This article explores the concept of self-harm and covers what it is, why people do it and how it can be treated. 
If you or a loved one has suffered from self-harm, then you most likely understand just how complicated it can be. 
Fighting an internal war in which you want to mutilate your own skin is an exhausting battle, and most people feel as though they are drowning in their own urges. 
For those who have never self-harmed, it can be a confusing and uncomfortable topic. 
Why would someone WANT to cause themselves pain? Isn’t that, well… painful? 
Precisely. The reason someone may not be able to understand this topic is the exact reason why those who self-harm, do. It is painful, and to them, pain on the outside means less pain on the inside (even if it is temporary). 
If you are looking for answers when it comes to self-harm, look no further. In this article, we will discuss what self-harm is, why it happens, and how it can be healed. 
What Is Self-Harm? 
For some people suffering from mental illnesses such as depression, or anxiety, their state of mind can quickly snowball into an overwhelming and distressing tidal wave of hopelessness, despair, stress, and fear. 
These intense feelings can seem both paralyzing and alarming, often simultaneously. In need of a release from these pent-up emotions, some turn to unhealthy coping mechanisms, like self-harm. 
Self-harm is any purposeful injury done to a person's own body in an attempt to release internal pain or temporarily be alleviated from it. 
People who engage in self harming practices are often not trying to attempt suicide but wishing to experience relief from the negative feelings inside of them. 
The methods used in self harm can vary, which we will discuss later on. 
History Of Self Harm 
Much like anything else that has stood the test of time, self-harm has a historical ‘starting point’ documented. Since much of society has only just begun to understand mental illness, it’s often argued that self-harm could have started decades before the first reported case. 
However, in the late 1800s, American doctors George Gould and Walter Pyle jotted down a few notes pertaining to women poking themselves with sewing needles. This medical phenomenon, now known as ‘self-harm,’ was happening all across Europe. 
Little did they know, this recording would be the first known documentation of self-injury known to man. 
This act was becoming so prevalent, that doctors eventually crafted the nickname ‘needle girls’ for patients seen with self-harm injuries. 
Since the beginning of the ‘needle girls’ era, self-harming practices have been found in monasteries, prisons, educational settings, and even dating back to Ancient Greece. 
Theories Of Self Harm 
So, why does self-harm occur? 
There has to be something causing hundreds of thousands of people all across the globe to participate in self-injurious practices. 
Unfortunately, unless you suffer from self-harming personally, it’s impossible to 100% understand why those who self-harm, do. However, there are a few theories Psychologists have come up with that may explain this happening. 
A Difficult Life Experience: 
Each person engaging in self harm has a unique reason for doing so. Going through a particularly difficult life experience, whether chronic or short term, whether in childhood, or adulthood, can trigger the beginning of a self-harm battle. 
Some experiences may include events such as: 
● School or work pressures 
● Being bullied 
● Abuse (sexual, physical, or emotional) 
● A relationship ending 
● Losing a job 
● Death of a friend, or family member 
Many people who experience a particularly distressing life event may feel as though they are completely powerless over the situation. In turn, self-harming gives them the feeling of control over something else uncontrollable. 
As children, many of us are taught that punishment is the result of doing something “bad”. If we grow into adults without understanding how to show ourselves compassion, we may result to forms of self-punishment as a way to relieve feelings of guilt, shame, or internal anger. 
Psychologists have been studying the theories behind why people self-harm for centuries. In a more recent study, Psychologists at Harvard noted that those suffering from self-injury engaged in an excessive level of negative self-talk. 
These people would call themselves “evil” or “defective”. 
Upon further investigation, these Psychologists found that many of the people who were harming themselves felt as though they ‘deserved punishment’ for things they had done, whether on purpose or by accident. 
Many of these adults never learned proper coping skills, self-forgiveness, or how to learn from their mistakes, and in turn, resorted to methods of self-punishment instead. 
People that go through traumatic events quickly learn it’s often not a onetime event. 
Flashbacks and dreams can happen regularly, and repeating trauma over and over again can become a heavy burden to bear. 
Many people who self-harm due to trauma have stated it relieves the memories for even a short while and allows the person to focus on this one singular thing. 
Others have come forward to acknowledge the blame they put on their own body for instances such as rape or abuse, and by engaging in self-harm practices they were punishing it fairly. 
Some trauma survivors who experience symptoms of post-traumatic stress disorder claim to engage in self-harming behaviors as a way to ground themselves, or “come back to reality”. When PTSD flashbacks, panic attacks, or dissociation arise they can feel overwhelming. In an attempt to come back to the present moment, methods of self-injury can “shock” them back into their previous state. 
Types Of Self Harm: 
There is no ‘one size fits all’ method of self-harm. Each case will look different depending on the unique person. It rarely ever looks the way it does in movies and TV shows and often goes far beyond that. It is ANY action taken to purposely harm your body. Some people may use more than one method to self-harm. 
