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How to talk about self-harm

4 min read
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Q: I have a dilemma. As a senior, I’m a leader in my sport (I don’t want to share which one). Our coach says I should be a role model for the younger players. I do try. I love the sport, and I enjoy looking after and helping to orient new teammates. Here’s my problem. I noticed scars from cutting on a new teammate’s arms. She’d worn long sleeves since I met her, which I thought was strange because it was really hot when we started practice this year. I saw her arms when she finished a shower. I don’t think she knows I noticed. Here’s what makes it tough. When I was younger, I did the same thing. Most of the seniors know because I went through a lot of depression and then therapy. I’m okay now. I don’t know how to handle this. I think I’m the only person who knows. I want to confront her and help her, but I don’t want to be a hypocrite. I also don’t want to share her secret publicly. Yet if I do nothing, I fear she will not get help, and her self-harming will worsen. How do I do this? I want to do the right thing. 17-year-old

Mary Jo’s Response: Thank you for your concern for your teammate and your willingness to reach out to her. You will do the right thing.

Discussing self-harm is delicate. Self-harm is defined as the act of purposefully harming oneself. People may self-harm for many reasons, from seeking relief from depression or a feeling of “numbness” to an attempt to communicate their needs to others.

I think confronting her might be off-putting. Think of it instead as a conversation. You are there to offer support and to express concern, not to force her to stop this behavior. Approaching the conversation without judgment is also key. Your personal experiences give you an edge and may help her. It’s not hypocritical to recognize her need and share how you moved past a similar challenge. You noticed; simply say you did.

I also want to remind you of your role. You’re her friend, her teammate and, as your coach said, her role model. You’re not her therapist. Once you’ve started the conversation, I suggest you mention counseling. If she is reluctant to connect with a healthcare provider, you can help her make the call. You can also share what you told me with a trusted adult. I recommend telling your teammate you plan to share; going behind her back is unkind.

Here are some strategies for the conversation.

Location: Find a safe, comfortable, private place. Do not begin this conversation within others’ hearing. This should not be a public conversation.

Listen: Use active listening techniques and be gentle. Don’t interrupt when she speaks.

Hold space: Offer the gift of your presence if she wants to sit in silence. Your body language can convey support without words.

Honesty: Tell the truth. Share your personal experiences with self-harm without judging her or yourself.

Support: Ask your friend how you can be of support. Remember your capacity to help. Do not assume the role of therapist, but rather encourage and empower your teammate to seek professional guidance.

Boundaries: Set emotional boundaries. Talking about self-harm can be triggering, which simply means the conversation could remind you of your past experiences and make you uncomfortable or uneasy. Connecting with a trusted adult is very important, not only for your teammate but also for you.

Best of luck to you both.

Have a question? Send it to Dr. Mary Jo Podgurski’s email podmj@healthyteens.com.

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