Self-harm is defined as the intentional, direct injuring of one’s own body (usually done without suicidal intentions). This can also be known as self-mutilation and self-injury. Self-harm behaviors include (but are not limited to): skin cutting (most common), burning, scratching, banging/hitting body parts, interfering with wound healing, hair-pulling and/or the ingestions of toxic substances or objects.
Self-harming behaviors may become life-threatening and, although suicide is not the intention of self-harm, individuals who self-harm are at an increased risk for suicide, as self-harming behaviors are found in 40-60% of suicides. However, not all individuals who self-harm are suicidal, so a generalization claiming such cannot accurately be made.
Understanding self-harm may be extremely difficult for those who do not self-injure. The motivations for self-harm are extremely varied, although it is most often done as a way to deal with deep emotional pain and to cope with/provide temporary relief from extreme emotions such as sadness, emptiness & emotional numbness, self-loathing, anxiety, stress, depression, a sense of failure, guilt and/or rage. It can usually be linked to other mental traits including low self-esteem and perfectionism.
Self-harm is a symptom of borderline personality disorder, but can affect individuals with other diagnoses as well, including those suffering from:
– Anxiety Disorders
– Substance Abuse
– Eating Disorders
– Post-traumatic Stress Disorder
– Personality Disorders
*Self-harm can also affect high-functioning individuals with no other clinical diagnosis.*
Self-harm behavior can occur at any age, but is most common in adolescence & young adulthood (usually between the ages of 12 & 24). It is generally associated with a history of trauma and abuse (including emotional and sexual abuse).
Symptoms of Self-Harm:
Self-injuring is usually done in secret and on parts of the body that are easy to conceal and hide from others. Individuals who self-harm may feel ashamed of and/or guilty about the behavior and most often try to cover the body parts that have been injured in an attempt to keep others from seeing the wounds.
It can be hard to detect self-harm behaviors, as most individuals who self-injure cover the physical wounds and do their best to hide emotional distress. However, there are certain things to look for that may indicate a person is self-harming.
If someone you know or care about is displaying warning signs, it’s important to reach out to them in a non-accusatory way. Offer support and do your best to be understanding and patient, as they may not be ready to admit to self-harming behaviors.
Myths about Self-Harm:
“Those who self-injure are just looking for attention”
Individuals who self-harm are not trying to draw attention to themselves or their injuries, which is why they most often injure themselves in secret and on parts of their body that they can easily conceal. Fear of others finding out and/or shame about the behavior actually makes it harder for them to come forward and ask for help.
“Those who self-injure are unstable and/or dangerous”
Labeling a person who self-harms as “crazy” or “dangerous” is both inaccurate and unhelpful. Often times these individuals are suffering from a previous trauma and/or another disorder like depression or anxiety (which the majority of the population struggles with) and they are self-harming in an attempt to cope. Instead of labeling them, educate yourself as much as possible and learn ways that you could potentially help.
“A person who self-injures want to die”
When an individual self-harms the intent is to cope with deep emotional distress, not to end his/her own life. That is why it is unfair and inaccurate to state that anyone who self-injures wants to die. However, the longer self-harm behaviors go on, the higher the risk of suicide becomes, so it is extremely important to seek help.
“If the wounds aren’t that bad, it’s not that serious”
The depth an individual’s physical wound has no correlation to the depth of the emotional pain he/she is feeling; the severity of the situation should not be based on whether the injuries are major or minor, but rather based on the fact that injuries are present at all. Any form of self-harm, big or small, is dangerous and reflects a deeper, emotional issue that needs healing.
If someone you love is self-harming, it can be extremely difficult to understand why they may not want to stop the behavior. The physical pain they inflict on themselves is used as a way for them to escape emotional pain, and they may be afraid of what happens when they no longer have that outlet.
There are several reasons a person might try to continue self-harming:
– To express feelings that can’t be put into words
– To release pain and tension felt inside
– To give a feeling of being in control
– To distract from overwhelming emotions or difficult life circumstances
– To relieve guilt and/or to inflict punishment on oneself
– To allow the person to feel something, rather than feeling numb
Instead of placing blame or guilt on your loved one, try to help them understand that self-harm is temporary relief, not a solution to the bigger issue, and can end up creating many more problems.
Reasons to stop self-harming:
– The relief felt is only temporary and will soon give way to feelings of shame and guilt
– It keeps you from learning more effective strategies for healing
– Keeping the behavior a secret can be difficult and lonely and place stress on relationships with family members and friends
– You may hurt yourself badly without meaning to and accidentally put yourself in serious danger by misjudging the depth of a cut or ending up with an infected wound
– By using self-harm and avoiding healing, you prevent yourself from learning how to deal with emotional pain in a healthy way, which can lead to major depression, drug and alcohol addiction and suicide
– Self-harm can become addictive. It is often started as a way to feel in control, but soon starts to feel like it is controlling you. It may turn into a compulsive behavior that seems impossible to stop
There are deep emotional issues that made you initially want to start self-harming. Without addressing these issues in a healthy way, healing will never occur. Self-harm is not a solution and may feel like a temporary escape, but will end up causing more problems in the long run.
A person can only heal if he/she truly wants to get better and is tired of the way things are. If you have been self-harming and are ready to seek help, know that you are making a brave and courageous decision that will only improve your life.
The first step is to confide in someone that you trust. This can be a terrifying notion, as you will be sharing all of the things you have tried so hard to hide. But letting someone know what you’ve been going through can bring a huge sense of relief and help you start the healing process.
Although you will eventually have to open up to your close family and friends, it might be easier to first confide in someone you respect and trust but has a little more distance from the situation (like a teacher, coach, religious leader, etc.) You want to choose someone that has always accepted and supported you, but won’t try to take control of your recovery process.
