Self Harm: A Call to Action

In the past few issues, self-harm has been explored along with ideas about how to help those who are suffering. I am hopeful that this conversation has served a purpose in supporting the overall understanding of self-harm and shift, even a little bit, how readers think about their role in supporting those who self-harm. In the last part of this three-part series, I would like to highlight the power of our interactions. What role does our relationship play in helping those who self-harm?

Before I understood addiction and recovery issues, I learned how to work with families managing daily life stressors. What I learned, both through family theory and in practice, is how we interact is often the reason for our relationship stress versus what we are discussing. For example, it is not often that financial decisions in a relationship are what keep people stuck. Typically, the stuckness comes from how we talk about the financial issues. Are we overbearing? Are we too persistent? Are we not persistent enough? Are we dismissive of our partner? A person does not develop hardship or recovery in isolation; our interactions have great power.

In the recovery world, we know that the interactional pattern of enabling is not useful for long-term recovery. It is not necessarily the specific behavior itself of paying off someone’s gambling debt as much as it is the pattern of the enabling behaviors. It is vital that we engage in a personal inventory of how we interact with others. Conversely, when we blame others for struggling and being sick, we put ourselves in a power position of how we know better and that they must not have our wisdom and life clarity. If we want to support each other on these paths of recovery, we must be aware of our interactions and how we are perceived by the ones we so dearly want to help.

In my clinical work, I have talked with those struggling with self-harm, and the main theme is an inherent feeling of isolation. Because of the intense stigma attached to self-harm, it seems harder to reach out and find others who “get it.” Often, they are met with the blaming stances of others, or worse. These interactions perpetuate the isolation, and the suffering continues. I would like to propose that we all, even those who self-harm, aim to be one of those who get it. We must interact with our loved ones, colleagues, peers, and students as though we know about self-harm. And if we do not know about self-harm, we need to go to a training, plan a training, or pick up a text resource.

To be one who “gets it” requires consistent welcoming messages. If you are a collegiate recovery program (CRP), one way to do this is to review your website and written materials. Assess if it demonstrates inclusiveness to the struggle of self-harm. Does it note that self-harm is an issue that is common among CRP students? Do our CRPs have clarity for what to do when a student who is self-harming is seeking their support? What does your program do when participants get sober from substances and then their self-harm behavior increases as they aim to cope? If we continue to interact with self-harm as though it is secondary to other types of addiction issues, it will continue to live in isolation, and our colleagues and students will not garner the help they need. Self-harm is not rare and it is not absent in our CRPs. However, if we are not interacting with our communities with the assumption that self-harm exists, we will enable the stigma.

This is your call to action. Assess your CRP materials and programming. Talk to your colleagues and peers about self-harm. Read a book about self-harm. Ask yourself how you interact with your communities about self-harm.

Dr. Tiffany Brown is a Lecturer and Clinical Director in the Couples and Family Therapy graduate program at the University of Oregon. She is a licensed Marriage and Family Therapist as well as a clinical fellow and approved supervisor with the American Association for Marriage and Family Therapy (AAMFT). Brown received specialized training in addiction and recovery through the Center for the Study of Addiction and Recovery at Texas Tech University as part of her doctoral studies. Brown’s expertise includes self-harm education, prevention, and intervention; the family dynamics of addiction and recovery; grief and loss; and collegiate recovery. For more information, email Tiffany at

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