Depressed man on bed at home | self harm prevention
Read time: 13 min

When emotional pain becomes too much, many people don’t know what to do. For some, the only answer is inflicting physical pain on themselves. 

Self-harm, or non-suicidal self-injury (NSSI), is causing intentional pain, injury, or damage to one’s own body. Common forms include cutting, bruising, or burning, but self-harm also includes other actions, such as punching walls or pulling out hair with the intent of injuring oneself. (Note: This is different from trichotillomania, or obsessive hair pulling, which focuses instead on the act of pulling and not the injury that comes from it.)

Using self-harm as a method for coping with emotional pain can be hard to wrap your brain around if you’ve never experienced it firsthand. The negative stigma that surrounds it can make it even harder to talk about. But understanding self-harm can help clue us in to the complexities of our own and others’ experiences. 

Getting to the root of why self-harm feels like the only option can lead to healthier ways of handling life’s stressors, however they manifest.

Why do some people self-harm?

“There’s a symbolic component that’s pretty powerful,” says Dr. Janis Whitlock, professor emerita of Cornell University and director of Cornell’s Self-Injury & Recovery Resources research program. “People who self-harm describe this broad, amorphous set of emotions and then translate those emotions to one space on the body to experience healing.”

Some people self-injure to feel more in control when navigating difficult emotions or feeling triggered by something, such as a break-up, being bullied, or unhealthy family dynamics. “My son would self-harm on a regular basis in middle school,” says a second-year student at Utah State University in Logan. “He had a very traumatic experience in life, and I think this is how he dealt with the way he was feeling.”

“People who self-harm describe this broad, amorphous set of emotions and then translate those emotions to one space on the body to experience healing.” - Dr. Janis Whitlock, professor emerita, Cornell University

There are other factors that can increase the chances that an individual will start self-injuring. “Anything that increases a perceived sense of emotional trauma or hurt can increase someone’s risk of NSSI [self-injury] behaviors,” says Dr. Whitlock. These factors might include:

  • Another mental health diagnosis (e.g., research shows there is a high co-occurence of self-harm and eating disorders).
  • A history of trauma, abuse, or neglect (e.g., a 2020 study found that individuals who reported childhood maltreatment were more likely to commit self-harm).
  • Marginalized or misunderstood identities (e.g., research shows LGBTQ+ individuals, particularly those identifying as transgender and/or bisexual, are more likely to self-harm).
  • Substance use (e.g., a 2019 study found long-term substance use to be a significant predictor of self-harm).

Is self-harm related to suicidal intent?

Not always. A major aspect of NSSI is in the name: non-suicidal intent. For people unfamiliar with self-harm, it can be hard to understand how hurting oneself is not the same thing as wanting to die, and pinpointing someone’s intent with self-harming actions might feel impossible. However, understanding intent is important when it comes to helping someone who self-injures.

Another important note is that abusing alcohol and drugs is not considered a form of self-harm, but it can exacerbate the problem.

How to seek help for self-harm

If you struggle with self-harm, think about how you can redirect that thought process and energy into something different. Here are some ways to do that.

Reconnect with your body

One way to regulate your emotions is by getting back in your body through movement. This can help redirect the energy that comes up when you’re feeling self-harm urges. You could play loud music and dance around in your home (I do this regularly), go to the rec center, or take a walk outside for 10 minutes.

  • Sink your heels into the floor and focus on how the ground feels.
  • Play with an animal.
  • Grab a chunk of ice and hold it in your hand.
  • Light a scented candle and focus on the scent.
  • Grab a snack—something with a strong taste, if you can—and let the flavor distract you. (I once had a therapist recommend biting into an onion: awful, but effective.)

There are plenty of other options out there for navigating difficult emotions. “Breathing exercises, fidget toys, and journaling can all help,” says a second-year student at Arapahoe Community College in Littleton, Colorado. Coming up with a list of options ahead of time can help, so it doesn’t demand too much mental power in the moment. Possible activities include:

  • Creating artHeadphones gif | self harm prevention
  • Reading
  • Listening to a podcast
  • Calling a friend
  • Playing a video game
  • Working on a jigsaw puzzle
  • Playing your favorite song

Ask for help

First, acknowledge that asking for help might feel scary or intimidating—especially if you’re having trouble recognizing that self-harm is something you’ve been using to try to cope. “People often don’t reach out if they deny there’s an issue,” says Dr. Whitlock. “Be honest with yourself about what’s going on and what support you need.”

When you decide to reach out, start with someone you can trust. This might be a friend or family member who you’ve spoken to about your mental health before, or a staff or faculty member on campus. “Find somebody—one person—to confide in, just to hear yourself say the words,” says Dr. Whitlock. “It’s helpful to start telling the story to someone.”

“I decided to go to counseling to cope with my self-injuring tendencies. Every session I attended helped me gain the confidence to be myself and, most importantly, to love myself. Don’t be afraid to seek help.” - First-year student at California State University, Channel Islands

Work with a therapist

Having a large support system is incredibly helpful, and a therapist can be part of that. “If the self-harm is chronic, it’s probably going to be hard to stop without therapeutic support,” says Dr. Whitlock. A therapist can help you come up with different coping skills to try, and regular appointments create a space for you to check in with yourself and be honest about what you need.

The type of therapy you engage with is also important. “Look for therapists that are familiar with dialectical behavioral therapy (DBT) or other modalities that focus on bringing one’s attention and thoughts out of the past or future,” says Dr. Whitlock. DBT is the most common form of therapy recommended for self-injury, but any format that strengthens your ability to stay in the present moment can be helpful. Remember, the ultimate goal is to find avenues that help you feel better.

“I didn’t want to feel hopeless and alone anymore,” says a first-year student at California State University, Channel Islands. “I decided to go to counseling to cope with my self-injuring tendencies. Every session I attended helped me gain the confidence to be myself and, most importantly, to love myself. Don’t be afraid to seek help.”

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