If the person using self-injury is currently in an abusive situation and would like it to end, provide some practical help such as information that might help them get out of that situation. The kind of practical help that is usually most useful is information on where to get accommodation, benefits and health care, Lists of phone numbers and offers to accompany the survivor to get help from agencies might may the difference.
It is important that you listen to the survivor and believe what they tell you. Even if you hear things that you find difficult to believe, keep an open mind.
Survivors need to be able to trust other people. This means that you have to be trustworthy and not betray the survivor.
Acceptance of self-injury as a coping mechanism is important for the survivor. While you may not understand the reasons for the self-injury, you can learn to accept that the survivor may need self-injury at the present time.
Let the survivor know that he or she is worthwhile and treat the person with respect. See the person as a person first rather that a survivor and a self-harmer.
Help empower the survivor to be able to make their own decisions about their own life. This may include accepting that the person has a right to injure self if he or she needs to. The main thing is ensuring that the person does so in as safe a way as possible.
Do not keep passing the person on to someone else who “knows more about these things.” There is nothing worse that being passed on from pillar to post. Why can’t you find out more from other agencies and then help the survivor decide and deal with it.
Help the survivor find creative outlets for self-expression i.e. painting, writing, singing, etc.
Safety and Self-InjuryNo matter what form the self-injury takes, try to ensure that the survivor knows about basic hygiene and the need for it in prevention of infection. If need be, offer to help sterilise blades or whatever else is used to cause the injury. Suggest keeping antiseptic wipes handy and using them.
Suggest that the survivor try to stay in control of what he or she is doing. Suggest not using alcohol or drugs while self-harming.
You may need to offer to help clean injuries or show the survivor how to do so. Talk about it openly with the survivor. They will not be encouraged to harm self just because you are open to talking about what they do to themselves.
For burns, run cold water over them until they cool. For cuts clean using antiseptic wipes and cover with a clean dressing.
Medical attention will usually be needed…

• If burns are large or deep.
• If a cut is deep and will not stop bleeding, apply pressure until it stops. If bleeding continues, or if cut is deep, then get medical attention.
• If an infection gets into the wound, then it is best to seek medical attention.
• If the survivor has overdosed, swallowed or inserted anything harmful into self, then medical attention is probably needed.

Medical AttentionIf medical attention is needed then survivors need to know that..
They have the same rights as other patients to be given pain relief.
They have the same right as other patients to have treatment and to refuse to have a student observing or treating them.
Treatment should not be dependent on agreeing to psychiatric intervention.
Staff can be asked to explain clearly all treatment being provided.

Language is a basic and fundamental medium of communication amongst people. It is cultural and reflects tradition and beliefs. In our experience, most survivors of ritual abuse have been taught or know other languages besides the usual language of the country they grow up in. In many groups, Latin is a commonly used language. It is sometimes taught to some of the children and is usually picked up to some extent even by those not taught it. Many survivors have problems when they hear Latin spoken or chanted.
Many survivors, depending on the group they belong to, know other more widely used languages such as German, French, Greek, etc. These languages may be taught to facilitate international networking, for business purposes or for other reasons of benefit to the group.
In addition to these languages, there are commonly used runic languages used by groups. Some of these are fairly well known as ancient written languages, others may be particular to a group. Because few people know these languages, they can add to the mystic and secrecy of a group. Some survivors appreciate their supporters learning these languages as it can sometimes make communication easier.

Never forget that this person has survived till now without your help.
Remember…

• A person who has multiple personalities is a person like you.
• The survivor is the expert on their own abuse and life…. not you.
• No matter how experienced you are, each person is a unique individual.
• Stick to sound support methods and principles.
• The survivor should be in charge of their own healing.
• Be honest.
• Check out who you are speaking with if the personality changes.
• Encourage communication with all personalities.
• Don’t keep secrets between personalities.
• Don’t get involved or take sides in any conflict between personalities, the survivor has to work things out for themself.
• Be aware that multiplicity arises out of creativity and is a means of survival and coping for the child.
• Encourage seeing the coping mechanism in a positive light

