Self-Harm
What is it?
Self-Injury (SI) or Self-Harm (SH) is the act of physically hurting yourself on purpose without the intent of taking your own life.
It is a method of coping during a difficult time that does help some people temporarily feel better because they have a way to physically express their pain, release their tension, and all the feelings they hold inside themselves. It is a way of dealing with deep distress and emotional pain. As counterproductive as it may sound to those on the outside, hurting their own bodies makes some people feel better. In fact, people who do it may feel like injuring themselves is the only way to cope with feelings like sadness, emptiness, guilt, anger, and shame.
The problem is that the relief that comes from self-harming doesn’t last long. It’s like having a gaping wound and trying to put a Band-Aid on it and hoping that will make it go away. What is actually needed are stitches. A band-aid may temporarily stop the bleeding, but it doesn’t fix the underlying injury that made the person want to hurt themselves in the first place. And it also creates its own problems.
If you self-injure, you probably are like most other people who do it and try to keep what you’re doing a secret. Maybe you feel ashamed or maybe you just think that no one would understand. But hiding who you are and what you feel is a heavy burden. Please understand that you do not need to go through this alone. There are people who can and want to help you.
IMPORTANT: If you need information on how to care for Self-Harm injuries, go to either website now:
First Aid Wound Care Guide or How to Care for Injuries
Signs of self-harm include:
- Cutting or severely scratching your skin
- Burning or scalding yourself
- Hitting yourself or banging your head
- Punching things or throwing your body against walls and hard objects
- Sticking objects into your skin
- Intentionally preventing wounds from healing
- Swallowing poisonous substances or inappropriate objects
Self-harm can also include less obvious ways of hurting yourself or putting yourself in danger, such as driving recklessly, binge drinking, taking too many drugs, and having unsafe sex.
Warning signs that a family member or friend is self-injuring:
- Unexplained wounds or scars: from cuts, bruises, or burns usually on the wrists, arms, thighs or chest (but can be anywhere on the body)
- Blood stains on clothing, towels, or bedding; blood-soaked tissues.
- Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.
- Frequent “accidents” – Someone who self-harms may try to explain away injuries (e.g. claiming they’re just klutzy, etc).
- Covering up – A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
- Needing to be alone for long periods of time, especially in the bedroom or bathroom.
Why would anybody intentionally hurt themselves?
Relief from feelings – Often people hurt themselves to try to relieve intense emotions and feel better. These intense feelings can seem uncontrollable, frightening, and dangerous. When people have them, they may think that hurting themselves is the only way to escape these feelings. People who hurt themselves are frequently unable to control their emotions, or at least feel that they can’t. They may have never learned how to control their emotions in a healthy way, and therefore they do the only thing they know how to do to make themselves feel better in the moment.
Euphoric Feelings – When people self-injure, they are hurting their bodies, no matter how they do it. But the body responds to the injuries that are inflicted upon it by working to minimize pain and damage and to heal the wound as quickly as possible. The brain releases substances called endorphins that work as pain-killers when you hurt yourself. Endorphins cause a nice physical sensation and can become addictive. Some people self-injure to produce these feelings of euphoria. But the problem with this is that the body can produce a tolerance to endorphins. The feeling of euphoria won’t be as strong during following self-injurious acts.
Physically Expressing Pain – The physical expression of emotional pain causes some people to achieve certain goals, such as “evidence” (scars, etc.) that they are suffering psychologically. Sometimes people who self-injure minimize or doubt what they are feeling on the inside, so they hurt themselves on the outside as proof or evidence that they really are in pain.
Communication – Self-injury is sometimes used by people to express what they are thinking, feeling, or experiencing to others. By doing this, the person who is self-injuring is more likely to get what they need from family, friends, or others. They might be trying to send out messages that they need help.
Establishing Control – Control is a necessary part of people’s lives and knowing we have some control is important for mental health. When we feel we are in control, we feel better. Self-injury is a way some people use to replicate a sense of control over their own bodies, and this feeling of control may make a person feel more comfortable.
Self Punishment – It is common for people who are survivors of abuse to blame themselves for the abuse or to feel that they “deserve” it. They may have been taught to believe that certain thoughts, feelings, or behaviors deserve punishment. People who self-injure are critical of themselves which leads to feelings of shame and guilt, and that can lead to an act of self-injury.
Stopping, Inducing, or Preventing Dissociation – Dissociation is “a psychological state in which the individual experiences an alteration in consciousness, memory, and sometimes identity.” People who experience it may feel detached from their bodies, a floating sensation, or a sense that they are separated from their bodies or watching themselves. Self-injury is way to reduce, induce, prevent, or stop a dissociative state.
Self-Nurturing – For many people, self-injury provides them with a way of nurturing themselves physically when they are unable to do so emotionally. Self-injury is sometimes used to heal yourself – to make the internal pain external – so that you may nurture and heal what only used to exist on a psychological level. You are caring for your internal and external scars. The self-care may be the gratifying part of self-injuring for the people that hurt themselves for this reason.
