How to respond to difficult, awkward, insulting questions and statements
We're sometimes asked questions about self-harm which can take us by surprise. It could be an uncomfortable question, we don't have the right words to answer or it's thrown at us almost like an insult. Then we are like a rabbit caught in the headlights and we run away as soon as possible. If we fail to answer or respond, the person who asked will be none the wiser (or remain in their ignorance) instead of learning and replacing their misconceptions with facts.
Here are some suggestions on how to respond to such questions and remarks as put together by our service users. You may wish to practice some of the answers in your head to be more ready next time you're asked these questions. The aim is to start a discussion, not to kill it dead. Even the most ignorant, aggressive person has the capacity to learn. Breaking down the stigma surrounding self-harm is a task for all of us.
Here are some suggestions on how to respond to such questions and remarks as put together by our service users. You may wish to practice some of the answers in your head to be more ready next time you're asked these questions. The aim is to start a discussion, not to kill it dead. Even the most ignorant, aggressive person has the capacity to learn. Breaking down the stigma surrounding self-harm is a task for all of us.
WHY DO YOU DO IT?
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It helps me get through the day.
I can express the pain I feel inside. It's the way I feel at the time. It's an impulse. Because the thoughts can torture me. Sometimes because of boredom. My brain is conditioned. Because tiredness can start the cycle. I hurt myself before others can hurt me. To feel something. I'm not quite sure, trying to work it out myself. |
It refocuses the mind.
Because of frustration. I feel I need to / I feel I should. Blood lets out what has build up. It expresses the anger. I turn on myself instead of anybody else. In order to reduce the emotions. I don't know. I punish myself. People do it for various reasons. I'm not ready to talk about it yet. |
THAT'S DISGUSTING! YOU'RE SICK!
It's my way to cope when life is out of control.
Others get drunk or angry and lash out. I don't like hurting others so I only hurt myself.
That statement made me feel uncomfortable.
This is unhelpful.
I could use some support and acceptance instead of criticism.
I don't have that much control over it.
Don't you think I already beat myself up about it?
It gets me through tough times.
It keeps me alive.
(With such statements it will take time and patience to get through. Decide whether this person and their relationship with you is worth the effort)
Others get drunk or angry and lash out. I don't like hurting others so I only hurt myself.
That statement made me feel uncomfortable.
This is unhelpful.
I could use some support and acceptance instead of criticism.
I don't have that much control over it.
Don't you think I already beat myself up about it?
It gets me through tough times.
It keeps me alive.
(With such statements it will take time and patience to get through. Decide whether this person and their relationship with you is worth the effort)
Is it your way to ask for attention?
Most of us keep it secret, it's very private. That is not attention seeking.
I haven't told anyone I just did it.
If no other way has worked it may be a cry for help.
I have tried other methods to get help. I ended up escalating the damage in order to get some help because minor damage did nothing.
I haven't told anyone I just did it.
If no other way has worked it may be a cry for help.
I have tried other methods to get help. I ended up escalating the damage in order to get some help because minor damage did nothing.
Why do you do it there? [Asking about visible part of arms] Are you attention seeking?
It works better for me.
It's easy. It's convenient. It happens.
It's safer.
I need to see it. It makes it real.
It makes more sense.
It's easy. It's convenient. It happens.
It's safer.
I need to see it. It makes it real.
It makes more sense.
Is it because of your mental health problems?
My mental health problems make it harder for me to cope. But not everybody who self-harms has mental health problems.
Mental health is not the cause but it's a contributory factor.
No, I don't think so. But there is always a psychological reason behind it.
Yes, they make my mind work in that way.
Maybe, I'm not sure.
It's impossible to unpick what is caused by my mental ill health and what is not.
Mental health is not the cause but it's a contributory factor.
No, I don't think so. But there is always a psychological reason behind it.
Yes, they make my mind work in that way.
Maybe, I'm not sure.
It's impossible to unpick what is caused by my mental ill health and what is not.
How does it help you?
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It calms me down.
It gives me release. It makes me feel alive. It helps me function. It gives me focus. It reduces anxiety. |
It clears my head.
It provides me with relief. I get a sense of satisfaction from it. I have achieved what I set out to achieve. I have completed the cycle. It gives me a sense of achievement. It stops me from trying to kill myself. |
What benefit do you get from self-harm?
I get release.
I get some control back.
It stops me thinking.
It stops me feeling.
It's distraction from reality.
You can't feel emotions when you're experiencing physical pain.
I get some control back.
It stops me thinking.
It stops me feeling.
It's distraction from reality.
You can't feel emotions when you're experiencing physical pain.
I cannot understand how hurting yourself helps you.
Some people's brains are wired in such a way that it works for them.
It releases the poison within.
It's the only way I can have some control back.
It puts me back in the driving seat, even for a very short while.
It feels like a violent storm and then it calms. It's like a "tornado in my head".
It feels like I'm trying to contain a storm in a bottle and I need to release the pressure or the bottle will break.
For some it's chaos. By hurting myself I'm trying to control the chaos.
It releases the poison within.
It's the only way I can have some control back.
It puts me back in the driving seat, even for a very short while.
It feels like a violent storm and then it calms. It's like a "tornado in my head".
It feels like I'm trying to contain a storm in a bottle and I need to release the pressure or the bottle will break.
For some it's chaos. By hurting myself I'm trying to control the chaos.
Doesn't it hurt?
Yes. That's why I do it.
No. Not till later.
Sometimes. It depends on my frame of mind.
No. Not till later.
Sometimes. It depends on my frame of mind.
Do you enjoy it?
No. I would rather not do it but it works for me.
