Self-harm is a major public health concern, with more than 5% of the US Adult population and 18% of youth reporting they have harmed themselves at some point in their life [1].
There are several reasons individuals harm themselves; for some, it is a way to cope with emotional pain and a symptom of an underlying mental health disorder. Others have reported self-harming as a way to achieve a sense of control or a stronger personal identity.
Current treatment focuses on addressing underlying mental health problems or emotional triggers that drive self-harm, and helping them develop functional alternatives to cope.
What is Self-Harm?
Self-harm is the act of deliberately hurting oneself, often to cope with overwhelming emotions, painful memories, trauma, or life challenges. This behavior can take a physical form or an emotional form. People may self-harm to escape feelings or negative emotions that they struggle to verbalize, turning emotional pain into physical pain.
Self-harm can provide patients with a temporary sense of relief; however, it often leads to long-term feelings of guilt, shame, and depression if underlying issues are not addressed. Many individuals who chronically self-harm do not intend to end their own lives, but instead use it as a coping skill to manage distress. This can lead to several devastating consequences, both physical and psychological.
Physically, self-harm can cause wounds that don’t heal, scarring, infections, tissue and nerve damage, internal bleeding, broken bones, and even organ failure. Some injuries may be more severe than individuals originally intended, requiring emergency medical care.
Psychologically, self-harm causes intense emotional and social consequences. These include low self-esteem, feelings of guilt or shame, social isolation, and problems managing relationships. It can also impact school or work performance and increase the risk of developing a substance abuse problem or other mental health disorders.
Self-Harm and Self-Injury: Is There a Difference?
Self-harm is a broad term that refers to intentionally causing pain or damage to one’s own body. This can be suicidal or non-suicidal in intent and includes a wide range of behaviors that can be harmful to one’s physical or psychological health.
Self-injury, on the other hand, is a specific type of self-harm that involves deliberately causing physical pain to the body without suicidal intent. It is often used as a coping mechanism to manage distressing emotions and is more common among young people. Common self-injury behaviors include cutting, burning, and hitting oneself.
Signs of Self-Harm: Identifying Red Flags
- Cutting, stabbing, or carving one’s skin with a sharp object such as a razor blade or knife
- Self-hitting, punching, head-banging, or pulling hair out
- Piercing the skin with sharp objects (not cutting)
- Scarring, scabbing, or open wounds on the arms or legs
- Burning with matches, lighters, or lit cigarettes
- Low self-esteem, isolation, and social withdrawal
- Strained relationships, decline in work or school, lack of motivation
Types of Self-Harm to Watch For
There are two primary forms of self-harm. Physical self-harm is the kind most people think of and relates to causing bodily harm or injury to the body. Emotional self-harm refers to behaviors that damage one psychologically and lower their self-esteem.
Physical Forms of Self-Harm
- Cutting
- Burning
- Hitting oneself
- Pulling one’s hair out
- Picking at one’s injuries/not letting wounds heal
Emotional Forms of Self-Harm
- Substance abuse
- Engaging in unsafe sex or toxic relationships
- Constant negative self-talk
Why Do People Self-Harm?
There are several reasons that people engage in self-harming behaviors. It is most commonly used as a negative coping strategy for those who lack coping skills to manage emotional distress, trauma, or negative experiences [2].
Psychological and Emotional Triggers
Psychological and emotional triggers are internal thoughts, feelings, or states of mood that increase the desire to self-harm. Common emotional triggers include shame, low self-esteem, loneliness, emotional numbness, or a feeling of emptiness. These intense emotions often feel unbearable, and self-harm is frequently used as a way to release them.
Environmental Influences
Environmental triggers are external situations that increase the desire to self-harm. These might include traumatic past experiences such as neglect or abuse, unstable home environments such as domestic violence, social isolation, a lack of control or loss (losing one’s job or home), and exposure to self-harming behaviors in others (more common among youth).
Understanding Self-Harm Relapse and Why It Happens During Recovery
A self-harm relapse is when someone who has stopped self-harming returns to engaging in these harmful behaviors after a period of abstinence or recovery. Relapse is a normal part of recovery and should not be viewed as a failure; rather, it is a natural part of the process. Relapses can happen during recovery for several reasons, including:
- Emotional triggers such as sadness, anger, and frustration can lead to a relapse.
- Chronic stress or life events such as relationship conflict, job loss, or trauma can increase the risk of self-harm.
- Unresolved trauma, such as physical, sexual, or emotional abuse, can resurface during recovery.
- Lack of coping skills or social support can make it difficult to manage distress and resort to self-harming as the only way to cope.
