How to Cope if Your Spouse Self Harms

Co-authored by Moshe Ratson, MFT, PCC

Last Updated: October 25, 2022 References

Realizing that your spouse self-harms can shake your marriage. Some people throw themselves into their spouse's care, only to resent them and feel drained with no obvious improvements. Remember that it is never your fault that your spouse self-harms. Take care of your needs and don't ignore your own life. Find ways to meet your needs and your spouse's needs by relaxing together and spending time together.

Things You Should Know

Encourage your spouse to get professional help; as much as you may want to help, you cannot treat your spouse’s mental or emotional health issues alone.
Don’t hesitate to call 911 or take your spouse to the emergency room if your spouse’s behavior escalates.
Support your partner by maintaining a loving and accepting environment free of judgement or criticism.
Don’t blame yourself and try to maintain your relationship by spending quality time together.

Method 1

Method 1 of 3:

Helping Your Spouse

1
Ask them to seek treatment. Do what you can to be supportive to your spouse. Often, this includes asking them to get help. Don't give them an ultimatum about seeking help, as this can lead to more guilt or resentment in your marriage. Instead, say that you think the self-harm is a serious issue and should be treated seriously. Ask them to see a professional.^{[1]
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- Don't pressure or guilt your spouse into getting treatment and support. Instead, tell your partner that they deserve support.^{[2]
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2
Educate yourself. Most people don't deal with stress or problems by hurting themselves. Your spouse likely has some very deep or complex wounds that contribute to their self-harm. Often, these problems are best discussed and worked through with a counselor, therapist, or psychiatrist. Don't feel like you have to take on the role of a therapist when you are not qualified to help someone with these problems. However, learn what you can about self-harm so that you can be informed about it.^{[3]
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- For example, people who self-harm do so with the intent to inflict pain yet not kill themselves. It's a way to express difficult feelings, punish oneself, or show distress.^{[4]
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3
Take risks seriously. If your spouse's behaviors escalate or are dangerous, don't hesitate to break your silence or get them immediate medical attention. If your spouse is threatening irreparable harm or that they want to kill themselves, do not hesitate in taking action. Call an ambulance, take them to the emergency department, call their therapist and their family. Get them immediate help.^{[5]
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- Any threats that might be serious should be taken seriously.
4
Support their treatment. Your spouse's treatment is a commitment that they want to be healthy and function in a healthy way. If your spouse agrees to treatment, support them in whatever steps they take, from seeing a therapist, starting medications, or joining a support group. If you start to feel upset or that your spouse is backsliding, remind yourself that they are taking steps and want things to change. Do everything you can to support that change, both for your relationship and for your spouse.^{[6]
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- Offer any assistance you can give. For example, offer to drive them to appointments or help them get through especially difficult days by talking with them or giving them a hug.
- Let your spouse know that you are not there to judge them or look down on them. You want what is best for them, and you will support them in any way you can.
- If your spouse does not initially accept your offer to help, do not push them. Those who self-harm may feel guilt or shame regarding their actions, and may not be prepared to open themselves up and be vulnerable about their situation.
5
Create a space of acceptance. Regardless of whether your partner decides to accept your assistance or not, try to create a space of openness and acceptance. Listen without judgment, and support them in the choices they make regarding their treatment and how they want to start the healing process.^{[7]
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- Remind your partner that even if they don't want to talk now, you'll be there for them should the need ever arise.

Method 2

Method 2 of 3:

