Disclosing Self-Injury

For the vast majority of people, talking about self-injury for the first time is a very scary prospect. I’m sure, like me, you have all imagined the worst case scenario of what could happen if we were to tell someone about it. Of course we can never be certain about how someone is going to react, and fear of the unknown is one of the most powerful disablers in our taking action.

The first time I admitted to anyone that I self-harmed, I was lucky to have a really good experience. I told a friend who asked me directly if the marks on my arm were because I self – harmed. I had this moment of panic where I jumped to thinking that the only response possible was to deny deny deny – and then I just heard this little voice saying “yes”. It certainly wasn’t something I planned to tell her, but it was just one of those rare moments when it felt right to let someone know just how much I was struggling. I trusted my judgment and luckily it paid off. She has become a big support to me, and has never judged me for self-harming or asked anything of me. She just accepted it and wanted to help in any way that she could. It was a good result. This positive experience encouraged me to be honest with certain other people in my life, and there is no doubt in my mind that it is in part their support which has helped me to move on and live my life without needing to resort to self harm every time life gets difficult.

Unfortunately though, telling people about self-harm hasn’t been all plain sailing and I have had some experiences that I would rather not have had. A while ago my family started quizzing me about self-harm, jumping to all sorts of wild conclusions and demanding that I promise to them that I would never self-harm again. They responded with comments I had been dreading about how “stupid” it was to self-harm, how it was attention seeking, and how I was doing it to make them feel guilty. It wasn’t helpful to me at all.

Making the decision to disclose about self harm is a big step. Of course we can not be in control of other people’s reactions, but I believe by thinking through the issues beforehand, it can increase the chances of a positive outcome.

  • Thinking about why you want to tell someone

Many of us get to that point in our lives where we just feel that keeping the secret of self harm to ourselves is not only lonely and isolating, but also destructive and impractical. Often it’s a gradual process of realization that this is not something that you want or should have to deal with by yourself anymore – and so you start to believe that the way forward is to disclose about the self harm to someone. We all have our own reasons for wanting to end the secrecy – all equally valid and it’s worth giving some time to consider why it is you want to talk about the self harm and what you want to get out of doing that. This is by no means an exhaustive list, but some examples might be:

– You believe the self-harming is escalating and it’s getting to the point where you feel you cannot control it or where you are in danger of causing yourself serious harm.

– You’ve hurt yourself badly and need medical attention.

– You want to stop and need support in order to do this.

– You want to be more open and connected to others and to decrease the emotional distance between yourself and those you care about.

– You want to be able to be intimate with your partner but the scars are making this difficult.

– You have a holiday coming up and you want to be able to wear short sleeves, bikini etc.

– Someone else found out and they’re threatening to tell.

– You just want someone to understand.

– You want someone to be able to sit with you when you’re feeling the urge to self harm.

  • Who to tell

One of the main considerations when thinking about disclosing about self-harm is who is the most appropriate person to talk to. Undoubtedly identifying someone you feel you can trust is paramount, and you are probably the best judge as to who this could be. Think about the people that have been there for you in the past and how they have responded when you’ve talked to them about a painful subject.

In part, the person you choose to talk to may need to be influenced by what you want to gain from talking about it. For example, if you want to talk about it to gain support from your partner then clearly your partner is the person you need to talk to! Very often though, we just “want to talk” or we want someone to know and understand and obviously if this is your reasoning, then you have much more scope in who to chose.

  • How to tell

There are different ways in which you can disclose to someone about the self-harm, and it’s worth taking some time to consider which would be the best approach for you.

Face to face: It can be a very empowering experience to actually say the words out loud to someone for the first time, and it also has the benefit of being able to interact with the person you’re telling in real time. However, remember that talking to someone face-to-face means that you’re going to be present when they make their initial reaction to your disclosure, and this reaction may not always be what you wanted or anticipated. First reactions are not always indicative of how helpful or supportive someone is likely to be.

If you are going to talk face to face with someone, pick the right time and place. Talking about self-injury is a serious matter. It is likely to be hard for you, and also for the person you’re talking to. Try to pick a place which is comfortable, private and where you are unlikely to be interrupted or distracted. Try also to pick a time when the person you’re telling is free to devote some time to you and to processing this information. If they are very busy or dealing with a difficult emotional issue themselves, they may be less able to give you the understanding and support you deserve. Do not disclose about self-injury during an argument. If you tell in anger, the person you’re telling is likely to get defensive and that response will be unhelpful to you.

It can be helpful to practice saying it out loud beforehand so you’re clear in your mind what it is you want to say and how you want to say it.

Email / letter: If you do not feel able to have a face-to-face then you could talk about it in a letter / email. This has the benefit of you being able to talk about it in exactly the way you want to talk about it without interruption. It also has the benefit of allowing the person time to digest the information you’re giving them and time to get their head around the best way to support you.

If you chose to write, it will be necessary to follow this up with a face-to-face discussion at some point in the future. Waiting for a response from them can be a very difficult and nerve wracking time, and it may be worth requesting in the letter / email that they let you know when they have read it so that you can stop wondering if they have read it yet or not. It may also be worth suggesting a plan for how you would prefer for this to be followed up, for example, “I’ll phone you in 2 days” or “Could you email me when you’re ready to talk with me about this”.

