Providing mental health services for children, adolescents, and families.


Talking about Self-Harm

Category: Adolescents Behavioral Problems Depression and Mood


While discussing the topic of self-harm is never an easy endeavor, if someone you care about is injuring himself or herself, it’s a conversation you may need to have.  Last year alone, nearly 2 million cases of self-injury occurred in the United States.  As a problem that predominantly affects adolescents and females, early detection and support can play key roles in stopping the cycle of self-abuse.  Before you tackle this tough talk, though, it’s best to prepare yourself by learning a little about this widespread mental health issue and trying to understand what your loved one is going through psychologically.

One of the most common misconceptions about this growing problem is that it’s an obvious dilemma—or worse, a cry for attention.  In reality, though, it’s often neither of the two, but rather an individual’s desperate response to the world around him/her.  It typically occurs in secret and while the most common form is self-cutting, it can also manifest as burning or punching the body, or picking at sores/scabs.  This type of behavior is usually exacerbated by binge drinking or drug use, but can occur concurrently with a number of different psychological disorders.  In fact, self-injurious behavior is listed as a symptom of borderline personality disorder.  It’s also associated with depression, as well as eating and anxiety disorders—yet causation between the conditions is unclear.  Although many people assume self-harm is an indication of suicidal tendencies, generally they’re thought of as separate conditions.  Naturally, there’s a risk that the injuries can go a little too far, but most individuals who engage in self-harm do not have suicide in mind.

“People who repeatedly self-harm may also begin to feel as though they cannot stop, and this may lead to feeling trapped, hopeless and suicidal. People who self-harm are also more likely than the general population to feel suicidal and to attempt suicide.”

Thus, if you suspect that someone you know is engaging in this type of behavior, it’s best to intervene as quickly as possible.  To see more facts on self-harm, check out this fact sheet from Beyond the Blue:  Understanding facts and figures surrounding self-injury is one thing, but trying to understand the motivation behind it is quite another.

Have you ever felt dissociated from yourself?  As though the world the world around you is so overwhelming painful that you can’t stand it—or worse you stop feeling anything at all?  It could be school, or home life, or relationship problems, or past memories that won’t go away.  Any number of things can trigger that feeling of disconnect from reality that you don’t know exactly how to deal with, especially when it keeps coming back.  This is the basis for self-harm.  Many people who have struggled with this problem actually describe it as a relief, or a method of self-soothing.  They replace the absence or excess of emotional pain with physical pain.  The trouble with this, however, is that any relief they may feel is only temporary.  Because they’re not treating the underlying problems, those feelings are likely to persist, leading to a cycle of self-harm.   Unfortunately, the soothing sensation they perceive can be addicting, all on its own, while the secretive nature of the habit typically causes them to withdraw further into themselves.  One of the best ways to understand is to hear what it’s like from people who have done it; here’s an honest collection from Buzzfeed that enables readers to do just that:  Still, if you’ve never experienced this for yourself, it can be difficult to imagine an emotion that would drive you to such an extreme reaction.

Fortunately, you don’t have to be a self-harmer to help a self-harmer; you just have to be there for him/her.  Despite what you’ve seen on TV, an intervention-style approach isn’t really recommended.  Listening without judgment and getting your loved one to open up about what’s triggering this behavior is—whether it’s to you or to a mental health professional.  If you panic or show revulsion, that could prompt further bouts of self-injury.  Ultimately, you can provide support and encourage them to get the professional help they need.  With this disturbing trend on the rise (as explained here:, it’s important that everyone be aware of the dangers this risky behavior poses, and how best to approach those affected.

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