Self-harm or self-injury means hurting yourself on purpose. 

While many people think of self-harm as immediate physical injury, it encompasses everything from cutting the skin, to pulling the hair, to putting oneself in a potentially dangerous situation. 

Self-harm, though not a mental health condition, is often an indicator of mental and emotional distress. 

People might self-harm to focus on the pain while numbing inner feelings of anxiety, depression, or worthlessness. Others might self-harm to punish themselves for a behavior that they’ve identified as wrong. 

It’s easy to get stuck in the cycle of self-harming because of the temporary relief that it brings. But the underlying emotions that a person experiences will only intensify if they continue to use self-harm as a maladaptive coping mechanism. 

Whether a person has recently started hurting themselves, or has been involved in self-harm behaviors for a while, it’s crucial to seek support from a mental health professional who is experienced in treating self-harm. 

Our trained mental health professionals at Handel Behavioral Health have the knowledge and skills to support individuals in their recovery from self-harm. With compassion and validation, our clinicians will help you identify and address the emotional pain that you’re experiencing. You will learn to tap into your inner strength and guidance to replace maladaptive coping behaviors with positive ones that empower and enrich your life. 

Handel Behavioral Health serves clients from all walks of life, all over the state of Massachusetts. We offer in-person therapy from our offices in Amherst, Springfield, Wilbraham, and Franklin. We also offer online tele-therapy services to accommodate your schedule and preferences.

To schedule an appointment with one of our trained therapist in Massachusetts, please call us at (413) 343-4357.

To learn more about what self-harm is, and what treatment for self-harm involves, please read on.

What is self-harm?

Self-harm is the act of deliberately causing harm to yourself. 

Self-harm does not only involve causing a physical wound on the body; it also involves putting oneself in a potentially dangerous situation, self-neglect, and doing something that goes against your core beliefs to cause yourself pain. 

–Alexandra Malin, LMHC and Clinical Supervisor with HBH

There are many behaviors which fall under the category of self-harm. Some examples are:

• Spending an excessive amount of money that you don’t have
• Putting yourself in a potentially dangerous social situation
• Intentionally going against your core beliefs to cause yourself harm 
• Self-neglect 
• Cutting yourself
• Burning your skin
• Poisoning yourself
• Overeating or undereating
• Exercising excessively
• Biting yourself
• Picking at existing wounds
• Carving symbols or words into your skin 
• Inserting objects into your body
• Misusing alcohol, prescription, or recreational drugs 
• Pulling out your hair
• Hitting or punching oneself

If you are concerned about an injury or not sure how to look after an injury, contact your GP.

If you have suicidal thoughts or impulses, contact the 988 Suicide & Crisis Lifeline.

If you or your loved one is in immediate danger, call 911 and go to the Emergency Department.

Why do people self-harm?

The motivation to self-harm and nature of self-harm depends on the individual. Most people self-harm as a coping mechanism for emotional distress and overwhelm. People might be attempting to: 

Distract themselves: Some people find physical pain easier to cope with than distressing feelings of loneliness, shame, sadness, or anger. 

Punish themselves: When someone feels shame or guilt for a past behavior that they’ve identified as wrong, they might use self-harm to punish themselves. 

Express themselves: People who self-harm might have difficulty communicating their feelings, wants, and needs to others. They might have learned to suppress their emotions as a child, and use self-harm to release an emotion they can’t outwardly express. 

Feel a sense of control: People who have experienced trauma, especially sexual abuse, might use-self harm to reclaim control over their bodies, feelings, or environment. 

Feel something: Many people who self-harm also suffer from depression and other mental health conditions that can leave them feeling numb. They might self-harm as an opportunity to experience a feeling. 

Self-harm is NOT attention seeking behavior. It’s evidence that an individual is experiencing emotional turmoil and distress, which needs to be addressed by a mental health professional.

