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2 Things Doctors Shouldn't Say to People Who Self-Harm

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Article updated July 15, 2019.

When I was a teenager, I spent years self-harming. In addition to the emotional pain involved with self-injury, this has lead to many awkward encounters with family, friends, strangers and sadly, even medical professionals. Although I understand the surprise when you find out someone’s been hurting themselves on purpose, the reactions I’ve received have ranged from comforting to triggering. Sadly, the reactions from medical professionals — those who were supposed to help me — are what hurt the most, and even made my trauma worse.

Here are the two things you shouldn’t say to someone who has self harmed:

1. “Let me see.”

When I first went to a therapist for cutting, the therapist said, “Let me see.” So, I lifted up my sleeves and showed her a series of light, surface cuts and minor scars criss-crossing up my arm. She didn’t react much, but the look on her face said it all — these seemed like a cry for attention and nothing to be taken seriously. At least, that’s what 13-year-old me thought she meant. So, I interpreted her indifference as a challenge. I started self-harming deeper, started cutting more, in different places, in different directions, with different instruments. Several therapists since then have asked me the same question, “Can I see?” and every time I show them, I look at their facial expression to see their true feelings. Many of them gave off the same flippant reaction, but luckily some did not. Every time a therapist or doctor commented on the extent of my cutting and scars, it only challenged me to be more extreme until finally they took me seriously.

Now that I no longer cut and my scars have long since healed, when a therapist asks to see my scars, I ask “Why?” Because it doesn’t matter how deep, how many, how severe someone’s wounds from self-harm are — what matters is that they have self-inflicted wounds. If that first therapist hadn’t shrugged me off after asking me to reveal something very personal about myself, I might not have some of these scars that I now have to live with for the rest of my life. 

2. “Oh, I see you’re right handed.”

My primary care doctor saw my scars and asked if I could promise I would quit self-harming. “No, I’m addicted,” I said. That was the wrong answer. I was sent to the mental hospital. And rightfully so. 

When I got to the hospital, I had to undergo a physical exam. The doctor looked at my arms and said, “Oh, I see you’re right handed.” He must have thought his joke was so funny, seeing as how this young girl had spent so much time cutting up her left arm that she didn’t get to her right arm yet, making it really clear that I’m right-handed. After I got out of the hospital, I started self-harming my right arm and several other parts of my body. I wanted my scars to be “even.” I didn’t want to hear anyone joke like that again. Here I was, in the mental hospital, at one of my lowest moments, and the physician who is supposed to care for my wounds only mocked them. All this did was reinforce that I shouldn’t be taken seriously, which of course, in my mind, challenged me to cut more.

In some ways, the joke is on me, though, as I’m the one who has to live with these scars and remember the reactions from people who were supposed to be there to treat me, support me and care for me. When medical professionals don’t take someone who self-harms seriously, it only makes things worse. Self-harm is not just about suicide, but it is about feeling pain and the rush of endorphins that follows. Doctors who brush it off as a cry for help are missing the complexity of what self-harmers are experts at knowing — cutting yourself feels bad and good at the same time. What I believe doctors need to say to their patients is those feelings are temporary, but the scars are permanent.

I was fortunate to find a cognitive behavioral therapist who taught me I was using self-injury as a coping mechanism, and helped me identify my feelings, my thinking patterns and ultimately helped me quit cutting. It took so many awkward encounters with doctors, so many new wounds, to finally find a doctor who understood me and treated me with respect. People who self-harm do so for many reasons, but for me, attention-seeking was not one of them. I didn’t want anyone to know I did it. It was my secret. For me, it was a release of all my emotional pain I kept inside for no one to see. It felt good in the moment, but I felt worse afterwards. I felt like an addict. I wish those doctors had taken the time to understand that about me before making a judgment based on stereotypes about teenagers and cutting. Anyone who hurts themselves on purpose as a coping mechanism should be treated with respect and medical professionals need to understand the rationale and emotions behind self-injury in order to help these individuals from hurting themselves permanently.

If you or someone you know needs help, visit our suicide prevention resources page.

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

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Thinkstock photo via shironosov.

Originally published: July 31, 2017
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