Nevertheless, there are a few common ways self-injury can occur: 
● Cutting (with scissors, a knife, or a razor) 
○ This is the most common form of self-injury. 50-70% of self-harm victims use cutting as their method of choice 
● Scratching 
● Carving words, symbols, or pictures into skin 
● Hitting or punching oneself - this can include using inanimate objects as well 
○ The second most common form of self-injury. (21% - 44%) 
● Piercing the skin with sharp objects 
● Pulling out hair 
● Burning: 
○ The third most common form of self-harm. (15% - 35%) 
Other less common methods of self-injury can include drinking something poisonous, excessively drinking alcohol and mixing drugs, purposely breaking bones, and infecting oneself. 
Switching Methods of Self Harm: 
According to a research study done at Leeds Beckett University in England, the methods of self-harm can vary in repeat episodes. 
Over a period of 30 months, researchers gathered data from over 33,000 self-harm episodes that resulted in a hospital stay. 
Their results showed that 23% of patients repeated self-harm behaviors, and out of those, 33% of them switched methods. 
These statistics led researchers to conclude that methods of self-harm can fluctuate and become difficult to predict. Hospital staff should be incredibly vigilant in determining a person’s risk level solely based on their method of self-harm. 
Why Do People Self Harm? 
As I discussed, there are many different reasons pertaining to why some people self-harm. While their reasons may be distinctly different, the end result is the same. No matter the rationale, they all feel a release of pent-up pain, anger, and hurt as they engage in these behaviors. 
A few reasons why people self-harm: 
● Expression of internal struggles 
● Turn invisible thoughts or feelings into something tangible 
● Conversion of emotional pain into physical pain 
● In an attempt to feel alive - many sufferers struggle with depression and dissociation 
● To enable a sense of control 
● Escape traumatic memories, dreams, or flashbacks 
● Silence overwhelming feelings and thoughts 
● Punishment for past traumatic events 
● Have something in life they can rely on for relief 
● Express suicidal thoughts and idealization, without actually acting upon them. 
Some people that have engaged in long-term self-harm behaviors say they eventually begin to crave it, like a drug and an addict. The distraction self-harm can bring from the darkness of depression can be too tempting for chronic harmers to ignore. Overcoming self-harm urges takes work and dedication. 
Who Engages in Self Harm Behaviors? 
With the ability to easily cover wounds with clothing, self-harm is much more prevalent than you may think. 
A research study was published in the Official Journal of Pediatrics on rates of self-harm in youth. 
The results are quite startling. Some girls as young as 7 years old reported engaging in self-harm behaviors. 
In this research study, self-harm was defined using the Self-Injurious Thoughts and Behaviors Interview. This classified self-injury as any of the following methods: cutting/carving, burning skin, inserting objects into the skin, picking at skin, hitting oneself, tattooing oneself, or ‘other’. 
Out of 665 school-aged students, the results were as follows: 
● 53 Students, or, 8% engaged in self-harm behaviors: 
○ Gender: 
■ Boys: 6.7% of boys self-injured 
■ Girls: 9% of girls self-injured 
○ Grade: 
■ 3rd grade: 7.6% self-injured 
■ 6th grade: 4.0% self-injured 
■ 9th grade: 12.9% self-injured 
○ Methods: 
■ Girls: Higher rates of cutting or carving 
■ Boys: Higher rates of hitting themselves 
Anyone can engage in self harm behaviors. Self-injury doesn’t spare or skip over anybody. Self-harm can occur in young school aged children, new mothers, and even successful middle-aged adults. 
There are a few risk factors that may increase the chances of a particular person developing self-harming behaviors: 
● Previous suicide attempt 
● Any pre-existing mental illness 
● Trouble with the law 
● Social isolation 
● Financial difficulties 
● Impulsive or aggressive character traits 
● Job problems or recent job loss 
● Medical illnesses 
● Substance use disorders 
Self-Harm Myths: 
As with any mental illness, some may choose to believe unfounded lies about why people may engage in self harm. Some may not be able to understand the concept at all and struggle with the idea of self-injury. Self-harm is an incredibly misunderstood concept, so bringing awareness to this misinformation is one of the first steps in correcting this train of thought. 
● Self-Harm Is a Suicide Attempt: 
A large majority of those who struggle with self-harm do not want to die. They are not self-harming to end their lives, instead, they self-harm to cope with difficult overbearing emotions. Suicide is a final decision while self-harm is a temporary action. 
In addition, suicide is often a drawn out, planned out event. While self-harm is often impulsive and unplanned. 
● Self-Harm Is for Attention: 
There is a great deal of shame and judgment when it comes to self-harm. Many times, those who cut, or burn themselves will cover their wounds with clothing, wearing long sleeves even on a hot day. Many of those who suffer from self-harm often keep it a secret, even from those closest to them. 
● People Who Self Harm Don’t Feel Pain: 
Those who engage in self-harm behaviors are not suddenly immune to pain, but rather find the physical pain bearable as they experience relief from distressing internal emotions. Some who self-harm may experience a rush of emotions from the release of endorphins, a reason why many become addicted. 
