If you don’t self-injure, it may be hard to imagine intentionally cutting or hurting yourself. The thought that a friend might be self-injuring can be shocking and confusing. You may be angry and frustrated with your friend for hurting themselves, and you may have no clue about what to do or how to help.

Here are some suggestions:

• Learn about self-injury. It can be tough to grasp why someone would want to intentionally harm themself. Learning why people self-injure helps you better understand what your friend is going through and empathize with them. This also helps you become better equipped to help them. Remember, too, that self-injury doesn’t just include cutting. Watch out for signs of bruising, broken bones, pinching, punching, biting or unexplained scars.

• Don’t ignore it. You might not want to hurt your friend’s feelings by confronting them, or you might be afraid to bring up the subject. But ignoring the fact that your friend is intentionally hurting themself doesn’t make the situation better. While self-injuring seems to feel good to the person, this feeling is fleeting. Afterwards, individuals feel terrible and ashamed. Also, serious injuries can occur. When alcohol or drugs are added to the mix, individuals are at risk for life-threatening injuries.

• Approach your friend in a compassionate way. People who self-injure often already feel embarrassed and guilty. When talking to your friend, try to understand their situation and be compassionate. Avoid getting angry, yelling or blaming them. Don’t tell them that what they’re doing is disgusting or wrong. Try not to judge or tell them to stop the behavior. Be open as you listen to your friend. Also, tell your friend that you’ll always be there for them.

• Be there. Self-injurers can isolate themselves, which only makes matters worse. Call your friend to see how they’re doing. Spend quality time with them, participating in activities you both enjoy. Basically, try to make yourself available — but within reason. It’s important for you to have boundaries, and to remember that you don’t have control over what your friend does. So if they continue to self-injure, this isn’t your fault.

• Encourage them to get help. Seeking treatment is the best thing a person who self-injures can do. Seeing a counselor can help them build better coping skills, learn to express their emotions in healthy ways, boost their self-esteem and lead to a happier life overall. You can find out about on-campus resources on your own and give the information to your friend. Or you can tell your friend that you’ll be happy to look for resources together.

• Call the counseling center yourself. If you’re still not sure about the best way to approach your friend or if he or she is unwilling to get help, call the counseling center and ask to speak with a therapist. They can answer any questions you have and give you some suggestions on how to help your friend.

• If it’s an emergency, get help. If your friend has a serious injury, call 911 or take them to the hospital ASAP. While most self-injurers don’t mean to cause a life-threatening injury, it’s something that does happen. Get them the help they need right away.