Signs Someone May Be Self-Harming & How You Can Help + What to Do If You or Someone You Know is Suicidal with Therapist Kati Morton

We all struggle with challenges in life, and find different ways to deal with and overcome these challenges. But what happens when our ability to cope turns toxic? What happens when our desire to survive ends up hurting us? In this week’s blog and podcast, I speak with therapist, author and grief counselor Kati Morton about self-harming behavior, how to identify and help someone who is self-harming, the difference between self-injuries and suicidal ideation, and what to do when someone you love is suicidal.

Self-injury is incredibly stigmatized and misunderstood in our world today. It can encompass a lot of different behaviors, including cutting, burning, eating disorders, over-exercising and punching things. The person who is self-harming often feels a release when they injure themselves, which helps them forget their internal pain. Self-injury is not just a personality disorder, a call for attention or a suicide attempt—it is a coping skill.

We need to stop labeling self-injury as a desperate call for attention, as this can be invalidating for the person who is struggling. It is normal to want to cope, and we all desire to be seen, heard and understood. Although society doesn’t encourage us to talk about our internal pain, it is perfectly okay to not feel better immediately or not be happy all the time. Our pain doesn’t just disappear if we ignore it or try plaster it over with false positivity. Life is hard, and talking about how hard it is helps us deal with the challenges we all face. We need to acknowledge and validate our struggles—we need to normalize human existence. 

When it comes to healing self-harming behaviors, we need to acknowledge that everyone is different, so different techniques will work for different people. In her practice, Kati focuses on:

1. Teaching their experience. Kati listens to and validates her clients’ unique stories.  
2. Changing the language they use to describe their behavior. Instead of identifying themselves with their behavior, Kati encourages her clients to describe their behavior as an “urge to…”.
3. Creating an impulse log and writing down what they are feeling when they engage in the behavior (around 1-3 things).
4. Coming up with healthy coping skills that will work for them. This can be almost anything, from journaling and mindfulness to walking or painting. She usually has her clients start off with 3-5 things, changing and adjusting these over time as needed. This is a way for her clients to channel their emotional energy into the healing process through specific skills and actions. 
5. Telling them that it is ok to relapse. Having a relapse is not shameful. Kati creates a space for honesty in her practice. She encourages her clients to tell her if something didn’t work and teaches them to explore and question why they went back to that behavior and how it felt at the time. Then she has them try different coping mechanisms to help them when the urge returns.
6. Getting to the root through exploration. Kati encourages all her clients to find the “why” behind their self-harming behavior by asking questions like “when does this start?” or “why does it exist?”.

What can you do if someone you love is self-harming?

1. Accept that you cannot fix them. The only person who can make it better is the person who is suffering. 

2. Let them teach you about their experience. The best thing you can do is be present and supportive and let them teach you about their experience. Don’t assume that you understand or know why they are doing what they do. Listen and be there for them in a non-judgmental and compassionate manner. 

3. Support them. Let them know that you are there if they need you. Check in and ask them how they are. When appropriate, ask questions and let them tell how they feel. Do your research (Kati recommends reading the book Cutting), and offer to help find help, but always be guided by the one who is struggling.

4. Don’t ask to see their self-injuries. If they offer to show you, avoid expressing shock--say something supportive like “that must have been very hard for you”. 

5. Don’t rush the recovery process.

Eating disorders can also be a form of self-harm. For people with eating disorders, food is often coping skill for something else going on in their life that they feel they cannot control. The only thing they think they can control is their body.

If thinking about food occupies more than 60% of your mental space, then it may be an unhealthy coping mechanism. If this is something you are worried about, Kati recommends:

1. Becoming aware of how much you think about food. Writing down your thoughts can be helpful, as it allows you to observe patterns and start thinking about the why behind your behavior. 
2. Recognizing that your relationship to food can change over time, from restricting calories to purging. As I mentioned in a recent blog and podcast, eating disorders occur on a spectrum.
3. Realizing that it is not about the food—it’s about the root behind your behavior, or what made food your coping mechanism. You need to get to the reason behind your actions.
4. Understanding that a good support system is key to recovery. You will need someone you trust to call, message or contact if you are having a hard time. Make sure you have people in your life that you can just “be” with—people who you can trust and open up to. Although it may be hard to trust, put effort and energy in these kinds of relationships. 

What should you do if you or someone you love is suicidal?

1. First, it is important to understand that someone who is suicidal is not just depressed—they have a complete lack of hope.

2. Recognize that suicidal thoughts are nothing to be ashamed of. They are very common, so the sooner you talk about your feelings and get support, the better. 

Suicide is a public health crisis with approximately 800,000 people dying by suicide each year. It is the 10th leading cause of deaths in the US and the 2nd leading cause of death globally. If you are feeling suicidal, contact the US national suicide prevention hotline today: 1-800-273-8255.

The UK national suicide hotline is: Samaritans Helpline: 116 123.

The Australian national suicide hotline is: 13 11 14 (within Australia).

The South African national suicide hotline is: Call 0800 567 567 or SMS 31393. 

For other hotlines, see Wikipedia.

Remember, talking about how you feel is a strength, not a weakness! The more you talk about your suicidal thoughts, the more control you have over them. When you bring them out into the open, you demystify them and can start dealing with the root of your thoughts and feelings.

3. If someone you know is feeling suicidal, check in with them constantly, be present, be supportive, don’t judge them, and be willing to listen to them and hear what they have to say, even if it is hard to see them in pain.

For more on self-harming behaviors, eating disorders, suicide and mental health, listen to my podcast with Kati (episode #197), and check out her website and YouTube channel. 

If you enjoy listening to my podcast, please consider leaving a 5-star review and subscribing! And keep sharing episodes with friends and family and on social media (don’t forget to tag me so I can see your posts!). 

Podcast Highlights

4:10 Self-harming behaviors and what to do about them

15:00 The dangers of toxic positivity  

20:20 Healthy techniques to cope with life’s hardships 

26:00 How to transfer emotional energy from the unhealthy to the healthy 

33:33 How to help someone who is self-harming

39:09 The relationship between self-harming behaviors and eating disorders

51:26 What to do when you or someone you know is suicidal 

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