If you are reading this because you have scars on your body and are trying to make sense of them, or because you love someone who does, this article is written for you. Self-harm is usually a way of coping with intense emotional pain, not a way of seeking attention. Scars are often the first visible sign that someone has been struggling silently for a long time.
Learn what drives self-harm, which warning signs require immediate help, and what evidence-based treatment includes. Remember there is a way out, and you don’t have to suffer alone.
What Is Self-Harm?
Self-harm, or non-suicidal self-injury (NSSI), refers to deliberate, direct harm to one’s own body without the intention to die. It is not a suicide attempt, though people who self-harm are at elevated risk for suicidal behavior, and the distinction matters clinically for how it is treated [1].
What self-harm most often is, at its core, is a way of managing emotional pain that has become intolerable [2]. Under extreme emotional distress, the brain seeks relief, and self-harm seems to offer it. It doesn’t come as a desire for pain—the physical sensation briefly interrupts an emotional state the person doesn’t yet have other tools to manage. That short-term relief is part of why self-harm is so hard to stop. But the relief fades, and the costs build over time.
Self-harm is not something only teenagers do, and it is not a phase. It is not attention-seeking behavior in most cases. People who self-harm most commonly go to significant lengths to conceal it, wearing long sleeves in summer, avoiding situations where the marks might be visible, and carrying the weight of the secret for months or years.
Why Do People Self-Harm?
The reasons are varied and often layered, but some of the most common include:
Releasing emotional pressure that has no other exit. When the internal experience becomes more than the nervous system can hold, self-harm can feel like a physical release.
Feeling something when everything is numb. Emotional numbness, particularly in the context of depression or dissociation, can become so pervasive that physical sensation helps confirm one’s own existence.
Punishing oneself. Self-punishment as a motive is particularly common in people who carry deep shame, whether from trauma, self-blame for things that were not their fault, or the internalized belief that they deserve to suffer.
Communicating distress that cannot be put into words. For some people, the visible evidence of inner pain is the only way the outside world can know something is wrong.
Regulating intense emotions. Researchers believe self-injury may trigger the release of the body’s natural opioids, which could help explain the brief sense of relief some people describe [3]. This is one reason stopping is hard without learning other ways to manage emotions.
What Do Self-Harm Scars Look Like?
Self-harm leaves a range of physical marks depending on the method and how long it has been happening. Recognizing these signs is important for anyone who loves someone they are worried about.
- Scars or cuts in patterns or rows, typically on the inner forearms, upper thighs, abdomen, or upper arms
- Burn marks, often small and circular
- Scars from picking or scratching that have broken the skin repeatedly in the same location
- Bruising or marks that do not match the explanations given
Scars cannot always tell you how severe someone’s distress is, how long it has been happening, whether the person is currently safe, or whether they are thinking about suicide. Scars require a conversation, not a conclusion.
When Should You Seek Immediate Help?
Some signs indicate that the situation has moved beyond what can wait. If any of the following are present, please reach out to a professional, call or text 988, or text CONNECT to 741741 to reach the Crisis Text Line [5].
- Recent or open wounds that require medical attention or that the person is concealing and not treating.
- Statements about wanting to die, disappear, or not exist anymore. Self-harm without suicidal intent is a different clinical picture than self-harm accompanied by these statements. Take them seriously.
- Giving away possessions or saying goodbyes in ways that feel final or out of context.
- Stockpiling or accessing items associated with self-harm. This is particularly concerning when someone who has previously self-harmed is seeking access to means.
- Significant and sudden changes in behavior: withdrawal from people they care about, stopping activities that previously mattered, extreme shifts in mood, or a sudden and unusual calm after a period of distress.
If you are unsure whether something is serious enough to act on, err toward action. The discomfort of being wrong is smaller than the consequence of not asking.
How Is Self-Harm Treated?
Dialectical Behavior Therapy (DBT) has some of the strongest research support for treating chronic self-harm, particularly in people with emotion dysregulation and Borderline Personality Disorder (BPD).
DBT targets the emotional intensity and impulsivity that often drive self-harm [4]. DBT offers skills for tolerating distress without acting on it, for reducing emotional intensity, and for navigating relationships that previously triggered overwhelming states.
Trauma therapies such as Accelerated Resolution Therapy (ART) can complement DBT by addressing the distressing memories that often sit underneath self-harm, using guided eye movements and imagery to help clients change how those memories feel in a brief, structured format.
Other treatments include somatic approaches that address the body-level dysregulation underneath the behavior, and mindfulness-based approaches that support awareness of the internal states that precede self-harm.
For people who have been using self-harm as a primary emotion regulation strategy for years, the work of building alternatives takes time and requires a clinical environment with enough structure to support the process.
Self-Harm Treatment at Maple Mountain Mental Health & Wellness
We work with complex presentations, including chronic self-harm, BPD, treatment-resistant depression, impulsivity, and the deep emotional pain that drives these patterns. Our treatment programs offer DBT as a core modality alongside trauma-focused therapy, somatic approaches, and the clinical depth that chronic self-harm requires.
Our residential home creates genuine distance from the environments where these patterns have been reinforced. If you are ready to explore what treatment could look like, we are here. If you or someone you love is in crisis right now, please call or text 988
Source
[1] Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: What we know, and what we need to know. The Canadian Journal of Psychiatry, 59(11), 565–568. https://doi.org/10.1177/070674371405901101
[2] Johns Hopkins Medicine. (2026, March 10). Self-harm. https://www.hopkinsmedicine.org/health/conditions-and-diseases/self-harm
[3] Bresin, K., & Gordon, K. H. (2013). Endogenous opioids and nonsuicidal self-injury: A mechanism of affect regulation. Neuroscience & Biobehavioral Reviews, 37(3), 374–383. https://doi.org/10.1016/j.neubiorev.2013.01.020
[4] Chen, W., & Zhuo, Y. (2026). Research progress on the characteristic features of non-suicidal self-injury addiction, neuroimaging correlates, and evidence-based interventions in adolescents. Frontiers in Psychology, 17, 1704139. https://doi.org/10.3389/fpsyg.2026.1704139
[5] Crisis Text Line. (n.d.). Self-harm. Retrieved October 14, 2026, from https://www.crisistextline.org/topics/self-harm/