Maintaining Your Relationship

1
Recognize that it's not your fault. Don't blame yourself for your spouse's self-harming behaviors. Even if things within your marriage are not going well, the self-harm is not your fault. You are not responsible for your spouse's behavior.^{[8]
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- Perhaps you take responsibility for increasing your spouse's stress or problems. This might be true, but you have not caused them to self-harm.
2
Avoid anger or judgment. Remember that your spouse isn't trying to purposefully hurt you or your marriage. They aren't trying to make you feel guilty or trying to get attention in this way.^{[9]
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Research source} Instead, recognize that your spouse is experiencing intense emotions that are difficult to cope with. Even if you feel angered or frustrated by your spouse's behavior, respond kindly to them instead of with anger.
- If you're struggling with your own intense emotions, take a break from talking to your spouse. Go on a walk or say that you need a moment before interacting.
3
Remember who they are outside of self-harming. While it's hard to see someone at their best when they are in crisis, remember who your spouse is outside of their self-harm. What are the things that attracted you to this person, and what made you want to marry them? Think about their good qualities and remind yourself that self-harm is not who they are, but just a part of their life at this moment.^{[10]
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- Spend time with your spouse doing something that you enjoy together and remind yourself that you can still have fun and enjoy each other together. Go to a movie or take a hike that you both enjoy.
4
Spend quality time together. Sometimes, self-harm can be one way that people deal with overwhelming stress or dissatisfaction. Think about what causes your spouse stress and see what you can do to help relieve it so you can spend time together. While this won't stop their self-harming, it can help you feel closer and build your relationship instead of taking it down.^{[11]
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- For example, if your spouse feels overwhelmed with taking care of the children or works tireless hours away from home, set aside time once a week where it's just the two of you doing something enjoyable together. Get a babysitter, make dinner plans, or buy tickets to see a movie.
5
Help reduce stress. You may also want to help reduce any additional stress that may exacerbate their desire to self-harm. If you know certain chores or errands like paying the bills cause your partner additional stress, offer to take up those responsibilities.^{[12]
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- Even if there is no predictable stress trigger, it may help your spouse maintain overall calm and mental balance when you offer to take on some stressful activities.

Method 3

Method 3 of 3:

Dealing with Stress

1
Take care of yourself. Don't get sucked into focusing only on your spouse's needs and forget about your own. Take care of your body by eating nutritious meals, sleeping well, and exercising. Do activities you enjoy and stay socially connected with friends and family. Get the support you need to get through by having someone to talk to and resources to fall back for your own health and safety.^{[13]
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- Don't ignore your own needs and wants. You might feel guilty for taking a night to be with friends or family, but remember that it's important for you to take care of yourself.
2
Talk to someone. You might feel like your spouse's self-harm is too much for you to deal with and feel overwhelmed by how much it affects you and the marriage. Perhaps you feel trapped in the marriage or that you can't leave your partner. These are normal and common reactions.^{[14]
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Research source} However, you might need some support and someone to talk to, which is where a therapist can help. Especially if you're keeping your spouse's self-harm a secret from family and friends, having someone to talk to can be a relief and a way to work through your thoughts and feelings.
- Find a therapist by calling your insurance provider or by calling a local mental health clinic. You can also get a recommendation from a physician, friend, or family member.
3
Cope with stress together. Self-harm is a way to cope with stress. Encourage your spouse to cope with stress in more beneficial ways that don't hurt their body. Offer to engage in coping strategies together, like going for a walk together or exercising together. That way, both of you can work through stressors and support one another in dealing with stressors effectively.^{[15]
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- Take the dog on a walk together, complete a puzzle, or go to the gym together.
4
Deal with stress daily. Make sure your own stress doesn't compound from day to day. Deal with each day's stress by engaging in daily relaxation exercises. Practicing relaxation for 30 minutes each day can help keep depression at bay and can help stabilize your moods.^{[16]
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- Find relaxation methods that feel good and that you want to do every day. Try daily yoga, qi gong, tai chi, or meditation.

Expert Advice

Understand that people self-harm for different reasons. Some people do it because they find the physical pain is easier to deal with than emotional pain, to punish themselves, to exit emotional numbness, or to communicate their pain.
Try not to make your spouse feel guilty. People are often experiencing guilt, pain, shame, blame, and more difficult feelings underneath their self-harm. Aim to be compassionate and respectful, even if you don't understand or accept what they are doing.
Let them know that you are here to listen and support them. Ask how they are doing, validate their feelings, and meet them where they are. You can suggest seeking counseling and therapy to get stronger, but you can't force them to stop.

From Moshe Ratson, MFT, PCC

Marriage & Family Therapist