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What to do and when to ask for help when self-harming behaviors occur?

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A first step to stop self-harming is to tell someone close to you. People who do it may experience fear, shame or frustration, so it is advisable to find someone you trust. However, the person who is listening to this information may feel angry, upset or confused, but it is important that they are aware of the emotions at that moment, because the person who is asking for help needs to receive a message of support, without judgment. Under no circumstances should they receive threats or accusations (for example, "if you love me you must stop self-harming") and they must know that they are not alone.

Sometimes, self-harm can occur in the educational context . For many young people, this can be a behavior that is done in secret and, therefore, can be very difficult to talk about. When it is talked about, it is usually with a classmate rather than with an adult. This can generate discomfort and concern among the rest of the classmates, who may feel insecure about how they should act to help. For all this, it is advisable that educational centers have a response protocol, which details how to act in the event of a case of self-harm, both individually and in a group.

Professional consultation and treatment

On the other hand, it is advisable to consult a professional when:

  • Self-harm is frequent (more than five times in the last year).
  • There is significant and persistent emotional distress.
  • The method is potentially dangerous (such as cutting yourself).
  • There is a high sensitivity to social rejection.
  • The person has tried to stop self-harming without success.

In these cases, it may be helpful to talk to your primary care provider or a mental health professional, such as a clinical psychologist. Currently, there are helpful treatments for self-harming behavior, which are usually carried out in an outpatient setting, so that the person can continue with their daily routines.

In this sense, psychotherapy can help :

  • Identify and intervene on the problems that may be at the basis of self-harming behavior.
  • Learn strategies to better control anxiety and other unpleasant emotions.
  • Learn to regulate emotions and better tolerate negative emotions.
  • Develop skills to improve in the area of ​​social relationships.
  • Learn strategies to solve problems more effectively.
  • Develop a more favorable and realistic image of oneself.

Therapeutic modalities

The therapeutic modalities that have shown the most effectiveness in addressing these objectives are:

  • Cognitive behavioral therapy (CBT): Helps identify maladaptive beliefs (thoughts) and behaviors that do not help achieve the person's goals or that are harmful to their physical and mental health, and replace them with healthier ones, or make them more flexible so that they no longer have a negative impact on the person's balance.
  • Mindfulness -based therapies: These are techniques that help you live in the present, perceiving and accepting current mental states, thus improving overall well-being and can reduce levels of anxiety and depression.
  • Problem-solving therapy: It is a therapy aimed at training in constructive strategies for solving practical or interpersonal problems, or for managing difficulties in the most adaptive way possible, to improve the person's functioning and quality of life.
  • Dialectical behavioral therapy: It is a type of cognitive behavioral therapy, which was initially developed to treat people with suicidal behavior and borderline personality disorder, but which is currently applied and is effective for other problems such as anxiety, depression or substance use disorders. The term dialectic refers to the opposing forces in the evolution of the person, in which the forces of change and acceptance are especially relevant. Therefore, it promotes change in the aspects that need to be improved, but also the acceptance of what is functional and adaptive about the person. This type of therapy is standardized, by phases and modules, and has specific components for the management of self-harming behavior.