Ask the Therapist: How do I help a friend with self-destructive tendency?

My friend recently revealed to me that she wants to self-harm when upset. It has been quite a shock to discover this. The matter is quite serious and I don't know how to help her. Please tell me how to handle this without breaking her trust. — Name withheld

Dear Friend,

Thank you for reaching out to me to help your friend! And may I say that you are indeed a good friend.

It is evident that your friend has trust in you, because people who think about self-harm, or who might be self-harming, can experience a great deal of shame and guilt. That you want to maintain this trusting relationship while helping your friend is very understandable; and, indeed, trust makes all the difference.

You most likely are aware that underlying such thoughts and behaviours are seemingly overwhelming and unmanageable feelings. Your friend will benefit from being able to talk to you about her feelings and the situations that trigger them. The best support you can give her is to encourage her to talk about her thoughts and feelings, and to listen to her in an empathetic, non-judgmental way. Talking about things will give her relief and bring down the level of intensity, so that her feelings will become manageable in healthy ways.

Together, you can explore other ways of coping with difficult feelings, such as journalling, spending time with trusted friends, engaging in self-soothing activities like a warm bath, or spending time in nature. It will be good for her to design her own unique recovery programme so that she can be safe from self-harm.

Encourage her to be truthful with you about how she really is feeling. If she continues to have these thoughts, I suggest professional counselling to explore underlying causes to arrive at a more complete mental health assessment. We also have to keep in mind that carrying too much responsibility and worry about your friend could be detrimental to your own mental health.

(Dr Annette is integrated psychotherapist at CHMC, Dubai. Got a query? Email us on wknd@khaleejtimes.com)

• Relationships