who self-harm
KidsHelpline recommend trying some or all of the following to help distract people who self-harm from their thoughts:
- mindfulness activities
- breathing exercises
- muscle relaxation strategies
- gentle exercise outdoors, such as walking
- creative activities which may include drawing, journaling, or listening to music.
Substituting self-harm behaviours with safer alternatives:
- drawing on their body with a pen
- rubbing ice on their skin
- gently flicking a rubber band around their wrist
- yelling into a pillow
- hitting a cushion
- eating a spicy piece of food.
Crisis support services across Australia include:
- Lifeline (Supports all ages. Operates 24-hours, 7 days). 13 11 14
- Kids Helpline (Supports ages 5 to 25. Operates 24-hours, 7 days). 1800 55 1800
- SANE (Supports all ages. Operates 10am to 10pm, Monday to Friday). 1800 187 263
Encourage your loved one to engage in activities that may improve their overall wellbeing. This may include:
- Getting enough sleep.
- Making an effort to hang out with understanding family or friends.
- Engaging in activities that are meaningful to them.
- Improving their stress management techniques.
- Making sure their self-harm is not the focus of most conversations you have with them.
Establishing a foundation for long-term support
For your loved one
Although your loved one may be able to stop engaging in self-harming behaviours in the short-term, it’s important to consider getting support from a health professional such as a general practitioner (GP), psychiatrist, psychologist or counsellor.
For you
It can be emotionally and physically exhausting caring for a loved one who is self-harming and it is important to look after you. Make sure you are eating and drinking enough throughout the day and getting an adequate amount of sleep. Engage in activities that bring you enjoyment – even if for just five minutes at the end of a busy day. This might be reading a book, watching a movie, putting your thoughts and feelings on paper, walking, yoga etc.
Creating a strong support network is important. Seek help by calling or texting trusted friends or family, reach out to other parents/carers who have been through or are going through similar things or organise someone to take over for a while so you can take some time out for yourself. A support network might be made up of:
- close friends
- family members
- community-based support groups such as the strive Australia private FB forum
- reaching out to a mental health professional.
About EDFA
EDFA is the only national organisation focused solely on providing support, education and advocacy to families and carers of those living with eating disorders. Our community of families and carers who have supported or are supporting a loved one with an eating disorder brings its wealth of lived-experience knowledge to all of EDFA’s activities.
We believe recovery is possible. We believe passionately in the power of hope. Together, with knowledge and support, we know hope can make a difference to those with an eating disorder as well as their families and carers. Join our community at www.edfa.org.au.
