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Help! For a friend who is cutting herself

Dear Alice,

Recently, I've noticed that my one or two of my friends have taken to cutting themselves. I'm concerned for them... but I've done the same thing in the past and they know it. How do I confront them without sounding like a hypocrite?

— Painfully confused

Dear Painfully confused,

Even if you've cut yourself before and your friends know it, you can still reach out to show that you are concerned about them and offer your support. In fact, your past experience may make you an even more helpful friend and resource. There are many ways to broach the subject with them; in all cases, it's good to move toward these conversations with care.

People naturally want to protect themselves from being judged or socially rejected. When and if you approach your friends, it will be up to you to set a tone of listening and helpfulness, rather than judgment or rejection. Also, consider the timing and setting of the conversation, as well as using certain body language, words, and tone to convey openness and respect.

What might be a good time and place to have this discussion? In the middle of a loud party, or at a public restaurant, might not be the ideal venue to bring up such a delicate subject. Perhaps a private, safe place like a bedroom or a quiet coffee shop when you and your friends have a few hours to spare would foster more frank and sensitive communication. It might also be best to talk privately with each friend instead of confronting them together.

Preparing to talk: Before you initiate a conversation, you might want to think about what main points you'd like to cover. Remember to couch your statements as if they are hypotheses, not facts. Even though you have personal experience with cutting, consider that you might not know exactly what your friends are going through. By expressing this, you'll open the door for them to tell you the specifics of their situations, and you can move from there. Once you've reviewed what you'd like to say, and chosen an appropriate time and place to talk, a non-threatening way to begin the conversation might be, "I really value you and our friendship, and because of that want I to mention something I've noticed." Or, "Is it ok if I bring up something that's caught my eye?"

Body language: Consider adopting an open and inviting posture by keeping your arms and legs uncrossed. Leaning slightly toward your friend as you talk and listen, maintaining eye contact, and subtly nodding as you listen all show that you are being attentive. Some experts suggest sitting next to people during difficult conversations sends a message of collaboration, while sitting across from them can communicate confrontation. Finally, keeping your voice at an inquisitive and soft tone, and being mindful of taking time to both speak and listen may help your friends open up. If these things sound natural to you, go ahead and give them a try, but you want to make sure you're comfortable in this conversation, which will communicate an environment of ease with your friend or friends.

While it might be challenging to approach these conversations, your concern is commendable, and preparation will give you a head start. If they'd prefer not to discuss their situation with you, remember that's their choice and they it deserves respect. Whether this is the case or not, it may be useful to guide your friends to other resources. S.A.F.E. Alternatives offers a website full of information plus a hotline (1-800-DONTCUT). Mental Health America also maintains a website full of useful facts and resources.

Good luck, and props for being such a good friend,

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Last updated Mar 31, 2014
Originally published Sep 26, 2008