Forms of Self-harm

• Cutting or scratching the skin

• Burning or scalding oneself

• Hitting or punching oneself

• Biting or picking at the skin

• Hair-pulling (trichotillomania)

• Inserting objects into the body

• Intentional self-poisoning or overdose

• Excessive alcohol or drug use

• Engaging in risky behaviours to cause harm

• Denying oneself basic needs such as food, sleep, or medication

Why do people self-harm?

People may self-harm for various reasons, including:

• Coping mechanism: Self-harm can provide temporary relief from overwhelming emotions or distressing situations.

• Expressing inner pain: Some individuals find it difficult to verbalize their emotions and resort to self-harm to express and release inner pain.

• Emotional regulation: Self-harm can serve to regulate intense emotions such as anger, sadness, or numbness.

• Feeling a sense of control: Individuals may feel a lack of control over their lives, and self-harm can provide a temporary sense of control over their bodies and emotions.

• Seeking attention or communication: For some, self-harm is a way to communicate their distress or seek attention from others when they feel unheard or misunderstood.

• Punishment or self-penance: Some individuals may engage in self-harm as a form of punishment for perceived faults or mistakes.

• Dissociation: Self-harm can help individuals dissociate from overwhelming thoughts or feelings, providing a temporary escape.

• Self-soothing: The physical pain resulting from self-harm may temporarily distract from emotional pain or provide a sense of relief.

• Coping with trauma: Individuals who have experienced trauma may turn to self-harm as a maladaptive coping mechanism to deal with the aftermath of traumatic events.

• Addiction or habit: Over time, self-harm behaviours can become addictive or habitual, making it hard to stop without professional help and support.

Warning signs of self-harm

• Unexplained cuts, bruises, or burns on the body.

• Wear clothing that covers up the body, even in warm weather.

• Frequent excuses for injuries or reluctance to explain how they got hurt.

• Isolation or withdrawal from friends and family

• Noticeable increase in mood swings or emotional instability

• Expressions of low self-esteem or self-loathing

• Obsessive behaviour around sharp objects or tools

• Hoarding of items that could be used for self-harm (e.g., razors, matches)

• Evidence of self-harm paraphernalia (e.g., bandages, antiseptic creams)

• Changes in eating or sleeping habits.

Risk Factors for Self-harm

Factors that can increase the risk of self-harm include:

• Mental health disorders: Conditions such as depression, anxiety, borderline personality disorder, and substance abuse disorders can increase the likelihood of self-harm.

• Trauma or abuse: Individuals who have experienced physical, emotional, or sexual abuse, neglect, or other traumatic events are at a higher risk of self-harm.

• Poor coping skills: Lack of effective coping mechanisms to deal with stress, emotions, or difficult life situations can lead individuals to resort to self-harm.

• Family history: A family history of self-harm or mental health disorders can predispose individuals to engage in self-harming behaviours.

• Peer influence: Being exposed to friends or peers who engage in self-harm can normalize the behaviour and increase the likelihood of imitation.

• Social or academic pressure: High levels of stress from academic expectations, bullying, relationship problems, or social rejection can contribute to self-harm.

• Low self-esteem: Negative self-perception and feelings of worthlessness can increase vulnerability to self-harm as a means of coping with distress.

• Impulsivity: Impulsive tendencies or difficulty in controlling impulses can lead to spontaneous acts of self-harm.

• Lack of support: Limited access to supportive relationships, therapy, or resources can leave individuals feeling isolated and without adequate help in managing their emotions.

• Access to means: Easy access to items such as sharp objects, medications, or substances that can be used for self-harm increases the risk of engaging in self-injurious behaviour.

What to do if you self-harm

If you self-harm, here are some steps you can take:

• Seek medical attention if needed: If you've caused serious harm to yourself, such as deep cuts or burns, seek medical attention immediately to ensure proper treatment and prevent complications.

• Reach out to someone you trust: Talk to a trusted friend, family member, or mental health professional about what you're going through. Sharing your feelings can help alleviate the burden and provide support.

• Explore healthier coping mechanisms: Work with a therapist or counsellor to identify and develop healthier ways to cope with difficult emotions and stressors, such as mindfulness, relaxation techniques, or creative outlets.

• Remove or limit access to triggers: Identify and remove or limit access to items or situations that trigger your self-harming behaviours, such as sharp objects or stressful environments.

• Develop a safety plan: Create a plan with your therapist or support system outlining steps to take when you feel the urge to self-harm, including alternative coping strategies and emergency contacts.

• Stay connected: Stay connected with supportive friends, family members, or support groups who can provide encouragement, understanding, and guidance during difficult times.

• Practice self-compassion: Be kind to yourself and recognize that recovery from self-harm is a process. Treat yourself with compassion and patience as you work towards healing and recovery.

• Seek professional help: Consider seeking professional help from a therapist, counsellor, or psychiatrist who can provide specialized support and treatment for self-harm and underlying mental health issues.

• Monitor your progress: Keep track of your progress in managing self-harm behaviours and celebrate small victories along the way. Regularly check in with yourself and adjust your strategies as needed.

• Stay hopeful: Recovery from self-harm is possible with the right support, treatment, and determination. Stay hopeful and believe in your ability to overcome this challenge.

How To Support Someone Who Self-Harms

• Educate yourself: Learn about self-harm to better understand what your friend or loved one may be going through and how you can best support them.

• Listen non-judgmentally: Create a safe and supportive space for your friend or loved one to express their feelings without fear of judgment or criticism.

• Express empathy: Show empathy and understanding towards their struggles without trying to minimize or dismiss their feelings.

• Encourage professional help: Encourage your friend or loved one to seek professional help from a therapist, counsellor, or psychiatrist who can provide specialized support and treatment.

• Respect their boundaries: Respect your friend or loved one's boundaries and avoid pressuring them to stop self-harming before they're ready. Offer support and encouragement without trying to force them into recovery.

• Offer practical support: Offer practical support such as helping them find resources, accompanying them to therapy appointments, or assisting them in removing triggers from their environment.

• Stay calm in crises: If your friend or loved one is in crisis or at risk of harming themselves, stay calm and take appropriate action to ensure their safety, such as calling emergency services or a crisis hotline.

• Be patient and supportive: Recovery from self-harm takes time, so be patient and supportive as your friend or loved one navigates their journey towards healing and recovery.

• Check-in regularly: Check in with your friend or loved one regularly to see how they're doing and offer your support. Let them know that you're there for them whenever they need someone to talk to.

• Take care of yourself: Supporting someone who self-harms can be emotionally draining, so make sure to take care of yourself as well. Seek support from friends, family, or a therapist if needed.

References

1. Cipriano, A., Cella, S., & Cotrufo, P. (2017). Nonsuicidal Self-injury: A Systematic Review. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.01946

2. Cornell University [The Cornell Research Programme on Self-Injury and Recovery]. (n.d.). The Cornell Research Program on Self-Injury and Recovery. Retrieved March 13, 2024, from https://www.selfinjury.bctr.cornell.edu/

3. Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal Self-Injury: What we know, and what we need to know. The Canadian Journal of Psychiatry, 59(11), 565–568. https://doi.org/10.1177/070674371405901101

4. National Alliance on Mental Illness [NAMI]. (2024). Self-harm | NAMI: National Alliance on Mental Illness. NAMI. Retrieved March 13, 2024, from https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm

5. Yan, H., & Yue, W. (2023). Risk factors, theoretical models, and biological mechanisms of nonsuicidal self-injury: a brief review. Interdisciplinary Nursing Research, 2(2), 112–120. https://doi.org/10.1097/nr9.0000000000000023