Self-harm is a complex behavioral problem that is often used as a way to cope negatively with emotional distress. Although many associate self-harm with suicide, many patients who develop a problem with self-harm actually fall under a pattern of addiction.
Self-harm can release similar neurochemicals in patients as drugs and alcohol, leading to an addictive cycle that can be difficult to break without intervention. Read on to understand the complexity of self-harm addiction and long-term treatment options for recovery.
What is Self-Harm and What Are Ways People Do It?
Self-harm is when someone intentionally hurts themself. It is treated as a symptom of unresolved mental health problems, trauma, or emotional issues. Self-harm is often used to cope with distress, low self-worth, or regain a sense of control.
Without intervention, self-harm can lead to several health consequences. It can result in physical injury such as wounds, infections, or serious bodily harm. It can also exacerbate psychological symptoms of underlying mental health problems such as depression and anxiety.
People self-harm in a variety of ways. Self-harm can be physical, with cutting being the number one way people harm themselves (45% report cutting themselves) [1]. Here are some other ways people self-harm:
- Carving, piercing, or cutting the skin with a sharp object such as a razor blade, knife, or needle
- Punching oneself, hitting oneself, pulling hair out, or banging one’s head against the wall
- Picking at open wounds on the skin and not letting scars heal
- Burning oneself with matches, lighters, or cigarettes
- Reckless driving (speeding, driving under the influence)
- Unsafe sex practices (having multiple partners and not getting tested for STDs; not using protection)
- Negative self-talk and criticism
- Substance abuse
Why Do People Self-Harm?
People self-harm for several reasons, and it is not always associated with suicidality. It’s common for individuals to want to release negative or distressing emotions or seek a sense of control by turning their emotional pain into something physical that they can manage.
Emotional Pain Relief
Emotional triggers like anger, aggression, sadness, low self-worth, guilt, and shame often lead people to self-harm. This is especially common in those who lack the communication skills to verbalize how they are feeling. These intense emotions can be caused by underlying mental health disorders, trauma, or chronic stress caused by life challenges such as divorce or job loss.
Seeking Control or Distraction
Many self-harmers report that it gives them a sense of control over their thoughts and feelings, especially when they feel powerless. The act can feel like reclaiming agency over one’s body in times of emotional chaos or helplessness. This sense of perceived control often reinforces the behavior, leading to a negative pattern of coping.
Self-harm can also shift focus from unbearable psychological pain to physical pain, which can often feel more manageable or easier to explain. This distraction can help “short-circuit” emotional distress by redirecting attention to bodily sensations [1].
Can You Get Addicted to Self-Harm?
Surprisingly to some, yes, self-harm can actually be addictive. It is a type of behavioral addiction, affecting brain chemistry in similar ways to substance abuse. Self-harm can become addictive in a variety of ways, including [2]:
- Brain Chemistry and Relief: Self-harm behaviors such as cutting or burning stimulate the brain’s natural opioid system, releasing chemicals such as endorphins to relieve stress and pain. This can produce similar feelings of pleasure that one gets from a high on drugs, leading to addictive patterns of self-harm.
- Emotional Regulation: Many patients who self-harm struggle with regulating intense emotions. Self-harm provides a maladaptive coping mechanism that gives individuals who self-harm a sense of control over their emotions or stress levels. This relief can reinforce behavior, making it difficult to stop.
- Sensitized Behavior: Self-harm behavior can become sensitized, meaning self-harm episodes become more easily triggered over time. Similar to how addiction to drugs or alcohol progressively worsens without treatment, the same goes for self-harm.
- Cycle of Shame and Guilt: After self-harming, feelings of shame and guilt often arise, which can increase emotional distress and reinforce self-harming behaviors. Leading to a vicious cycle that can be hard to break.
How Addiction is Defined
Addiction is defined as a chronic, relapsing complex medical disease characterized by compulsive use of a substance or behavior despite harmful consequences. It impairs daily functioning, physical health, mental health, relationships, and overall quality of life.
Self-harm shares features with addiction, such as compulsivity (inability to stop), loss of control over the behavior, tolerance (needing to self-harm more intensely or frequently), cravings for self-harming, and relapse during recovery. It also affects similar brain circuits and triggers the release of pleasure-inducing brain chemicals such as dopamine and endorphins [2].
Why Emotional Regulation is Key for Managing Self-Harm
Learning how to effectively regulate emotions is key for managing self-harm because it helps patients identify and manage their triggers. Emotional regulation consists of [3]:
- Awareness: Identify, recognize, and understand one’s emotions.
- Modulation: Adjust intensity, frequency, or duration of emotions.
- Expression: Expressing emotions in safe and socially acceptable ways.
- Response flexibility: Choose an emotional response that is thoughtful and adapts to the situation, not reacting impulsively or automatically.
