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Understanding Self-Harm


What is Self Harm?

Nonsuicidal self-injury (NSSI), also known as “self-harm” is the act of physically harming one’s own body without suicidal intent.  The most commonly reported methods of self-harm include cutting of the skin (70-90%), head banging or hitting (21-44%), and burning of the skin (15-35%).  Many self-harmers engage in multiple methods of self-harm.  Other methods include:

  • Excessive scratching of the skin 

  • Preventing wounds from healing 

  • Ripping hair out 

  • Punching (oneself or objects to injure the hands/knuckles)

  • Intentionally infecting oneself 

  • Drinking harmful substances (such as bleach or detergent)

  • Intentionally breaking bones

  • Misuse of drugs or alcohol

  • Deliberately starving oneself or binge eating 

  • Overexertion with exercise 


The classification of these (and other) acts as self-harm is dependent on the intent. If a person is doing something to hurt themselves, regardless of the severity, it is considered an act of self-harm.  

NSSI itself is not a mental illness.  Instead, it is often a symptom of emotional distress.  


Why do People Self Harm?

  It can be difficult to understand why a person would intentionally harm themselves.  The urge to self-harm often begins with overwhelming emotional distress.  One may use self-injury to seek one or more of the following results: 


  • A sense of control

  • A distraction from overwhelming emotions and/or circumstances

  • Self-punishment as a result of low self-esteem or self-loathing

  • An escape from numbness through the pain that self-harm can provide

  • A physical indication of emotional distress (essentially, to “make the outside match the inside” so that it feels more “real” to them,  or to seek help from others)


It is also believed that self-injury can release endorphins, neurotransmitters that relieve pain and improve mood.  This can make self-harm addictive for many people, as the rush/ “high” that comes with this release can provide temporary relief.  This can lead to self-harm becoming a strategy (albeit, an unhealthy one), for emotional regulation and self-soothing.  

Additionally, every self-harmer may do so for different reasons, and some struggle to fully understand it themselves.



Who is at Risk of Harming Themselves?

Anyone, of any age, gender, ethnicity, or socioeconomic status can suffer from self-harm.  However, it is most commonly seen in adolescents and young adults.  Although it is often believed that self-harm and mental illnesses such as depression, BPD, or anxiety go hand-in-hand, self-harm can be present regardless of the presence of other mental illnesses. Any difficult experience can lead to self-harm.  Some common examples include: 


  • School/work pressure

  • Bullying 

  • Financial trouble 

  • Abuse/neglect

  • Discrimination 

  • Loss

  • Breakups 

  • Overwhelming negative emotions 

  • Mental or physical illness

  • Low self-esteem/self-hatred

  • Addictive behaviors or substance abuse 

  • Previous suicide attempts 

  • Previous self-harming episodes


Signs that Someone May be Self-Harming

Many people who self-harm try to keep it a secret, making it a difficult issue to detect.  Generally, a combination of frequent, unexplained injuries, symptoms of depression (such as low mood, lack of interest in anything, becoming socially withdrawn, self-loathing, and changes in eating habits), and emotional instability can be strong indicators of self-harming behavior.  A few additional signs that someone may be self-harming include: 


  • Long sleeves/pants in hot weather to cover injuries 

  • Excessive use of first-aid materials 

  • Keeping sharp objects on hand 

  • Misuse of alcohol or drugs 

  • Suicidal ideation 


Treatment for Self-harm

Treatments such as psychodynamic therapy, cognitive behavioral therapy, and dialectical behavioral therapy can be used to equip self-harmers with healthy coping skills and support for difficult circumstances.  Additionally, there are support groups (both online and in person) that can provide a safe place for open communication about self-harm.  


How to Help Someone Who is Self-Harming 

Those who self-harm are doing so to try to live lives with less emotional distress.  What they need most from their loved ones is compassion and understanding.  Therefore, to help a loved one who self-harms, you must be prepared to listen to them about their struggles, even if those conversations are uncomfortable.  Do not dismiss their emotions, make them promise to stop, or threaten them with treatment.  Doing so will only make it difficult for them to trust you.  Instead, educate yourself about self-harm, offer to help them find treatment, offer to join them in a support group, and regularly check in with them.  


Life can be extremely difficult, and there are such overwhelming circumstances that can make self-harm seem like the only way to cope.  However, self-harm can be overcome, and hope can still be found despite everything.  


References:

E David Klonsky, et al. “Nonsuicidal Self-Injury: What We Know, and What We Need to

Know.” The Canadian Journal of Psychiatry, vol. 59, no. 11, 1 Nov. 2014, pp. 565–568, www.ncbi.nlm.nih.gov/pmc/articles/PMC4244874/, https://doi.org/10.1177/070674371405901101. Accessed 6 Sept. 2024.


Gillette, Hope. “Is Self-Harm an Addiction?” Healthline, Healthline Media, 5 Oct. 2023,

www.healthline.com/health/is-self-harm-an-addiction#signs. Accessed 6 Sept. 2024.


“Self-Harm.” NAMI, 11 Jan. 2024, www.nami.org/About-Mental-Illness/Common-with-Mental-

Illness/Self-harm/. Accessed 6 Sept. 2024.

“Self-Harm.” Samhsa.gov, 2023, www.samhsa.gov/mental-health/self-harm. Accessed 6

Sept. 2024.


“Self-Harm - Types and Signs.” HSE.ie, 1 Sept. 2022, www2.hse.ie/conditions/self-harm/.

Accessed 6 Sept. 2024.


“Self-Injury (Cutting, Self-Harm or Self-Mutilation).” Mental Health America, 2024,

www.mhanational.org/conditions/self-injury-cutting-self-harm-or-self-mutilation. Accessed 6 Sept. 2024.


Singhal, Arvind, et al. “Risk of Self-Harm and Suicide in People with Specific Psychiatric and

Physical Disorders: Comparisons between Disorders Using English National Record Linkage.” Journal of the Royal Society of Medicine, vol. 107, no. 5, 13 Feb. 2014, pp. 194–204, www.ncbi.nlm.nih.gov/pmc/articles/PMC4023515/, https://doi.org/10.1177/0141076814522033. Accessed 6 Sept. 2024.



“Treatment and Support for Self-Harm.” Mind.org.uk, 2024, www.mind.org.uk/information-

support/types-of-mental-health-problems/self-harm/treatment-for-self-harm/. Accessed 6 Sept. 2024.


“Understanding Self-Injury/ Self-Harm - Mental Health Literacy.” Mental Health Literacy, 18

Jan. 2016, mentalhealthliteracy.org/understanding-self-injury-self-harm/. Accessed 6 Sept. 2024.



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