Yes. It can be like a drug. It releases endorphins in the brain that feels good.
When I do it on impulse, neither.
Not while I'm doing it. Sometimes I feel happier afterwards.
I enjoy the relief afterwards.
Yes. It can be like a drug. It releases endorphins in the brain that feels good.
When I do it on impulse, neither.
Not while I'm doing it. Sometimes I feel happier afterwards.
I enjoy the relief afterwards.
Do you find it exciting?
No. I feel compelled to do it.
Yes. I look forward to the release. The pain gives me something to focus on and I can switch other thoughts off.
I cannot separate if doing it is exciting or if the expected result excites me.
If I stop before the cycle is completed I feel angry and frustrated.
Yes. I look forward to the release. The pain gives me something to focus on and I can switch other thoughts off.
I cannot separate if doing it is exciting or if the expected result excites me.
If I stop before the cycle is completed I feel angry and frustrated.
You're too smart to be doing this!
It's not a matter of intelligence.
I have mental health issues and that can affect anybody.
I'm dealing with high expectations. There is a lot of pressure.
I set my own standards very high and not reaching them is frustrating.
I have mental health issues and that can affect anybody.
I'm dealing with high expectations. There is a lot of pressure.
I set my own standards very high and not reaching them is frustrating.
But your life is so good. Other people have it worse.
People can deal with stress in different ways.
You don't know everything that goes on in my life.
Different issues have different impact.
What appears as trivial may not be.
You don't know everything that goes on in my life.
Different issues have different impact.
What appears as trivial may not be.
Have you tried distractions and other coping strategies?
Self-harm is not the first thing I reach for.
Distractions don't always work.
I haven't found another method as effective.
What would you suggest?
Distractions don't always work.
I haven't found another method as effective.
What would you suggest?
Do you feel guilty?
Yes, very. I let myself down every time I do it.
No. I have no thoughts of anybody or anything.
No. I need to do this to survive.
Yes. I do anything I can to hide it.
I am told that I should feel guilty.
No. I have no thoughts of anybody or anything.
No. I need to do this to survive.
Yes. I do anything I can to hide it.
I am told that I should feel guilty.
Don't show me, I don't want to know!
That's rather unhelpful.
It will take time.
I'm trying to understand it myself. Let me know if you'd like us to talk about it.
I can see you're not ready yet. I'd like to discuss it with you, but only when you're ready.
It will take time.
I'm trying to understand it myself. Let me know if you'd like us to talk about it.
I can see you're not ready yet. I'd like to discuss it with you, but only when you're ready.
You're a man! Men don't self-harm!
Self-harm may not seem manly but coping with pain is
Why can't you stop?
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It's more complex than that.
Because I'm addicted to it. I tried, it backfired. Because I may kill myself if I have no way to bring the intensity down from time to time. It's part of my routine. It keeps me alive. It's part of my self-management. This is under my control. Other things aren't. |
It's life.
It's hard to stop when my boundaries aren't respected. The urges are very powerful. They're called "urges", not thoughts! Like hunger it's a need. The more you leave it, the worse it gets. Because nothing else works. Remaining with the urges isn't always good. The familiarity is comforting. |
Why do you do it soon after you've done it?
Sometimes it's not enough
Do you know the reasons behind it? What started it off?
Yes, I do (you are not obliged to give full explanations if you're not ready)
I'm not sure, I started a very long time ago.
I'm not sure, I started a very long time ago.
Why do you need therapy?
Because I'm trying to understand my behaviour
Why have you chosen to do this?
I don't choose - I have to do it or do worse. It's about damage limitation.
I'd rather hurt myself than someone else.
Because of the feeling and its meaning.
I'd rather hurt myself than someone else.
Because of the feeling and its meaning.
Are you better now?
I'm working on it.
It's a process.
I manage the self-harm better.
I'm different.
(If you do not wish to use the word "recovery" use the word "discovery" to describe this process)
It's a process.
I manage the self-harm better.
I'm different.
(If you do not wish to use the word "recovery" use the word "discovery" to describe this process)
What happened to your arms?
I'm not ready to talk about it. I may be in the future but not yet.
I've been through some things. I self-harm to deal with that.
I've been through some things. I self-harm to deal with that.
Where are your scars?
Not all self-harm leaves visible scars.
Are you crazy?
How do you define crazy?
What is 'normal'?
What is 'normal'?
Are you trying to kill yourself?
No, I'm not. It's not the same thing.
Self-harming is preventing me from doing that.
Self-harming is preventing me from doing that.
Are you a danger to others?
No, I'm more of a risk to myself.
Do you do it for pain or for blood?
It depends on my state of mind.
It depends on how I feel.
Sometimes pain, sometimes blood, whichever I need at the time.
It depends on how I feel.
Sometimes pain, sometimes blood, whichever I need at the time.
Why don't you just grow up?
Self-harm isn't a teenage 'thing', it can affect people of all ages.
You don't simply outgrow self-harm, it grows with you.
You don't simply outgrow self-harm, it grows with you.
Why don't you stop?
I wish it was that easy!
I am trying.
I'm not sure I can.
I am good at managing it. I don't self-harm anywhere near as much as I want to.
I am trying.
I'm not sure I can.
I am good at managing it. I don't self-harm anywhere near as much as I want to.
Have you eaten today?
I understand you're asking because you care. I've got a food plan that I'm sticking to and that's between me and my GP
How much do you weigh?
I'm not comfortable answering that.
I don't know. My GP weighs me regularly but doesn't tell me.
I find weights very triggering.
I don't know. My GP weighs me regularly but doesn't tell me.
I find weights very triggering.
