Understanding Self-Harm and Getting Help
Whether you're experiencing self-injury or someone you love, here's what it is, why it happens and how to get help
Self-injury, also known as self-harm or non-suicidal self-injury (NSSI), is a behavior where a person intentionally hurts themselves without wanting to die. Millions of people worldwide struggle with self-injury at some point in their lives; the most common reason for self-injury is an attempt to manage negative emotions (emotion regulation). In this article, we will cover some of the reasons for self-injury, what you can do if you or a loved one harm themselves, and things you can do for yourself or share with someone who struggles with self-injury.
Why Do People Intentionally Hurt Themselves?
The short answer is: we don't know. Researchers are actively searching for a specific reason or event that causes a person to start self-injuring, but so far research has been inconclusive. While we do not know the exact reason why some people harm themselves, there are many risk factors for self-injury, such as (but not limited to):
Depression or a depressive disorder
Borderline personality disorder
A history of sexual assault/abuse
A history of trauma or PTSD
Being an adolescent
One of the main areas of current research is to determine why some people who experience these risk facts start to harm themselves, while others do not. Overall, there is agreement among therapists, researchers, and individuals who struggle with self-injury, that the behavior temporarily helps control negative emotions.
What Can I Do if I Self-Harm?
Talk to someone you trust about your self-injury, such as a friend, a counselor, or a family member. One of the most influential factors in recovering from self-injury is having someone in your corner who is non-judgmental, caring, a good listener.
Keep a Thought Journal. Keeping track of your thoughts and feelings is a great way to learn more about your triggers, what causes stress, and how you respond to the stressors. Journaling has been shown to be beneficial for mental health, and at times can also work as a distraction from intense emotions.
Do something positive to distract yourself/practice good self-care. Instead of harming yourself, take time to do something relaxing for you. Bake cookies, take a warm bath with scented bath bombs or go for a walk (take your dog if you have one!), or do a 7 Cups Mindfulness exercise. Self-care should be a priority in our daily lives, not a luxury that we can fit into our schedules. Good self-care strategies are positive, calming, and help you feel better; ‘Sleeping it off', using drugs or alcohol, or getting into fights are not positive self-care strategies.
Use thought-tracking or a strategy from cognitive-behavioral therapy (CBT).
The ABC's of CBT are:
Antecedent - what happened that caused me to feel this way?
Behavior - how did I act at the moment, and how can I change things in the present moment to have a better outcome?
Consequences - how did my actions affect the outcome of the situation?
Let's go through an example.
Situation: Suzie had an argument with a friend earlier today, and she feels overwhelmed by what was said. Suzie feels so overwhelmed she thinks about harming herself to make the negative feelings go away, but then she remembered the strategy she worked on in therapy last week, the ABC's of CBT. She takes out a piece of paper and writes A, B, and C on separate lines.
A (Antecedent): I had an argument with Emily today, and I am really upset that we had a fight because we have been friends since childhood.
B (Behavior): I want to harm myself because I am so upset with what I am feeling. Instead of harming myself I am going to do something positive, like take my dog Jack for a walk. Tomorrow I will talk to Emily and patch things up with her, when we have both calmed down.
C (Consequence): I took Jack for a walk and I don't want to hurt myself, and I am looking forward to clearing things up between myself and Emily tomorrow.
What Can I Do if Someone I Care About Struggles with Self-Injury?
Don't panic. Talk with the person and listen in a non-judgmental manner. If their reasons for hurting themselves do not make sense to you, that is okay. The person in front of you is in distress and this is the best way they know to handle that stress.
Encourage them to get professional help.
Ask because you are concerned about their emotional health, not because you are curious about self-harm. Don't shame them, tell them to cover up their scars, or tell them they are sick.
Don't take it personally if they do not want to talk to you.
Psychotherapy is the best method of treating self-injury; there are no medications specifically to treat self-injurious behavior. However, if you have been diagnosed with a mental health disorder your doctor may recommend antidepressants or other medications which help treat a condition associated with self-injury.
Self-injury is a complex behavior and people have different reasons for engaging in the behavior, and psychotherapy for self-injury typically involves treating other areas as well. Therapy can help the person understand and work the intense emotions associated with self-injury, as well as control urges to self-injury.
Self-care is a priority, not a luxury, in our daily lives.