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Self-harm

Reviewed by Diane Warns, PT

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What Is Self-Harm?

Self-harm or self-injury is intentional harm or pain directed at your own body. It is an attempt to relieve emotional pain by causing physical pain.

People who self-harm may do so to temporarily relieve tension or bring a feeling of calmness. Self-harm is usually not intended to be life-threatening, although it may occur alongside suicidal ideation or unintentionally escalate to a serious injury.

One analysis found that about 17% of people self-harm at some point in their lives and that the average age that people begin self-harming is 13. Another study reported that about 27% of adolescents had thoughts of harming themselves.

Treatment and support can help individuals struggling with self-harm, whether they’ve just started the behaviors or have been engaging in them for long periods. 

Why People Self-Harm

People self-harm for many reasons. While self-harm is not by itself a mental health disorder, it can be a sign that the person is struggling with their mental health. Some reasons why people self-harm include dealing with past trauma, transferring emotional pain to physical pain, and expressing suicidal feelings.

Self-harm may happen because someone wants to:

  • Manage their feelings: Sometimes, someone will try to manage difficult emotions or anxiety by self-harming. Strong emotions, like those caused by trauma, can be difficult to handle, particularly if someone’s coping skills aren’t working. Self-harm may happen in those situations. For some people, physical pain can help distract them from the painful or strong emotions that they are experiencing.
  • Feel a sense of control: Self-harm can be a way for someone to feel more control over their body or environment. In some situations, people who struggle with dissociation or feeling numb may turn to self-harm as a way of feeling something.
  • Communicate distress: You may self-harm to communicate how you are feeling to the people around you. Although many people hide their self-harm from others, it can still be a way of trying to communicate distress and other emotions.
  • Punish themselves: Self-harm can also be a way for someone to punish themselves for their feelings or behaviors. They may feel that they are at fault or deserve to be punished.

Is Self-Harm a Mental Illness?

Self-harm is not a mental health disorder on its own. However, individuals with some mental health disorders may be at increased risk of self-harming. Additionally, self-harm may be an indication of mental illness, such as:

Types of Self-Harm

Self-harm encompases a range of behaviors, with the common characteristic being intentional harm. Self-harm can be both physical and emotional.

Physical Self-Harm

Some forms of self-harm involve physical harm to the body. Physical forms of self-harm can leave behind scars or other physical damage that can increase feelings of shame or guilt. Some types of self-harm to the body include:

Emotional Self-Harm

Although emotional self-harm may not result in physical scars, it can still result in lasting damage. Emotional self-harm can occur because of events in a person’s childhood or adolescence, such as experiencing negative criticism, bullying, neglect, or other forms of abuse. Examples of emotional self-harm include:

  • Inner criticism and negative self-talk
  • People pleasing
  • Unhealthy codependent relationships

Symptoms of Self-Harm

If you are concerned that someone you love may be self-harming, there are some common symptoms of self-harm that you can watch out for. 

  • Cuts, bruises, burns, or scars that the person can’t explain: These are often located on the wrists, arms, legs, and chest.
  • Behavior changes: You might notice that the person begins eating differently or won’t eat around other people, for example. They might decide to change the amount that they are exercising. 
  • Statements: Individuals who are self-harming may make statements expressing self-loathing or not wanting to go on. They may express that they want to punish themselves or blame themselves for things that have happened in their life.
  • Overall physical appearance: Self-harm can lead to weight gain or loss. Individuals may begin wearing clothing that covers more of their body than before, regardless of the temperature.

Getting Help for Self-Harm

Get Help Now

If you engage in self-harm or are thinking about harming yourself, help is available now:

Prevention

Here are some steps you may be able to take to prevent yourself from self-harming:

  • Recognize your triggers: Learning what gives you the urge to self-harm and what that urge feels like can help you prepare to prevent yourself from self-harming. Think about what happened before you self-harmed or had the urge to self-harm. What thoughts, situations, people, or objects are present or remind you of something challenging? How does the urge to self-harm feel? You may feel a racing heart, have repetitive thoughts about harming yourself, or feel very strong emotions.
  • Distract yourself: Look for activities that will help distract you from thoughts or urges to self-harm. This might include exercising, listening to music, ripping something up, breathing exercises, talking to someone, or journaling. Notice what helps distract you from urges to self-harm so that you can use those distractions again in the future.
  • Wait five minutes: If you feel the urge to self-harm, try to wait five minutes. This might feel difficult at first, but over time, you may be able to delay self-harm until you are able to distract yourself or find other help.
  • Talk to family, friends, or a medical professional: Talking to someone about your urges to self-harm can help you manage those urges and get support and treatment. 

Treatment

There are a number of treatments that can help you with the urge to self-harm. Scheduling an appointment with your doctor or a therapist will help you get the treatment that you need. 

  • Psychotherapy: Talk therapy is one of the most widely used treatments for self-harm. Cognitive behavioral therapy (CBT) is one type that can be useful in challenging self-harm urges and behaviors.
  • Medications: While there are no medications that specifically treat the urge to self-harm, medication for anxiety or depression can help treat underlying mental health conditions that may be contributing to your urge to self-harm.
  • Hospitalization: if your self-harm is severe, your therapist may recommend hospitalization. This can provide you with a safe environment to continue your treatment.

Get help to stop self-harming. Visit our list of therapists today.

Helping Others with Self-Harm

Discovering that a loved one is self-harming can be frightening and worrying, but there are actions that you can take to help them.

Prevention

While there is no sure way to prevent a loved one from self-harming, there are steps you can take to reduce their risk.

  • Respond with compassion: If a loved one approaches you about their urges to self-harm, remember that it might have been difficult for the person to seek help. Self-harm is often a way of dealing with difficult emotions, so responding with compassion will help open up communication.
  • Encourage them to seek help: Encourage your loved one to get help and support them as they do so. You can offer to help them find a therapist or set up an appointment.
  • Be available: Let your loved one know that you are there for them to talk about any difficult emotions that they might be feeling.

Treatment

Seek immediate medical help for a loved one who has taken an overdose, is experiencing a great deal of pain, is having difficulty breathing, or has lost a large amount of blood. More minor injuries, such as burns or cuts, may also require medical attention. 

After the immediate concerns are addressed, encourage your loved one to seek treatment for their mental health needs.

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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