Finding out that someone you love self-harms can knock the wind out of you. You might feel scared, sad, confused or even angry, and you may worry about saying the wrong thing. That's normal. This guide is for adults supporting a friend, partner, sibling or other adult in their life. If you're the parent of a teen, our team works with teens too. It covers how to support someone who self-harms, how to help someone who self-harms when they're not ready to talk, what to say and what to avoid, how to help through hard moments, when it's an emergency and how to look after yourself too.
This post is general information, not medical advice. If someone is hurt and needs medical care, or anyone is in danger, call 911. If you or the person you're supporting is thinking about suicide, call or text 9-8-8 any time, day or night.
Finding out someone you love self-harms
You might have noticed something, or they might have told you. Either way, your first reaction matters, but it doesn't have to be perfect. Take a breath. Try to stay calm and keep your voice gentle, even if you feel shaken inside.
It's okay to say, "I'm really glad you told me," or "I care about you, and I want to understand." You don't need to have answers right away. Showing that you're still there is a powerful first step.
What self-harm often is, and is not
The UK's National Health Service (NHS) describes self-harm as most often a way to express or cope with emotional distress. People may also self-harm to feel in control, to punish themselves or to relieve feelings that seem unbearable. The reasons can change over time and are different for everyone.
Self-harm is not the same as a suicide attempt. The NHS notes that not everyone who self-harms wants to end their life, and some people describe it as a way of getting through intense distress. At the same time, there is a clear link between self-harm and suicidal thoughts, so it always deserves to be taken seriously.
Self-harm is not "attention seeking." It's a sign that someone is hurting and needs care.
How to start the conversation
If you want to raise it, choose a private, calm moment when neither of you is rushed. Lead with care, not alarm. You might say:
"I've noticed you seem to be going through a hard time. I'm here if you want to talk."
"I care about you. Can you tell me a bit about what's been going on?"
"You don't have to explain everything. I just want you to know you're not alone."
Let them decide how much to share. If they don't want to talk now, let them know the door stays open.
If you're wondering how to support a friend who self-harms, or how to help a friend who self-harms when you're not sure they want help, the same basics apply: stay kind, stay curious and keep showing up. Small things, like a text to check in or an invitation that doesn't depend on them being okay, can mean a lot. The same is true if you're learning how to support someone with self-harm thoughts who hasn't acted on them. Talking about the thoughts is a good thing, not a danger.
What to say, and what to avoid
The NHS suggests asking how the person would like to be supported, letting them know you're there, and trying to understand their emotions without judging them, rather than focusing only on the self-harm.
Things that often help:
listening more than you talk
asking, "What would be helpful right now?"
naming their strengths and the things you love about them
letting them stay in control of their own decisions where it's safe
Things to avoid:
showing shock, disgust or panic
ultimatums, like "stop or I'll leave"
calling it attention seeking
demanding they stop right away
promising to keep everything secret no matter what
You can be honest that if you're ever worried about their safety, you'll call for help.
Supporting someone through urges and hard days
There may be times when the person tells you they're struggling or having urges. You don't need to fix it. Being calm and present can help a lot.
You might sit with them, talk about something else, go for a walk together or help them use grounding, like noticing what they can see, hear and feel around them. Ask what has helped before. Keep the focus on getting through the moment and on their feelings, not on details of the self-harm itself.
If the person is your partner
If you're figuring out how to support a partner who self-harms, it can be hard to know where your role begins and ends. You can love and support them without becoming their only source of help. Try to encourage professional support, while keeping your relationship a place of warmth rather than constant checking.
It's okay to have your own feelings and limits. You might say, "I want to support you, and I think we both need more help than I can give on my own." Couples counselling can also help you both talk through how this is affecting your relationship.
When it is an emergency
Some situations need help right away:
If someone is hurt and needs medical care, or anyone is in danger, call 911.
If the person talks about wanting to die or has a plan to end their life, call or text 9-8-8, or call 911 if they're in immediate danger.
Asking directly about suicide doesn't put the idea in someone's head. Our guide on how to talk about suicide safely explains how to ask.
Looking after yourself as a supporter
Supporting someone who self-harms can take a lot out of you. You might feel worried all the time, guilty when you're not available or helpless. The NHS reminds supporters that they may not be able to help on their own and that it's important to look after themselves too.
Keep up with sleep, food and things that recharge you. Talk to someone you trust about how you're feeling, without sharing more of the person's private story than you need to. Counselling for yourself can be a place to process what you're carrying.
What to say to someone who self-harms on a hard day
On a really hard day, simple words often work best:
"I'm here. You don't have to go through this alone."
"Nothing you tell me will make me care about you less."
"Do you want to talk, or would you rather I just sit with you?"
"Would it help to call someone together?"
How therapy helps
Therapy gives the person a safe, private space to understand what's behind the self-harm and to learn other ways to cope with overwhelming feelings. One approach often used is dialectical behaviour therapy (DBT), which teaches skills for handling intense emotions and urges. We teach DBT in one-on-one sessions only. We don't run groups.
We offer therapy for self-harm at our Kitchener-Waterloo, Cambridge and Ottawa offices, and online anywhere in Ontario on a secure, encrypted video platform. Supporters are welcome to book for themselves too.
Sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover some or all of the cost. Coverage varies, so check your plan.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with a Registered Psychotherapist (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Book a free 15-minute consultation with our admin team. You don't need to explain everything. "Someone I love is struggling" is enough.
If you're in crisis: if someone is hurt and needs medical care, or anyone is in immediate danger, call 911. If you or someone you're supporting is having thoughts of suicide, call or text 9-8-8 any time, day or night. Our crisis lines page lists both.
You don't have to do this perfectly. Showing up with care is what matters most.
Last reviewed: October 2026
Sources
Self-harm: assessment, management and preventing recurrence (NICE guideline NG225), National Institute for Health and Care Excellence (NICE)