Understanding Self-Harming Behavior

Self-harm or self-injury is when a person intentionally and repeatedly harms themselves. Cutting is the most common, but other methods include scratching, punching, picking skin, pulling hair or burning. It is estimated that about two million Americans injure themselves intentionally. The majority are teenagers and young adults and while the behavior is more common among females, males do it too. Although the intention isn’t to kill oneself, an individual is at higher risk for suicide if self-harming behavior is left untreated.

Self-harm is often used as a coping mechanism to deal with stress and emotional pain. Research has shown the most common reasons people injure themselves are “to stop bad feelings, to relieve feelings of aloneness, emptiness, or isolation, to distract from other problems, to decrease feelings of rage, to release tension, and to control racing thoughts.” Whatever the reason people began, the emotional benefit decreases over time causing the person to hurt themselves more frequently and do more harm each time. It is easy to understand how this practice can quickly escalate into a dangerous cycle without treatment.

Self-harming behavior often co-occurs with other psychiatric disorders including depression, anxiety, post traumatic stress disorder and borderline personality disorder. The behavior that is originally used to ease emotional pain ends up causing more pain in the form of shame and guilt for hurting themselves.

Warning Signs

• Fresh cuts and scratches
• Scars, burns, bruises, cuts appearing in the same place over and over
• Wounds that don’t heal
• Hair loss or bald spots
• Keeping sharp objects around
• Wearing long sleeves and long pants even in hot weather
• Mood changes
• Social withdrawal
• Change in school performance
• Inability to handle stress
• Claiming to have accidents frequently (trips, falls, etc.)

If you notice any of these warning signs in a friend or loved one, you should talk to them to express your concerns and let them know that help is available.

Treatment

To treat self-harming behavior the person needs to address the problem(s) and situation(s) that led them to hurt themselves in the first place and then develop healthy coping mechanisms to deal with future stress. Treatment can usually take place on an outpatient basis, but inpatient treatment should be considered if a person isn’t showing improvement. Following an evaluation by a mental health professional, psychotherapy and medication are usually recommended. Dialectical Behavior Therapy (DBT) has proven to be a very effective treatment. DBT teaches skills to help reduce the intensity of emotions and provides alternative ways to cope when the urge strikes to do harm. One example of this is holding ice cubes on the skin. The cold ice provides an initial shock, similar to a cut or scrape, without doing damage.

Resources

S.A.F.E. Alternatives

National Alliance on Mental Illness

Mental Health America

WebMD

“Schools Face the Teen Cutting Problem” – Wall Street Journal

5 Facts About Teen Self-Injury