Self-Harming Behaviors

What does it mean to self-harm?

Self-harm means injuring your body deliberately in a way that leaves marks or causes damage. It may also be called self-injury, self-mutilation, self-inflicted violence, self-destructive behavior, self-abuse, and parasuicidal behavior. Self-harm does not mean that you want to die. You may hurt yourself, even though you want to live.

What are examples of self-harming behaviors?

• Cutting, biting, or scratching yourself until your skin is broken and bleeds.
• Head banging or hitting yourself hard enough to cause bruises.
• Burning your skin using heat, chemicals, or cigarettes.
• Pulling hair from your scalp or eyebrows.
• Pulling off your fingernails or toenails.
• Picking at scabs continually until you bleed and the sore does not heal.
• Refusing to take prescribed medicines.
• Putting foreign objects under your skin.

Why do people self-harm?

If you deliberately harm yourself, you may be trying to cope with something that you feel you cannot stand any longer. You may have been physically, emotionally, or sexually abused. You may have a history of some other form of trauma. You may want to escape from intense emotions such as rage, loneliness, bitterness, or guilt. You may want to escape from feeling numb and emotionless. You may use self-harm to manipulate others, or you may feel ashamed of your actions and try to hide the evidence from others.

Self-harm may replace an unbearable situation, intense emotion, or numbness. It may help you to release tension, feel safe again, or feel alive. You may feel that you can get revenge or get back at someone by hurting yourself.

Self-harm can release body chemicals called endorphins. Endorphins give you a sense of well-being. Unfortunately, this sense of well-being does not last long. The next time you are faced with intense emotions or emotional numbness, you are likely to self-harm again to escape and feel better. If you self-harm, you may be at a higher risk for suicide due to acting on impulse and the danger of certain self-harm behaviors.

How are self-harming behaviors treated?

The following can help reduce symptoms:

• medicines, especially for symptoms of anxiety, panic, depression, or obsessive thoughts
• short-term, structured time in the hospital if you are seriously thinking of hurting yourself
• day treatment programs, including structured activities and group therapy every day
• therapy that helps you to identify, express and manage your feelings
• therapy that helps you feel cared about and understood
• learning different ways to cope, such as things to do other than self-cutting when under stress
• treatment for any alcohol or drug abuse problems

One type of therapy that may help is dialectical behavior therapy (DBT). DBT teaches you to manage unbearable situations in a healthy way instead of harming yourself. DBT teaches you how to deal with stress, regulate your feelings, and to validate your feelings. Many mental health centers and therapists provide DBT. Your therapist can help you learn safer, alternative ways to communicate, self-soothe, and cope. Journaling, art therapy, relaxation techniques, and physical exercise may be useful to replace self-harm behaviors.

What can I do to help myself?

First, ask yourself these questions:

• Why do I feel I need to hurt myself? What has brought me to this point?
• How will I feel when I am hurting myself?
• How will I feel after hurting myself?
• What else can I do that won't hurt me?

Deciding to stop self-harm is a very personal decision. Your first task when you decide to stop is to break the cycle and find new ways to cope. When you pick up a knife or lighter or get ready to hit something, you have to make a conscious decision to do something else. Here are some ideas:

If you are angry, frustrated, or restless:

• Wrap yourself in a blanket and rock back and forth until you feel more settled.
• Flatten aluminum cans or hit a punching bag.
• Throw ice against a wall hard enough to shatter the ice.
• Clean your room or your whole house.
• Exercise.

If you are sad, depressed, or unhappy:

• Do something slow and soothing, such as taking a hot bath with bath oil or bubbles.
• Do whatever makes you feel taken care of and comforted such as lighting incense, listening to soothing music or calling a friend.

If you are craving sensation or feeling unreal:

• Squeeze ice hard.
• Bite into a hot pepper.
• Rub liniment under your nose.
• Take a cold bath.

If you want to see blood or pick scabs:

• Draw on yourself with a red felt-tip pen or paint yourself with red paint.
• Get a henna tattoo kit. After you put the henna on you can pick it off as you would a scab and it leaves an orange-red mark behind.

If you are thinking of committing suicide, seek help immediately.