Self-harm, or self-mutilation, is the act of deliberately inflicting pain and damage to one's own body. Self-harm most often refers to cutting, burning, scratching, and other forms of external injury; it can, however, also include internal or emotional harm, such as consuming toxic amounts of alcohol or drugs or deliberately participating in unsafe sex.
Individuals who self-injure may feel that doing so helps release pent-up feelings of anxiety, anger, or sadness. But evidence finds that over time, those raw emotions—along with additional feelings of guilt and shame—will continue to be present, and may even worsen. In addition, self-harm can be dangerous in itself, even if the individual has no wish to cause themselves significant or long-lasting damage.
The roots of self-harming behavior are often found in early childhood trauma, including physical, verbal, or sexual abuse. It may also be an indication of other serious mental health issues that are independent of trauma, such as depression, anxiety, or borderline personality disorder. In some cases, self-harm that arises suddenly may be an attempt to regain control after a particularly disturbing experience, such as being assaulted or surviving another traumatic event.
Self-harm occurs most often in teenagers and young adults; recent data found rates ranging from 6 to 14 percent for adolescent boys and 17 to 30 percent for girls. Adults, however, can and do engage in self-harm, particularly those with mental health conditions or a history of self-injury.
Although both boys and girls self-harm, the rate appears higher in girls; they also tend to start at an earlier age. However, some experts contend that the types of self-harming behaviors that boys are more likely to engage in—such as punching walls when angry—may not be reported as self-harm in large surveys.
Not necessarily. Self-injury can look like attempted suicide, and some who self-harm do ultimately go on to attempt suicide. But many people who intentionally hurt themselves are not suicidal. Rather, they are simply taking extreme measures to distract themselves from—or attempt to soothe—mental anguish.
It can be difficult to detect when someone is hurting themselves, because self-harm is often done in private and kept hidden out of shame and fear. Fresh cuts and scratches, bite marks, and burns can all be warnings of self-injury when they occur frequently. Other physical signs may include scars, bruises, and bald patches, particularly those that indicate a repeated pattern of harm.
Other, less obvious signs could include an individual who seems especially prone to accidents or who wears long sleeves or long pants even in hot weather; these behaviors may be attempts to disguise self-injury. People who self-harm may also show signs of depression or emotional unpredictability, such as making comments about their sense of hopelessness or worthlessness.
Self-injurious behavior can be hard to detect, as it's often done in secret or in areas that are easy to hide. Signs may include unexplained wounds or clusters of cuts; heavy use of wristbands, long-sleeve shirts (even during hot weather), or bandages; or heightened depression or anxiety.
Generally, yes. But recent neurobiological evidence suggests that those who self-harm have a higher pain threshold. In addition, rather than responding negatively to pain, those who self-harm are typically calmed by it.
Research suggests that youth who visit self-harm websites are 11 times more likely to have thought about hurting themselves than youth who haven’t visited such websites. Starting a non-judgmental conversation about the sites, and mental health in general, can help parents determine whether their teen may be engaging in self-harm.
It depends. Some self-harm- and suicide-related websites are against the practice and provide resources for individuals to get help. Others, however, glamorize self-harm or suicide, or offer information on methods, concealment, or other dangerous aspects of self-harm.
Anyone who is struggling with self-harm should, first and foremost, seek help. Most often, this is a therapist specialized in self-injury, who can help the individual understand the root causes of their behavior and practice healthier coping mechanisms.
Help can also come from friends, partners, or other trusted loved ones. When an individual experiences an urge to self-harm, talking about those feelings with a close other—even if self-harm isn’t discussed directly—can help mitigate the urge and help to make sense of difficult emotions.
Responding with compassion—and recognizing that self-harm is an attempt at coping with painful feelings—is the first step. Next, encourage the person to seek help, assist them in finding other outlets for their negative feelings (such as exercise), and make yourself available to discuss any difficult emotions they are experiencing.
Identifying self-harm triggers—and avoiding them when possible—can help to reduce self-harming behavior. Replacing self-harm with self-soothing activities, such as painting, taking a hot shower, or exercising, can also help reduce the urge to self-injure.