Self-Harm

By Amalia Sirica, LCSW on December 8th, 2021

The National Alliance on Mental Illness (NAMI) defines self-harm as any action that results in hurting yourself on purpose. If you or a loved one are experiencing urges to self-harm, it can feel scary and isolating. Rest assured, there is help out there, and you are not alone. 

One study of college students found that 15.3% of them would engage in Nonsuicidal Self-Injury (NSSI) at some point in their lives, with higher rates among women. Another study of adolescents found an average of 18% of study participants performed NSSI in their lifetimes. According to the American Psychological Association (APA), NSSI is less common in adults — about a 5% lifetime rate. People self-injure regardless of racial identity or socioeconomic status, but that identifying as LGBTQ+ might put a young person at greater risk for self-harm behavior. 

At a Glance

• The National Alliance on Mental Illness (NAMI) defines self-harm as any action that results in hurting yourself on purpose.
• Some forms of self-harm are more obvious, but others are more subtle. 
• The most common forms of self-harm are skin cutting (70–90%), headbanging or hitting (21–41%) and burning (15–35%).
• A trained therapist can offer support if you are trying to stop self-harming behavior. 
• Support groups can also be useful, as it can be helpful to speak to other people who are experiencing the same things as you. 

What Is Self-Harm? 

Self-harm is any action that results in hurting yourself on purpose. Some examples of self-harm behaviors are cutting, burning, banging your head against a wall or anything that causes non-fatal harm to oneself. 

Risk factors for self-injury include: 

• Depression and feelings of hopelessness
• Being prone to emotional dysregulation (struggling to handle emotional states)
• Low feelings of self-worth
• Individual pain tolerance 

One study also identified Nonsuicidal Self-Injury as a gateway to suicide in young adults. As such, self-injurious behaviors need to be taken seriously, particularly in younger people. 

Self-injury can produce feelings of shame and fear in those struggling with it. If the self-injurious behaviors are physical in nature (i.e., cutting and burning), they can produce lasting scars. There continues to be stigma and shame surrounding self-injurious behavior and suicidal ideation, but these experiences are best treated with warmth and compassion. It is often challenging to reach out for help because of the shame and fear of perceived judgment. 

FAQs

Why do people self-harm?

The individual struggling with self-harm often may not be sure of why they are feeling these urges. Self-harm is often an unhealthy way to cope with trauma or a mental health condition like depression or PTSD. As with all other mental health conditions, people struggling with self-harm deserve to be treated with care and compassion. 

What is considered self-harm?

Self-harm is any action that results in hurting yourself on purpose, physically or emotionally. 

Forms of Self-Harm

People who engage in self-harm often hurt themselves in more than one way. The most common forms of self-harm are skin cutting (70–90%), headbanging or hitting (21–41%), and burning (15–35%). 

According to the Mental Health Foundation of New Zealand, forms of self-harm include: 

• Cutting skin on wrists, arms or legs 
• Biting and scratching at skin
• Headbanging and punching self 
• Burning of skin
• Hair or eyelash pulling 
• Taking overdoses of drugs or medication 
• Taking poisonous substances
• Inhalation of a harmful substance 

These forms of self-harm can be obvious, but there are also more subtle forms of self-harm. These can include unsafe sex practices, deliberately over-eating to the point of feeling ill, over-exercising or denying oneself food, or purposefully staying in unhealthy relationships. These forms of self-harm may not be as apparent or acutely dangerous, but they can certainly cause significant distress and pain. 

Help for Self-Harm Now

The urge to self-harm can feel intense and overwhelming. The Scottish Association for Mental Health (SAMH) has compiled an excellent resource on alleviating urges to self-harm. They describe the experience of learning first to understand the patterns of self-harm, followed by recognizing the triggers and the early urges to self-harm. From this place, a person can then learn to distract themselves from the urge to self-harm. There are many ways to distract from these urges, with each person benefiting from different techniques. 

Some possible means of distraction: 

• Exercise, hit cushions, dance, jump around 
• Take a walk in nature, listen to music  
• Clean your room
• Cook a good meal 
• Practice deep breathing 
• Journaling
• Reach out to a friend or loved one 

Treatment and Therapy 

If you or a loved one is struggling with self-injurious behavior, you are not alone, and there is help. There are no fixed reasons why people self-harm. It can be related to a specific event, but it has also been described as a way to release pain or express suicidal feelings or feelings of hopelessness without taking fatal action. It is important to discover the root of the self-injurious behavior, the pain that someone is experiencing and that there are people that can help you with this process. 

A trained therapist can offer support if you are trying to stop self-harming behavior. Both cognitive-behavioral therapy (CBT) and Dialectical Behavioral Therapy (DBT) have been found useful in treating NSSI. 

Support groups can also be useful as it can help to speak to other people experiencing the same thing as you are. A primary risk factor for NSSI and suicidal behaviors is isolation or a feeling of not belonging. Support groups can help to lessen these feelings of loneliness and help someone understand that they are not the only one struggling with urges to self-harm. 

How To Help Someone Who Self-Harms

Witnessing a loved one struggle with self-harming behavior can be a painful experience and lead to feelings of hopelessness and fear. It is important to remember that you alone cannot help your loved one, and it is essential to have your own support while supporting them. 

That said, there are some things that people can do to offer compassion and empathy to loved ones who are struggling with self-harm. The National Health Service (NHS) suggests the following actions: 

• Encourage them to speak to their doctor.
• Ask them how they would like to be supported. 
• Let them know you are there for them. 
• Try to understand their experiences and emotions without judging them, rather than focusing on self-harm.
• Let them control their decisions, but get them medical attention if needed.

The SAMH resource also speaks in-depth about how to support a loved one who is struggling with self-injury. The critical thing to remember is that we cannot force anyone to get help. However, we can be a source of support and resources.

If you or a loved one is currently experiencing urges to self-harm, please know that there is help and hope out there. The Nobu app offers mental health resources and access to licensed therapists online for an additional fee.