Reenacting Previous Abuse – Self-injury can be a way to reenact abuse that took place at an earlier time. For example, the expression of their emotions may have been ignored, denied, or invalidated as a child or their family may have not been able to express their own emotions in a safe way, and therefore these individuals may engage in self injury as a way to express feelings or even exert a sense of control.
** People who self-injure usually have an uncomfortable feeling of distress preceding the act, which then leads to wanting a release or an escape. SI will lessen these feelings, but ONLY temporarily. **
Here are some of the biggest myths about self-harm and why they’re not true:
Myth: People who self-injure are only doing it to get attention.
Fact: The truth of self-injury is that people who self-harm almost always do so in secret. They are not trying to manipulate others to feel sorry for them or draw any kind of attention to themselves. If anything, the shame people feel about what they’re doing makes it extremely difficult for them to ask for help.
Myth: People who self-injure want to die.
Fact: Self-injurers usually don’t want to die. When they self-harm, they don’t have the intention of killing themselves – all they are trying to do is cope with their pain. Actually, some people who engage in self-injury use it to help themselves continue living.
Myth: If the wounds aren’t bad, it’s not that serious.
Fact: The severity of a person’s wounds has nothing to do with how much they may be suffering. Don’t assume that because the injuries are minor, there’s nothing to be concerned about.
Myth: People who self-injure are crazy.
Fact: Many people who self-harm do have a mental illness, but so do millions of other people. Self-injury is their personal coping resource. Giving them a label of being “crazy” isn’t helpful in any way, nor is it accurate.
If self-harm helps, why stop?
- Although self-harm can give you temporary relief, it comes at a cost. In the long term, it causes many more problems than it can possibly solve.
- The relief is very short lived, and is quickly followed by other feelings like shame and guilt, even fear. It also keeps you from learning healthier and more effective strategies for feeling better.
- You can hurt yourself very badly, even if you don’t intend to. It’s extremely easy to misjudge the depth of a cut or end up with an infected wound when you do something impulsively.
- If you don’t learn other ways to deal with emotional pain, it puts you at risk for bigger problems down the line.
- Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.
Why should you stop hurting yourself?
- Because you do not deserve to be hurt, not by anyone, not even yourself.
- Because you have already been through so much pain and do not need more pain added to that. And because there are safer, gentler ways to find some relief and you deserve to find those ways.
- Because you deserve the same kindness that everyone else does, and that you would give to a friend.
- Because you deserve to have compassion for yourself, the way others have it for you. And because it’s better to reach out to others and get support or to find inner resources to rely on, rather than to add to your own hurt and torment.
- Because you have a voice, a right to be heard, and you deserve to be treated with love, not with hate.
- Because if you hurt yourself, you are repeating and reinforcing what your abusers or people who put you down told you, and none of that is true. And because even if you don’t believe it, hurting yourself will hurt the people who truly love you.
- Because any relief you may get from hurting yourself is only fleeting and will not last. You will need to keep hurting yourself more frequently and even more severely to get that tiny bit of relief, and may end up doing permanent damage or may even inadvertently kill yourself.
- Because one day, you WILL see the beauty in yourself and know that you should be treated with care.
Suicide is Preventable
If you or someone you know are having suicidal thoughts, there is help available. You do not need to live in pain anymore. Considering suicide is not the only option. There are many ways to cope, many other ways to escape suffering. Suicide is a permanent solution and it is never the answer.
Warning Signs and Risk Factors:
- Talking about suicide
Any talk about suicide, dying, or self-harm – such as “I wish I was never born” and “I’d be better off dead.” - Seeking out lethal means
Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt. - Preoccupation with death
Unusual focus on death, dying, or violence. Writing poems or stories about death. - No hope for the future
Feelings of helplessness, hopelessness, and being trapped (“There’s no way out/I can’t escape”)
A belief that things will never get better or change. - Self-hatred
Feelings of worthlessness, guilt, and shame. - Feeling like a burden
(“Everyone would be better off without me.”) - Getting affairs in order
Making out a will. Giving away prized possessions. Making arrangements for family members. - Saying goodbye
Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won’t be seen again. - Withdrawing from others
Increasing social isolation. Wanting to be left alone. - Self-destructive behavior
Increased alcohol or drug use, reckless driving, unsafe sex or any kind of self-injurious behavior (such as cutting, burning, or hitting themselves). - Sudden sense of calm
A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to take their own life. - Psychiatric Disorder(s)/Past History of Attempted Suicide
Those who have a psychiatric disorder and have made a serious suicide attempt in the past are at a much higher risk for trying to do it again. - Genetic Predisposition
Family history of suicide, suicide attempts, depression or other psychiatric illness.
How to Assess Immediate Risk
The following questions can help you assess the immediate risk for suicide:
- Do you have a suicide plan? (PLAN)
- Do you have what you need to carry out your plan? (Pills, gun, etc.)? (MEANS)
- Do you know when you would do it? (TIME SET)
- Do you intend to commit suicide? (INTENTION)