Tips for Talking About Your Self-Harm Behaviors:
As you start talking, share all of the feelings and emotions you had/have that led up to the self-harming, rather than the details about the self-harm behaviors themselves. This will help the person you are talking to understand the situation better and understand what you’ve been going through and what led you to that point.
Communication between you and the person must happen, but make sure you communicate in a way that makes you feel the most comfortable. This could mean starting the initial communication through email or writing a letter (although it is best to eventually meet face-to-face), but it also means sharing only what you feel ready to talk about. Don’t pressure yourself or feel pressured by someone else to disclose more than you are ready to, including showing your injuries or answering questions that make you uncomfortable.
The person that you are confiding in will most likely need time to process everything that you’ve said. The conversation will most likely be difficult and scary for you, but it will also be difficult for them as well because they care about you and don’t want to see you hurting. The person may react in a way that you aren’t expecting or in a way that upsets you, so try to prepare yourself ahead of time. Remember that strong emotions are going to be involved and that their possible reactions of shock, anger and/or fear are coming from a place of genuine concern for you and your wellbeing. Give them time to take in what you’ve said and to learn more about self-harm so they can support you better.
The next step is to better understand yourself and your behaviors. This may seem daunting, but it starts with identifying and acknowledging all of your emotions and feelings, which can help you understand what led to the self-harming.
Tips for Understanding:
Right now you are using self-harm as an answer to a deeper problem. By trying to understand the reasons behind your self-harm and what you are using the behaviors to escape from is the start of being able to manage those deeper emotions. When you are able to identify exactly what you are feeling, you can start to learn new and healthy ways of dealing with the emotions that have been ruling your life for so long. As you start to understand your emotions, they will hold less power over you and the desire to hurt yourself will decrease.
Self-harm is used as an attempt to deal with strong emotions; If you can identify exactly what emotions and feelings spark the desire to self-injure, you can start addressing the deeper issues at hand and find healthy alternatives to dealing with the emotional pain. When you find yourself wanting to self-harm, try to understand what it is that you are actually feeling (sadness, anger, shame, loneliness, guilt, emptiness, etc.) and allow yourself to address that emotion directly. When you identify the emotional trigger, you can learn to manage it in a healthy way.
Becoming self-aware means being able to understand what you are feeling and why you are feeling it. It grants the ability to understand the connection between your feelings and your actions. A lack of self-awareness may make it hard for you to pinpoint the emotional triggers behind your self-harm behaviors. If this is the case and you are having trouble discerning why you are self-injuring, it may be because you are afraid of releasing those true emotions. It is scary to pay that much attention to your feelings and often times it seems much easier to numb them or find an escape. But true healing comes with addressing them head on, and as you start to address them, you will begin to realize that they fade much quicker when you give them the attention they need. When you stop fighting against them, they lose their control over you and you will begin to develop a healthy sense of self and a healthy relationship with your emotions.
The last step is to find new coping strategies. You are always going to have emotions and strong feelings that may start to feel overwhelming. Until now you’ve used self-harm as a way to deal with strong emotions, so when those feelings come up again, it’s important to find a different and a healthy way of releasing them.
Alternative Coping Techniques:
If you self-harm to express pain and intense emotions:
If you self-harm to calm/soothe yourself:
If you self-harm because you feel disconnected and/or numb:
If you self-harm to release tension or vent anger:
Tips for when you feel a strong need/desire for the cutting sensation:
Seeking the help from a trained professional is extremely beneficial and in some cases necessary for the healing process. Self-harm is an expression of inner pain and often there is a link between self-harm behaviors and childhood trauma. Talking to a counselor or therapist that you trust can help you get to the base of your emotional distress and help you find new ways of dealing with it.
There may be a root cause for your self-harming behaviors that you haven’t been able to identify yet or a connection to your past that you may not be able to see on your own. A therapist can help you become more self-aware and better able to understand your emotions and behaviors.
Remember that it might take time to find a therapist that you trust and feel comfortable talking to. It is important to find someone who has experience treating trauma and self-harm and one that you feel a good connection with. You should always feel safe, respected and understood and feel at ease with them, especially sharing personal issues.
*Be patient and keep looking until you find the therapist that you feel the most comfortable with.*
Tips for helping a friend or family member who self-harms:
It can be heartbreaking to watch someone you love hurt themselves and is most likely going to bring up a lot of strong emotions. Acknowledging your own feelings towards the behavior and situation is extremely important. You may feel a range of emotions including shock, confusion, anger or even guilt. Find a healthy way to process and handle your own emotions before helping your loved one.
Learn as much as you can about self-harming, including reasons why a person might start and continue the behavior. Educate yourself and try to empathize with your loved one. Understand that self-harming is an indicator of a much deeper issue that they are most likely uncomfortable talking about.
ALWAYS avoid judgmental comments and criticism, which are likely to make the situation worse. The individual who self-harms is generally already feeling emotions of guilt and shame, and you don’t need to add to that. Instead use the first two tips (dealing with your own emotions and educating yourself about self-harm) to help you be more supportive and less judgmental.
You want to help your loved one so badly that sometimes you may become impatient and, ruled by your emotions, you may resort to threats, ultimatums and/or punishments. These are all counterproductive and could end up delaying the healing process. Express your concern and continually offer your support. Make sure the person knows you will always be there when they are ready to talk.
Talking about the issues at hand may be something that makes both you and your loved one uncomfortable, but it’s important to always remain open to it. If the individual hasn’t yet come to you about their self-injuring behaviors, talk to them openly about it in a non-confrontational way. Let them know that you are just trying to understand what they are going through and that you are always there for them. Encourage them often to express any emotions they may be feeling.
sources for this page: http://www.helpguide.org & The Mental Health Foundation, UK