Self-Harm
Learn about self-harm behaviors, warning signs, and effective support strategies. Find compassionate guidance for yourself or someone you care about who is struggling with self-harm.
If you or someone you care about is struggling with self-harm, please know that you're not alone, and help is available. Self-harm affects people from all walks of life, and recovery is possible with the right support. This page offers information about self-harm, strategies for coping, and resources for finding help—whether you're personally experiencing these urges or supporting someone who is.
What Is Self-Harm?
Self-harm (also called self-injury or self-mutilation) refers to deliberately hurting your own body as a way of coping with emotional pain, intense anger, or frustration. While cutting is the most commonly discussed form, self-harm includes many behaviors that cause injury to body tissues [1].
Self-harm is not usually a suicide attempt, though people who self-harm may also experience suicidal thoughts. Instead, self-harm often serves as a way to:
Release overwhelming emotions
Distract from emotional pain with physical pain
Express feelings that seem impossible to put into words
Feel a sense of control
Punish oneself due to feelings of worthlessness or guilt
Feel something when experiencing emotional numbness
It's important to understand that self-harm is typically a sign of deep emotional distress rather than attention-seeking behavior. People who engage in self-harm are using it as a coping mechanism, albeit an unhealthy one, for dealing with difficult emotions or situations [2].
Recognizing Signs of Self-Harm
Self-harm is often hidden, as many people feel shame or fear about their behavior. Recognizing the signs can help you identify when you or someone you care about might need support.
Physical signs may include:
Unexplained cuts, burns, bruises, or scratches, often in patterns
Fresh cuts, burns, or other wounds
Scars, often in patterns
Wearing long sleeves or pants, even in hot weather
Frequent "accidents" or injuries with implausible explanations
Finding sharp objects or implements that could be used for cutting
Emotional and behavioral signs might include:
Expressing feelings of worthlessness or hopelessness
Difficulty handling emotions
Relationship problems or questions about identity
Isolation or withdrawal from regular activities and friends
Impulsivity and unpredictability
Statements of helplessness, hopelessness, or worthlessness
Remember, the presence of these signs doesn't automatically mean someone is self-harming, but they may indicate emotional distress that deserves attention and support [3].
How Self-Harm May Present Differently
Self-harm can manifest differently among individuals. Various factors influence how and why someone might engage in self-harming behaviors:
Age Differences
Adolescents may be more likely to self-harm due to intense emotions, peer influence, and developing coping skills, while adults might self-harm in response to trauma, relationship difficulties, or mental health conditions. Older adults might self-harm due to isolation, loss, or physical health problems [2].
Gender Considerations
Research suggests that self-harm affects people of all genders. While historically it was thought that females were more likely to engage in cutting behaviors and males in hitting or burning, current understanding recognizes that self-harm behaviors span across gender identities [3].
Cultural Factors
Cultural background can influence both the expression of self-harm and the willingness to seek help. In some communities, mental health stigma may make it harder to acknowledge self-harm and seek support [4].
Factors That May Contribute to Self-Harm
Understanding the factors that might contribute to self-harm can help in addressing the underlying issues:
Individual Factors
Difficulty regulating emotions or expressing feelings
Low self-esteem or self-worth
Perfectionism
Impulsivity
History of trauma or abuse
Certain mental health conditions like depression, anxiety, borderline personality disorder, or eating disorders [5]
Environmental Factors
Family conflict or dysfunction
Exposure to others who self-harm
Experience of discrimination or bullying
High-stress environments
Major life changes or losses
Social isolation
Self-harm is complex and usually results from a combination of factors rather than a single cause. Each person's experience is unique, and understanding personal triggers is an important part of the recovery process.
Impact on Daily Life and Relationships
Self-harm can significantly affect daily functioning and interpersonal connections:
Personal Impacts
Self-harm often creates a cycle that's difficult to break. The behavior might provide temporary relief from emotional distress, but it's typically followed by feelings of shame, guilt, or embarrassment. This can lead to further emotional distress, reinforcing the cycle.
Physical complications can include infection, permanent scarring, and accidental severe injury. The energy devoted to hiding self-harm and managing wounds can interfere with school, work, and other activities [1].
Effects on Relationships
When others discover someone's self-harm, they may react with shock, fear, anger, or confusion. These reactions, while understandable, can sometimes make the person who self-harms feel misunderstood or judged, potentially increasing isolation.
Family members and friends often feel helpless, worried, or overwhelmed. They may struggle with how to provide support without enabling the behavior or becoming overprotective [6].
Treatment and Support Options
Recovery from self-harm is possible with appropriate support and treatment. Different approaches may be helpful depending on individual needs:
Professional Treatment
Psychotherapy: Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Mentalization-Based Therapy have shown effectiveness for self-harm. These approaches help develop healthier coping skills, improve emotion regulation, and address underlying issues [5].
Medication: While there's no specific medication for self-harm, treating underlying conditions like depression or anxiety may help reduce self-harm urges.
Crisis services: For immediate support during intense urges, crisis lines, text services, or emergency rooms can provide safety and stabilization.
