Self-harm or self-injury is a deeply personal struggle that many individuals face, yet it is often misunderstood or overlooked.  

At Handel Behavioral Health, our therapists in Massachusetts are trained in the complexities of self-harm and can guide individuals toward understanding, managing, and ultimately overcoming these maladaptive behaviors. 

Our therapists will help individuals recognize and heal the underlying causes of self-harm, including low self-esteem, anxiety, depression, trauma, family dysfunction and conflict. Individuals will then learn healthy coping techniques to manage intense feelings, rather than react to negative emotions with self-harming behaviors. 

Whether you’re seeking therapy for yourself or a loved one, our team of expert counselors are here for you. Contact us today at (413) 343-4357 to start working with one of self-harm counselors online in Massachusetts or in-person from our offices in Amherst, West Springfield, Wilbraham, Natick, or Franklin.

Additionally, to learn more about helping a loved one who self-harms, visit our practice tips blog.

What is self-harm?

Self-harm, which may also be called self-injury, self-mutilation, or self-abuse is the act of deliberately causing harm to oneself. 

According to Alexandra Malin, Licensed Mental Health Counselor and Clinical Supervisor with Handel Behavioral Health, “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 inflict pain on yourself.” 

Common examples of self-harm behaviors include:

• Cutting the skin 
• Burning the skin 
• Excessive starching, to the point of drawing blood
• Hitting or punching oneself, or hitting/banging one’s head
• Piercing the skin with sharp objects
• Inserting objects under the skin or into body piercings
• Intentionally breaking bones
• Ingesting harmful chemicals
• Overeating or undereating
• Abusing alcohol or substances

What are the Warning Signs of Self-Harm?

Self-harm can often be a silent struggle and masked beneath the surface of a person’s outward appearance or behavior. Understand the warning signs of self-harm to provide support and guide individuals toward recovery. 

Common warning signs of self-harm include: 

1. Unexplained cuts, bruises, or burns particularly in areas that are easy to conceal like arms, wrists, or thighs can suggest self-injurious behavior. 
2. Wearing concealing clothing, even in warm weather, may suggest that someone is trying to hide the physical evidence of self-harm. 
3. Emotional withdrawal or isolation from friends, family, and social activities. People who engage in self-harm may seem distant, avoid eye contact, or withdraw from relationships they typically associate with. 
4. Frequent expressions of self-criticism or negative self-talk may suggest that someone is self-harming. A person who engages in self-harm often struggles with feelings of worthlessness or deep emotional pain. 
5. Mood swings or intense emotional relapse, such as shifting between deep sadness, irritability, or anger may reflect a person’s effort to cope with overwhelming feelings through self-destructive behaviors. 
6. Preoccupation with sharp tools or objects can signal that a person is planning or engaging in self-harm. 
7. Behavioral changes and risk taking behaviors may indicate an attempt to numb or escape emotional pain. This may include substance abuse, dangerous drinking, picking fights, or engaging in impulsive actions that put them at risk. 
8. Showing signs of depression or anxiety, such as persistent sadness, irritability, fatigue, or excessive worry often act as triggers for self-harm behaviors. 

If you recognize any of these warning signs in yourself or a loved one, it’s imperative to take them seriously. Early intervention and therapy can make a significant difference in managing self-harm and beginning the journey toward healing.

Mental Health Conditions That Co-Occur with Self-Harm:

Self-harm is rarely an isolated issue. Understand the mental health conditions that co-occur with self-injury to provide effective support. 

Common mental health conditions that accompany self-harm:

• Anxiety 
• Depression
• Bipolar Disorder
• Personality Disorder
• Substance Use Disorder
• Post-Traumatic Stress Disorder (PTSD)
• Trauma
• Eating Disorders
• Obsessive-Compulsive Disorder (OCD)
• Schizophrenia or Psychosis 
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Chronic Stress or Burnout

What Does Therapy for Self-Harm Involve?

Therapy is one of the most effective ways to address and heal from self-harm. Our therapists understand that the process of recovery is deeply personal and will work with clients to create a treatment plan that addresses their unique needs and concerns. 

Clients will begin to understand their behavior, develop healthier coping tools, and work through their emotional pain that underlies self-harm. The following is an overview of what therapy for self-harm typically involves at Handel Behavioral Health:

1. Building a safe and supportive therapeutic relationship: Our therapists will establish a safe and trusting relationship between themself and the client. Clients will find a non-judgmental space where their emotions can be explored openly, allowing them to feel understood and supported. 
2. Identifying the causes of self-harm: Clients will work with their therapist to identify the underlying causes or triggers of their self-harming behaviors. This might include unresolved trauma, chronic stress, anxiety, depression, or feelings of emotional numbness. By understanding what drives the urge to self-harm, clients can begin to make sense of their behavior and address the root causes rather than just focusing on the symptom itself.
3. Developing healthier coping mechanisms: Clients will learn to replace harmful coping mechanisms with healthier alternatives. Therapists work with clients to help them learn new ways to manage intense emotions. These might include techniques such as mindfulness, breathing exercises, creative expression, and physical activity. 
4. Cognitive-Behavioral Therapy (CBT) for self-harm: CBT is a highly effective therapeutic approach which helps individuals identify negative or distorted thinking patterns that contribute to their emotional distress and self-harming behaviors. By challenging these harmful thoughts and beliefs, clients can learn to reframe their thinking and develop healthier perspectives on themselves and their emotions.
5. Dialectical-Behavioral Therapy (DBT) for self-harm: DBT is a highly effective therapeutic approach which emphasizes emotional regulation, distress tolerance, and mindfulness. Clients will learn how to access their emotions while learning how to change the behaviors that cause harm. 
6. Exploring trauma and emotional pain: In therapy, clients can explore past traumatic experiences in a safe and confidential environment. Trauma-informed therapy can help clients understand how their past experiences may contribute to their current coping mechanisms. As clients process intense emotions, they can work towards healing and self-compassion. 
7. Involving support systems: For individuals who feel isolated, having a support system can be a significant difference in maintaining progress from self-injurious behaviors. Love one’s can learn how to offer encouragement and support in moments of distress or crisis. 
8. Medication (if necessary): Medication may be prescribed by your psychiatrist or psychiatric nurse practitioner in certain situations, especially if there are co-occurring conditions such as depression, anxiety, or PTSD. 
9. Ongoing support and maintenance: Ongoing therapy can help individuals stay connected to the skills they’ve developed in therapy and ensure they’re better equipped to handle life’s challenges without resorting to self-harm.

Start Working With a Therapist for Self-Harm in Massachusetts Today:

If you or your loved one is seeking healthier ways to cope with life’s challenges, our therapists are here for you. 

To start working with one of our therapists for self-harm online in Massachusetts or in-person from our offices in Amherst, West Springfield, Wilbraham, Natick, or Franklin, contact us today at (413) 343-4357.

About The Author