Finding Healthy Ways to Heal From Self-Harm
There are several ways to overcome self-harming behaviors and find healthier coping skills to manage emotional distress.
Creative Outlets and Physical Activity
Find healthier ways to increase endorphins and swap self-harm with more positive physical sensations to provide a similar function as self-harm. Ideas include:
- Get creative! Paint, draw, make sculptures with play-dough.
- Find functional replacements for self-harming, such as snapping a rubber band on your wrist, using a stress ball, or screaming into a pillow.
- Relax your nervous system and soothe your senses. Take a bubble bath, cuddle your pet, get a massage, spend time outside, or use a weighted blanket.
- Get regular exercise. The more intense the better, as this releases more endorphins. These can include running, brisk walking, swimming, dancing, strength training, or a fitness class such as Zumba.
Creating A Safety Plan for Emergencies
Create a safety plan during moments you have self-harm urges, thoughts of suicide, or are experiencing a mental health crisis. A safety plan is a small guide on what to do and whom to call during a crisis.
It may include positive coping skills to reduce distress, a number of resources and professionals, places to go that promote a sense of tranquility, and family and friends who are trusted supports.
Calling the Self-Harm Hotline: National and Local Resources
If you are experiencing thoughts of self-harm, suicide, or a mental health crisis, there are several hotlines and resources available to support you. They often offer confidential support, 24/7, and can connect you with professional mental health services if necessary.
Below are the numbers for:
- 988 Suicide & Crisis Lifeline: Call or text 988 anytime
- Crisis Text Line: Text CONNECT to 741741
- SAMHSA Distress Helpline: Call or text 1-800-985-5990 or text “TalkWithUs” to 66746
- For life-threatening emergencies that require immediate medical help, please call 911.
Long-Term Healing: Treatment Options
Treatments for self-harm focus on developing awareness of the connection between one’s emotions and their behavior, addressing underlying mental health disorders or trauma, and helping patients build functional alternatives to self-harm.
Dialectical Behavior Therapy (DBT)
DBT was originally developed as a treatment for Borderline Personality Disorder to reduce symptoms associated with suicidality, self-harm, and emotional instability. DBT helps patients become aware of their emotions and how those influence their behaviors, relationships, and mood.
DBT focuses on helping clients manage emotional distress, soothe and regulate their emotions, strengthen relationships, and practice mindfulness by observing their thoughts in a non-judgmental way. Research shows that DBT can lead to a 37% reduction in frequency and intensity of self-harm episodes [4].
Cognitive Behavioral Therapy (CBT)
CBT is a widely used therapy to treat a range of mental health disorders and behavioral addictions, such as self-harm. CBT helps patients reframe negative thoughts that drive self-harm behaviors, develop positive coping skills, and set long-term recovery goals.
CBT is usually offered individually, but studies have shown that CBT combined with family interventions can greatly reduce self-harm behaviors in youth [5].
Psychiatric Help
There is no medication to directly treat self-harm, however, medication can be prescribed to treat underlying mental health problems related to impulsivity and mood instability. Patients who struggle with impulse control problems, such as those with bipolar disorder, may benefit from mood stabilizers, especially when paired with therapy.
Antipsychotics may be prescribed to reduce feelings of emotional recklessness, anger, impulsivity, paranoia, and severe mood swings. Medication is often most effective when combined with conventional treatment, such as DBT and positive lifestyle changes.
Holistic Healing and Lifestyle Changes
Holistic healing activities provide a safe space to express emotions, get creative, relieve stress, and build resilience. Maple Mountain offers several holistic therapies to promote deep emotional and physiological healing to help those in recovery from self-harm. These include:
- Creative art therapies such as drawing, dance, or music
- Acupuncture and massage
- Mindfulness, meditation, yoga
- Animal-assisted therapies (e.g., equine therapy)
- Life coaching
- Support groups
- Nutritional guidance
Mental Health Treatment Center in Utah
We understand the difficulty in treating self-harm and that it requires a comprehensive approach to care.
Maple Mountain Mental Health and Wellness‘ compassionate team of clinical psychiatrists and experienced therapists is committed to providing life-saving interventions to help reduce self-harm behaviors in adults. Reach out for support.
Sources
[1] Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 565–568.
[2] Leon, J. et al. (2016). The Addictive Model of Self-Harming (Non-suicidal and Suicidal) Behavior. Frontiers in psychiatry, 7, 8.
[3] McRae K, Gross JJ. Emotion regulation. Emotion. 2020 Feb;20(1):1-9. doi: 10.1037/emo0000703. PMID: 31961170.
[4] Lener, L. et al. (2021). Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychological medicine, 51(7), 1057–1067.
[5] Klonsky, E. D. (2020). Treatments for Self-Injurious Thoughts and Behaviors in Youth: Progress and Challenges. Evidence-based practice in child and adolescent mental health, 5(3), 354–364.