There are many different things that survivors of ritual abuse may try to talk about. Although talking is usually very difficult and painful, as it is designed by the abusers to be, with the right sort of support, they can do it. There are a few common elements that many survivors talk about and though all can’t be covered here, the most common in our experience are the following.
Teaching: Many survivors talk about being taught in the ways of the ‘group’ from a very early age – usually pre-school. They talk about things such as being taught to endure pain, how to obey without question, learning how not to cry, to more fundamental lessons in languages (both written and oral), history and tradition, beliefs and position in life. The lessons learned early in life can be instrumental in forming the survivors belief systems and that can last for a lifetime. A lesson they are taught very young is not to talk about the group or family or tell anyone.
Helping: Keep telling survivors that they are allowed to talk and tell. Keep giving permission and reassuring the survivor that it is okay. If talking is a problem, survivors can sometimes be encouraged to write or draw at first until it gets easier for them to talk. Thinking of simple ways of enabling people to communicate can be effective.
Beliefs: Survivors often have a different belief system from what is generally considered normal in this society. They are taught from an early age about the beliefs of the group and are taught in such a way that it is almost impossible not to believe what is taught. Most survivors believe that they are worthless and have no rights whatsoever.
They may believe that they are evil and the cause of everything that happened. They may believe that abusers are all powerful. They may not believe that want happened to them was even abuse. Some survivors may believe in lay lines or astral planes. They may have been taught to believe that they can be controlled or attacked on the astral plane during sleep for example.
Helping: Try to encourage the survivor towards believing that s/he does have rights and is a worthwhile person. Ask about beliefs as the survivor may be aware of ways of protecting self from within the belief system.
Supporters may find the belief system that the survivors hold difficult to comprehend or understand. The survivor may feel the same way about the supporters beliefs. Do not expect survivors to be able to reject their own beliefs just because you think them to be wrong or are shocked by them. Beliefs held by survivors are usually taught and formed through a lifetime of experience and cannot just be ditched.
Religion: Sometimes the survivor is brought up in a very religious manner. The parents, extended family and others may have very firm and clear beliefs that what they are doing is right. The religion may be couched in terms of a church-like system with all the trappings. The belief system may be in a god or the devil. It may be a belief in an spirit, unseen force or an astronomical body. While it may be okay for adults to hold whatever beliefs they wish, the line must be drawn when children, adults and animals are abused and forced to do things that are morally and legally condemned by most.
Helping: Some survivors do, even when they have left the abuse situation, continue to believe in part in the religion they grew up with. This is their right. The bottom line to hold with a survivor is that they were abused, they were forced, and they were given no choices. This can never be right, regardless of any religious teachings. People can and do have a right to make choices for themselves, but have no right to take away another persons right to choose for themselves.
Pornography: Many survivors, with difficulty, talk about the use of pornography. They talk about being photographed and/or filmed and most will talk about the events as being ‘hard core’ pornography.
Helping: Believing survivors when they try to talk is vital. It costs a great deal to tell you about these experiences. Honour this and stay open to hearing. Many survivors who have endured this are afraid of cameras, videos and filming equipment. They also worry about the fact that pictures and videos of them are out there in the world.
Deprivation: Abusers use various kinds of deprivation to force survivors to behave the way they want. Depriving of food, drink and sleep are all common experiences. Sleep deprivation, even after a few days, can cause anyone extreme disorientation. Sensory deprivation, through ensuring survivors can see, hear, touch and smell nothing at all, is used to mould survivors to the abusers wishes.
Helping: Remind the survivor that the abusers had no right to do these things and that they are losing their power as more is talked about. The fact that the person is talking to you is proof of this fact.
Power: Survivors often believe that they have no power and for most while in the group setting, this would have been true. They may believe there is an all-powerful force, which they cannot prevail against, and that the power of the group is absolute.
Helping: It can be a long slow process, but the survivor can be helped to realise that he or she has some power. In the first instance, there is the power of speech, which can be encouraged to continue to break silence. Encourage the survivor to make decisions for self and begin to take back control.
Symbolism: Survivors often talk about the use of various symbols, which convey meanings that only those associated with the group would know. Some of these symbols are common to different groups across this country and indeed, the world. Symbols are used to add mysticism and a ‘religious’ flavour to the proceedings. They are also used to cause fear, pass messages and convey a sense of importance, pomp and ceremony.
Helping: Check with the survivor that there is nothing you are wearing or in the room you are using that causes upset. If the survivor is willing, get them to teach you about the symbolism.

Don’t panic – that helps no one at all!
Be prepared to believe what you hear.
Stick to skills such as listening, believing and empowering.
Don’t get caught up in the fear of the survivor.
Be calm, encouraging and confident.
Reassure survivors (if still involved) that they can get away.
Don’t isolate yourself from support for yourself.
Be clear, direct and honest. Say if you have problems in support.
Be aware of the possibility of multiplicity but don’t go looking for it.
Remember, getting out of abuse is a process not a single event.
Encourage survivors to sever links with the abusers.
Be aware that survivors may not have had a choice in abusing others.
Be aware of the wider picture when you hear part of a story.
This is the survivor’s story not yours. If you have feelings you are finding difficult – deal with them – get support for yourself.
Find out about other resources for the survivor and for you.
Don’t promise what you can’t deliver.