- Social isolation and boredom: Feeling isolated, bored, lonely, or disconnected can increase vulnerability or relapse.
- Stopping medication, therapy, or discontinuing treatment can weaken recovery efforts and lead to relapse.
- Poorly managed mental health problems, such as depression, anxiety, or borderline personality disorder, can contribute to relapse.
Coping Skills to Regain Control
Coping skills help individuals understand and regulate their emotions to reduce associated distress. They also help build resilience to prevent relapse when challenges emerge. Some helpful coping skills to manage emotional distress in individuals who self-harm include:
- Identifying and recognizing triggers
- Mindfulness and relaxation techniques, such as deep breathing exercises or yoga
- Self-compassion and positive self-talk
- Expressing emotions safely to let frustrations out without physical harm
- Seek professional mental health support for guidance
Healthy Alternatives to Self-Harm
Alternatives to self-harm often provide immediate sensory distractions to functionally replace self-harm behaviors and provide a similar response and release of endorphins that one may get from self-harming. Ideas include [3]:
- Physical sensations such as snapping a rubber band on your wrist, chewing ice, punching a pillow, or squeezing a stress ball.
- Creative arts such as drawing or painting on yourself, coloring in a coloring book, or engaging in a craft like knitting or sculpting.
- Physical activity such as exercise, yoga, dance, strength training, gentle stretching, or going for a walk.
- Soothe your senses by taking a warm bath, getting a massage, or spending time outdoors in nature.
- Distract yourself by watching your favorite show, listening to a new album, playing video games, or reaching out to friends and family for social connection.
Calling The Self-Harm Hotline
If you are experiencing a mental health crisis, or are struggling to manage distress and fear you may relapse, you can call the crisis hotline 24/7 for confidential support. Here, a trained counselor will assess your current situation, provide compassionate support, and can refer you to a mental health professional or call emergency services if they believe an immediate danger is present.
Text CONNECT to 741741 for free, confidential support from a trained volunteer Crisis Counselor, available 24/7.
Treatment Options for Self-Harm Recovery
At Maple Mountain Mental Health and Wellness, we use evidence-based therapies, trauma-informed care, and innovative holistic treatment to address self-harm behaviors and underlying mental health problems such as depression, anxiety, and borderline personality disorder.
Talk Therapies
Dialectical Behavior Therapy (DBT): DBT is a first-line treatment to address self-harm behaviors in patients. It focuses on increasing their tolerance to emotional distress, developing mindfulness related to their behaviors, regulating emotions, and strengthening relationships.
Cognitive Behavioral Therapy (CBT): CBT is used to treat a variety of mental health disorders by reframing negative thinking patterns with mental illness, building positive coping skills, and setting goals. It helps patients understand triggers related to self-harm and break unhelpful thought cycles.
Trauma-Sensitive Care
Trauma-Informed Staff: Our compassionate team follows the principles of trauma-informed care, such as safety, collaboration, empowerment, and resilience to create an emotionally safe space for patients to rebuild their self-worth and improve mental well-being.
EMDR and ART: Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Accelerated Resolution Therapy (ART) are used in the treatment of trauma and PTSD. They both use guided eye movements to facilitate the healing of memory fragmentation and process trauma-associated emotional distress.
Holistic Healing
Holistic therapies at Maple Mountain provide a safe emotional outlet for releasing stress, enhancing mental resilience, and promoting overall well-being. They can also act as a sensory swap and alternative for those trying to achieve similar physical sensations they do from self-harm.
Some of our holistic services at Maple Mountain include:
- Massage therapy
- Acupuncture
- Art therapy (painting, drawing)
- Music therapy and sound baths
- Movement, mindfulness, and meditation
Support Groups
Group therapy and peer support groups at Maple Mountain provide a space to foster community and feelings of mutual understanding. Self-harm is a topic many patients avoid talking about due to the stigma surrounding the behaviors. Support groups can help people feel less alone in their struggles and gain new insights or tools to implement in their own healing journey.
Self-Harm Treatment at Maple Mountain 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] Self-injury (Cutting, Self-Harm or Self-Mutilation). Mental Health America.
[2] Wilkinson, P. et al. (2021). A Qualitative Study of Understanding Reasons for Self-Harm in Adolescent Girls. International journal of environmental research and public health, 18(7), 3361.
[3] Woodley, S. et al. 2020. How Individuals Who Self-Harm Manage Their Own Risk—‘I Cope Because I Self-Harm, and I Can Cope with my Self-Harm. Sage Journals.