● Only Teenagers Self Harm: 
This statistic is false and can greatly inhibit an adult from reaching out for help. While the rates of self-harm are much higher among teens, this does not mean an adult can’t engage in self-injurious behaviors. Oftentimes, self-harm among adults’ manifests as drinking alcohol excessively or taking large amounts of drugs, rather than cutting themselves. In addition, oftentimes when adults engage in self-harm it does not result in a hospital stay, skewing the statistics. 
● Young People Self Harm in Order To “Fit In”: 
As stated, self-harm is often done in private and covered up. Many adolescents that engage in self-injury do so not because they want to fit in with their peers, but because of the pain associated with not fitting in. Bullying and rejection can lead to depression, a risk factor for self-harm. 
● Everyone Who Self Harms Has Been Abused: 
Blanket statements such as these are incredibly harmful and only spread misinformation further. While abuse is a risk factor for self-harm, not every single person who has injured themselves has been abused. Risk factors such as body dysmorphia or anorexia are two disorders that elevate the chances of self-harm occurring yet are not correlated with abuse. 
● Self-Harm Is Just a Phase: 
Self-harm is not a ‘phase’ but a deep-seated negative coping mechanism for stress, anxiety, and depression. While an adolescent may stop self-harming, research has shown cravings and invasive thoughts linger for years afterward. 
● Self-Harm Is Not Treatable: 
Since self-harm is a coping mechanism for mental disorders, it is entirely possible to re-learn healthier, more productive ways to manage depression, stress, anxiety, and more. 
Treatments For Self-Harm: 
While self-harm is a destructive behavior that shows up in the physical, there is much more going on internally. This is why both short- and long-term strategies are critical to implement for those suffering from self-harm. 
Self-harm will not stop until a person is able to manage their distressing emotions. So, while the goal at the moment is to stop the action, the long-term goal is to uncover and heal from inner wounds. 
Short Term Treatments for Self-Harm: 
● Medication: While there is no medication specifically for self-harm, consulting with a doctor about medications for depression, or anxiety can significantly impact a person's overall mental wellbeing and reduce overwhelming emotions. 
● Stress Management Skills: 
○ Grounding techniques 
○ Breathwork 
○ Journaling 
○ Exercise 
○ Calling a trusted friend 
● Understanding Triggers: Being able to pinpoint what circumstances may trigger the tornado of emotions that lead to self-harm can be an effective way to avoid these situations, and in turn, avoid self-harming procedures. 
● Distraction: If the urge to self-harm is beginning to take over, distraction is a tool many people use to work through the cravings. Different distractions will vary based on the emotions being felt, so understanding what feelings are taking over at the moment is key. 
○ Anger: 
■ Tear something up 
■ Exercise 
■ Punch or scream into a pillow 
○ Sadness / Fear: 
■ Pet an animal 
■ Spend time outdoors 
■ Allow yourself to cry 
■ Take a nap 
○ Control: 
■ Clean up around your house 
■ Write a list 
■ Declutter 
■ Clench, then relax 
○ Numb or Dissociated 
■ Snap a rubber band on your wrist 
■ Take a cold shower 
■ Smell something very strong (perfume) 
○ Shame: 
■ Cut out relationships that make you feel bad 
■ Acknowledge that mistakes are part of life 
○ Self-Hatred: 
■ Express yourself through art 
■ Write a letter to yourself, then write back with extreme acceptance and compassion 
■ Work out to release internal anger 
Long Term Treatments for Self-Harm: 
Psychotherapy, otherwise known as talk therapy, or counseling can help those struggling with self-harming behaviors. 
Therapy can: 
● Identify, and cope with underlying issues that trigger self-harm 
● Help learn emotional management skills 
● Help learn to regulate feelings of stress or anxiety 
● Help boost self-confidence 
● Improve relationship and social skills 
Each therapist has a different method by which they treat their patients. When it comes to self-harm, the technique used all depends on the person, their unique situation, and the reason behind why the behaviors are occurring. 
A few common types of therapy to help with self-harm are: 
● Cognitive Behavioral Therapy (CBT): Helps identify unhealthy, negative thinking patterns and change them into positive, adaptive ones. 
● Dialectical Behavioral Therapy (DBT): A subtype of cognitive-behavioral therapy that teaches patients healthy behavioral skills to manage stress, regulate their emotions, and improve their relationships with others. 
● Mindfulness-Based Therapy: This type of therapy enables a patient to live in the present and become more conscious of their underlying thoughts. In turn, a client is able to better perceive the actions of those around them, engage in self-care behaviors, reduce anxiety and depression, and overall elevate their wellbeing. 
Do You or a Loved One Suffer from Self Harm? 
Self-harm is a difficult topic to deal with, whether you are suffering yourself - or someone close to you is. Remember to always approach the subject with compassion, empathy, and understanding. Keep in mind the myths we have discussed and remember there is always an underlying reason for the behaviors existing in the first place. There is treatment out there, and it is possible to live life harm free. 
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