On the telephone: Telling someone on the phone can be an option, especially if the person you’re telling is not local to you and you want to be able to tell them in real time. However, try to remember that talking on the phone means that neither party will have the benefit of non-verbal clues and therefore misunderstandings are more likely. If you’re telling someone who lives a long distance from you, it may be a good idea to have a very clear idea of how this person can best help you since they may feel impotent and unsure of how they can be of help when you have a long distance relationship.

  • Explain to the person why you are telling them

If you can, try to explain to the person why you are telling them. It’s a good idea to have this mapped out in your head beforehand so you can be very clear about what you want and need from them.

If you’re telling a loved one, make it clear you are telling them because you love and trust them. Often loved ones feel guilt that they didn’t know previously or feel that they have in some way made the situation worse. Try to reassure them that you are telling them because you want them to know and that you need their support.

It can help to have some very clear ideas about how they can best give you what you need. For example:

I’m telling you because sometimes I just need you to sit with me.

I’m telling you because it makes me self-conscious when you look at my scars.

I’m telling you because I want you to understand what I’ve been through.

I’m telling you because I don’t want to keep secrets from the person I love.

I’m telling you because we’re going on holiday and I want to be able to wear short sleeves.

  • Try to avoid overly graphic descriptions

The amount and nature of the detail you give about the self harm may largely depend upon the person you’re telling.

Obviously, if you’re talking to a doctor or therapist, it may be helpful to you to be able to share with them exactly what you do, how you do it, how it feels and you may include some graphic descriptions about this. Professional people who have experience of treating clients who self – harm are more likely to be in a position where they feel comfortable hearing about the details of your self harming, and will be able to respond appropriately.

However, if you start giving graphic descriptions to friends and loved ones without professional experience of dealing with self harm, they are likely to be ill equipped to deal with it. If you start talking about exactly what you do when you self-harm, or about your worst ever injury, then person you’re telling may become focused on this aspect of it, rather than understanding the real issues at hand. If a description is too graphic, some people may tune out from what you’re saying because it’s too difficult or gruesome for them to hear.

If talking to a friend or loved one, it may be more appropriate to focus your conversation more on the emotional aspects of self harm rather than providing a detailed description of the physical act itself. Talking to them about why you self harm, or how it helps you, or what it is you want from them, is more likely to provide a helpful response. Think about how best to get the response you need from them.

  • What to expect

It really can be helpful to prepare for the way that people may react when you disclose to them about your self harm. Some people may respond in exactly the way you dreamed and imagined they would – and others may respond in a way you didn’t predict. It is worth spending some time planning how to respond to their response. Please bear in mind that these are just possible consequences.

Expect them to have questions

Self-harming is not something that is talked about very much in the media and therefore it is not necessarily something that the person you tell will understand. Obviously if you are telling a therapist or a doctor then they are likely to be better equipped to understand the issues you are dealing with, but others may feel they need to ask questions in order to understand.

It’s important to give them the opportunity to ask questions – and for you to answer the questions that you feel you can and want to answer. However, try to be clear about your boundaries regarding questions. You should not feel pressured into answering anything that you don’t feel comfortable answering. If you feel unprepared to answer then it’s okay to say that.

It might be an ideal to think of some of the questions they may ask beforehand so that you can be as prepared as possible. Here are some examples:

– Why do you do it?

– Do you want to kill yourself?

– How long have you been doing it?

– How does it help?

– Do you want to stop doing it – and why?

– How can I help?

– Is it my fault? Is it something I’ve done?

– Why didn’t you tell me before?

– What triggers you?

– How often do you do it?

– Why don’t you just stop?

Expect them to have some misconceptions about self-injury

There are many misconceptions held about self-injury and so it can help if you are prepared to deal with these misconceptions by educating yourself about self-harm beforehand. Here are some of the misconceptions they may have:

– Self harm is a failed suicide.

– Self harm is just to get attention.

– Only teenage girls self harm.

– Self harmers are a danger to other people.

– Self-harming is just a current trend.

– If you wanted to stop, then you would stop.

What if they don’t react in the way you expected them to?

If someone reacts in a way that you didn’t expect or want, try to take some time to speculate why they may have reacted in the way they did. Finding out someone you care about is self-harming can result is very strong reactions, including confusion, anger, fear, embarrassment, shock, sadness, guilt, etc, and this can result in a reaction from them which is a long way from your ideal.

First reactions are not always the best indicators of how supportive a person is going to be towards you. A person’s initial reaction can change once they have had time to process the information you’ve given them. If you feel able to, be prepared to try again once some time has passed.

Some people may make value judgments about you and the self-injury. These judgments usually come from a place of fear and ignorance about the issues regarding self-harm and are not a reflection of you as a person.

What if they demand I stop self-harming and I’m not ready?

This is a real concern, especially if you are not ready to make the commitment to stop self-harming. It’s highly likely that the person you’re telling may feel compelled to demand you stop self-harming, and they are also likely to believe they are doing the right thing in asking this of you. They may also feel a sense of duty or responsibility to protect you if they know of this behavior.

Try to be clear with them that any demands that you do not self harm will not be helpful to you and the pressure it will cause is likely to be counterproductive. It may help to reassure them that you are under the care of a therapist or doctor, and so this is something that is certainly worth considering for your own benefit as well as their peace of mind. Being clear about the best way they can support you can be helpful.

Whatever happens, reaching out for help and support is a courageous step and is something you should be proud of yourself for. Dealing with difficult and painful issues is not something you should have to do alone, and you are worthy of love, understanding and support when dealing with self injury.