What Is Self-Harm?
Self-harm or self-injury is the act of deliberately harming the surface of one’s body. Acts of self-harm are not usually intended to be suicide attempts, but rather are unhealthy ways individuals cope with emotional pain, trauma or anger.
Warning Signs and Behaviors
Self-harm behaviors include but are not limited to:
Cutting part of the body, commonly the arms, wrists, or thighs
Overdosing on prescribed or illegal drugs
Using cigarettes or lighters to burn the skin
Causes of Self-Harm
People who self-harm are usually trying to relieve, control or express their distressing feelings. An individual may self-harm for different reasons, and sometimes it can be difficult to put the reasons into words. Individuals may not know any other way of expressing their emotional pain or they might feel in control of their pain when they self-harm.
Self-harm occurs most often during the teenage and young adult years, though it can also happen later in life. Those at the highest risk are people who have experienced trauma, neglect or abuse.
The urge to hurt oneself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, self-injury can stimulate the body’s endorphins or pain-killing hormones, thus raising an individual’s mood.
What to Do When Someone Self-Harms
Perhaps you have noticed a friend or family member with frequent bruises or bandages. If someone is wearing long sleeves and pants even in hot weather, they may be trying to hide injuries or scarring.
Keep in mind that this behavior is usually a symptom of another condition like depression or anxiety. If you’re worried a family member or friend might be hurting him/herself ask them how they’re doing and be prepared to listen to the answer, even if it makes you uncomfortable. This may be a hard subject to understand. One of the best things is tell them that while you may not fully understand, you’ll be there to help. Don’t dismiss or trivialize their emotions.
Gently encourage the individual to get treatment by stating that self-harm isn’t uncommon and doctors and therapists can help. If possible, offer to help find treatment. Don’t go on the offensive and don’t try to make the person promise to stop, as it takes more than willpower to quit.
Check whether the person is thinking about suicide, and call your local hospital or mental health service if you think they are. Call an ambulance (phone 911) or take the person to the emergency department of the local hospital if they need urgent medical attention.
Supporting someone who self-harms can be a stressful experience, so think about getting support for yourself as well.
Treatment for Self-Harm
Treatment should be tailored to an individual’s specific issues and any related mental health conditions an individual might have. Treating self-injury behavior can take time, hard work and individual compliance. Because self-injury can become a major part of an individual’s life, he or she may need treatment from a mental health professional with specific experience treating patients with self-injury issues. If the self-injury behavior is associated with a mental health disorder, such as depression or borderline personality disorder, the treatment plan focuses on that disorder, as well as the self-injury behavior.
Known as “talk therapy” or psychological counseling, psychotherapy can help an individual:
Identify and manage underlying issues that trigger self-injuring behavior
Learn skills to better manage distress
Learn how to regulate emotions
Learn how to boost self-image
Develop skills to improve relationships and social skills
Develop healthy problem-solving skills
Several types of individual psychotherapy may be helpful, such as:
Cognitive behavioral therapy (CBT) – Helps individuals identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
Dialectical behavior therapy – A type of CBT that teaches behavioral skills to help tolerate distress, manage or regulate emotions, and improve relationships.
Psychodynamic psychotherapy – Focuses on identifying past experiences, hidden memories or interpersonal issues at the root of emotional difficulties through guided self-examination.
Mindfulness-based therapies – Help individuals learn live in the present and appropriately perceive the thoughts and actions of those around them to reduce their anxiety and depression.
In addition to individual therapy sessions, family therapy or group therapy also may be recommended.
There are no medications that specifically treat self-injuring behavior. However, if an individual is diagnosed with a mental health condition, such as depression or an anxiety disorder, a doctor may recommend antidepressants or other medications to treat the underlying disorder associated with self-injury. Treatment for these disorders may help individuals feel less compelled to hurt themselves.
If an individual injures themselves severely or repeatedly, a doctor may recommend that he or she be admitted to a hospital for psychiatric care. Hospitalization, often short term, can provide a safe environment and more intensive treatment until the individual gets through a crisis. Day treatment programs also may be an option.