Treatment Settings
Care may be provided in various settings:
Inpatient/residential treatment for severe or dangerous self-harm
The appropriate level of care depends on the severity of self-harm, risk of suicide, presence of co-occurring conditions, and available support systems [7].
Self-Care Strategies and Coping Skills
Developing alternative coping strategies is essential for reducing reliance on self-harm:
For Managing Urges
When you feel the urge to self-harm, try these alternatives: Physical activities such as going for a run, punching a pillow, squeezing ice, or snapping a rubber band on your wrist. Creative expression like drawing, journaling, playing music, or other artistic outlets can also help redirect overwhelming emotions. Sensory experiences including taking a cold shower, listening to loud music, or holding something with an intense texture may help ground you. Mindfulness practices such as deep breathing, progressive muscle relaxation, and grounding techniques can also be effective in managing difficult moments.
For Long-Term Emotional Health
Building these skills can help address underlying issues: Identifying and naming emotions to better understand your triggers. Practicing self-compassion and reducing self-criticism to develop a gentler relationship with yourself. Building a support network of trusted individuals you can reach out to when struggling. Creating a safety plan for moments of crisis with specific steps to take when urges arise. Setting and working toward meaningful goals that give you purpose and direction. Maintaining physical health through sleep, nutrition, and exercise to support your overall wellbeing.
Many people find that working with a therapist helps them develop and practice these skills effectively [5].
How Loved Ones Can Provide Support
Supporting someone who self-harms requires patience, understanding, and self-care:
Helpful Approaches
Learn about self-harm to understand what your loved one is experiencing. Listen without judgment, acknowledging their feelings. Encourage professional help without forcing or threatening. Focus on the person, not just the behavior. Recognize progress, even small steps. Maintain appropriate boundaries and your own well-being. Be patient. Recovery takes time and often includes setbacks.
What to Avoid
Demanding promises to stop or giving ultimatums can increase feelings of shame and failure. Expressing shock, disgust, or anger about the self-harm may make the person feel judged and less likely to open up. Making the person feel guilty or ashamed reinforces negative self-perceptions that may contribute to self-harm. Taking away all privacy can damage trust and increase feelings of powerlessness. Attempting to become their therapist, while well-intended, can create unhealthy relationship dynamics and lead to burnout.
Remember that while you can offer support, you cannot control another person's behavior. Professional help is usually necessary for recovery from self-harm [6].
Finding the Right Treatment Center
When you're ready to seek professional help for self-harm, our comprehensive treatment center directory can help you find the right support:
Using Our Facility Locator
Our easy-to-use facility locator tool is designed to help you find treatment centers that specifically address self-harm and related concerns. You can search based on your location to find facilities near you, making it easier to access regular treatment and support.
The directory allows you to filter results based on several important factors. You can search for facilities that offer specific levels of care, from outpatient therapy to more intensive inpatient programs. This helps ensure you find the right intensity of treatment based on your current needs and situation.
You can also filter by treatment methods, allowing you to find centers that specialize in evidence-based approaches for self-harm such as Dialectical Behavior Therapy (DBT) or Cognitive Behavioral Therapy (CBT). Our directory includes information about insurance acceptance, helping you identify centers that work with your specific insurance provider to minimize out-of-pocket costs.
Each facility listing includes detailed information about specializations, available programs, and contact information, making it easier for you to reach out directly with questions about their approach to treating self-harm.
Remember that seeking help is a sign of strength, not weakness. Taking the step to find professional support shows courage and commitment to your wellbeing or that of your loved one [7].
Related Conditions and Resources
Self-harm often occurs alongside other mental health conditions that may need attention:
Hope for Recovery
Recovery from self-harm is absolutely possible. Many people who once relied on self-harm develop healthier coping mechanisms and go on to live fulfilling lives free from self-injury. The path isn't always straightforward, there may be setbacks along the way, but with appropriate support, persistence, and compassion, healing can and does happen.
If you're currently struggling with self-harm, please know that your pain is valid, but you deserve kindness, not harm. Reaching out for help can be difficult, but it's a crucial step toward healing. You are not alone, and things can get better.
If you're supporting someone who self-harms, your compassion makes a difference. By offering understanding while encouraging professional help, you're providing valuable support on their journey to recovery.
References
[1] American Psychological Association. (2022). "Understanding self-injury." https://www.apa.org/topics/self-harm
[2] National Alliance on Mental Illness. (2023). "Self-harm." https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm
[3] Mayo Clinic. (2023). "Self-injury/cutting." https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
[4] Mental Health America. (2022). "Self-injury and cultural considerations." https://www.mhanational.org/self-injury
[5] Substance Abuse and Mental Health Services Administration. (2023). "Evidence-based practices for self-harm." https://www.samhsa.gov/resource/ebp/self-harm-treatment
[6] National Institute of Mental Health. (2023). "Helping someone with self-injurious behavior." https://www.nimh.nih.gov/health/publications/helping-someone-with-self-injurious-behavior
[7] International Society for the Study of Self-Injury. (2022). "Treatment resources." https://itriples.org/treatment-resources
If you or someone you know is in immediate danger of self-harm or suicide, please call 988 (Suicide & Crisis Lifeline), go to your nearest emergency room, or call 911.