Situations that can trigger self-harm:

• Relationship issues with partners, friends, or family
• Pressure to perform at school or work
• Family issues 
• Financial stress 
• Bullying
• Trying to fit in (some social groups are more accepting of self-harming behaviors)
• Feeling badly about one’s self (guilt, shame, worthlessness)
• Physical, emotional or sexual abuse
• Feeling depressed

While self-harm and suicide are separate issues, individuals who engage in self-harm behaviors and individuals who attempt to end their lives are both experiencing high levels of emotional distress. There’s always the danger that self-harm could go wrong and cause death, though this may have not been the individual’s intention.

Co-Occuring Mental Health Conditions:

People with depression and other mental health conditions might self-harm to feel something other than numbness, even if that’s physical pain. 

-Alexandra Malin, Clinical Supervisor and LMHC with HBH

Individuals who struggle with the following mental health conditions are more likely to self-harm:

• Anxiety 
• Depression
• Dissociative Disorders
• Bipolar Disorder
• Personality Disorder
• Substance Use Disorder
• PTSD/Acute Stress
• Trauma
• Eating Disorder

What are the signs of self-harm?

One of the most noticeable signs of self-harm is withdrawal. You might notice that your loved one or friend disappears for periods of time when they’re typically engaged in spending time with you. 

-Alexandra Malin, Clinical Supervisor and LMHC with HBH

Warning signs of self-harm can include:

• Noticeable wounds that aren’t easily explained
• Avoidance of social situations
• Wearing long-sleeved clothing at inappropriate times in attempt to hide wounds
• Tools such as scissors, razors, knives, lighters in places where they don’t belong 
• Personal identity issues
• Changes in behavior linked to mental health: more tearful or more irritable 
• Impulsivity
• Feelings of worthlessness and hopelessness 
• Neglect of self-care and personal hygiene  

People who self-harm might not look for help on their own. If someone close to you reveals that they are self-harming, or you suspect that they are self-harming, support them through the first steps to recovery. 

Check out our practice tips blog to learn more about helping a loved one who self-harms.

What does treatment for self-harm involve?

In order to break the cycle of self-harm, treatment is often aimed at recognizing and treating the underlying causes such as low self-esteem, impulsivity, shame, depression, trauma, abuse, family dysfunction, and conflict. 

A mental health professional trained in self-harm will help the individual replace maladaptive behaviors with healthier and more productive ones. 

For example, if the individual is self-harming to experience a feeling, the clinician will help them work towards reducing their emotional numbness. This can involve mindfulness-based therapies to guide the individual toward their inner self, to identify their feelings in the present moment. 

If the individual is self-harming because they suffer from low self-esteem, the clinician will help them work through their feelings of worthlessness and shame. The clinician might offer Dialectical-Behavioral Therapy to help the individual build mindfulness and awareness of their emotions, strengthen their relationships, and manage stressful situations. 

Cognitive-Behavioral Therapy can help the individual identify unhealthy and disordered thoughts that trigger their self-harm behavior. They’ll learn skills to induce positive thoughts and behaviors at home, in school, and in social situations in order for the individual to become more comfortable with certain stressors. 

Medications are not used to treat self-harm, but if there is an underlying or co-occurring mental health condition that requires medication management, they can be prescribed by a psychiatric nurse practitioner, primary care physician, or a psychiatrist.

Individuals can also access online self-harm support groups such as:

• Recover Your Life: one of the largest online self-harm support communities
• r/selfharm/: a subreddit for self-harmers to relate to each other, ask questions, and build a community of support
• Advocates/Virtual-Support-Group-Self-Injury: a virtual group to share and connect over various perspective and experiences with self-harm
• Find Help/Self-Injury Recovery Anonymous: an online anonymous support group to find encouragement and useful information to deal with self-harm.

The Take-Away

If you or someone close to you is self-harming, know that you are not alone. You deserve to find healthy alternatives to cope with difficult experiences, and we believe in you. 

Our trained mental health professionals at HBH can help you break the cycle of harming yourself to cope with difficult emotions and situations. You will find ongoing support that involves identifying your motivations for self-harm, and replacing maladaptive behaviors with habits that bring you fulfillment and satisfaction.  

To schedule an appointment with one of our clinicians in our offices in Amherst, Franklin, West Springfield, Wilbraham, or online, please contact us today at  (413) 343-4357 or request an appointment online.

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