What Everyone Needs to Know About Self-Harm

What Renee taught me about why some people cut themselves.

Posted Jun 11, 2018

When I met Renee she told me she was nervous all of the time. And, she was cutting herself.

Some people resort to self-harm when they're overwhelmed by emotions. When we feel utterly alone and out of control, we’re capable of doing illogical things to stop bad feelings. Self-harm can become a reliable way to cope, albeit unhealthy. It can also be unlearned and replaced with healthier ways to self-soothe.

Fear and feeling "bad." 

When we met, Renee told me that her mind was constantly yelling at her, just like her father had yelled at her throughout her childhood.

“You’re a stupid little shit,” the male voice in her head would say.

As an adult, this made her feel she was a “bad person.” And both the real and imagined anger of other people terrified her – they were huge triggers for Renee, connecting her back to early memories of her father’s rages.

Big feelings of fear, shame, rage, and sadness, would come up quickly and felt absolutely excruciating. The only way she could stop them was to inflict pain on her own body. Her cutting seemed to satisfy two purposes:

  • It somehow stopped the emotions from intensifying any further.
  • It was self-punishment for her perceived badness.

Start with compassion.

Symptoms like cutting are often described as “just crazy.” In fact, they are in some ways wise. Self-harming behaviors can be understood of as a person’s best attempt to become calm in the face of overwhelming emotional distress combined with utter aloneness. Despite the fact that cutting is ultimately hurtful, both the intention and the short-term effect of self-harming behaviors is to help, not to hurt. 

My patients are relieved when I share this positive understanding of their self-harming behaviors. I invite them to approach the part of themselves driven to cut with a stance of curiosity and compassion.

Then learn healthy ways to self-soothe.

Symptoms like cutting won’t go away until the sufferer has other ways to calm their emotional overwhelm. To ask someone to stop cutting without offering alternative ways to get relief is akin to asking a trapeze artist to give up her safety net. Renee and I experimented with many ways to help calm her emotions such as:

  • Grounding her feet on the floor.
  • Breathing.
  • Trying to put words on her feelings.
  • Talking about light-hearted things like her favorite television shows.
  • Wrapping a blanket around her.
  • Calling a trusted friend.

Finally, process core emotions.

Renee and I worked together on calming her anxiety by learning what core emotions were being triggered and accessing and processing the anger at her father. She slowly learned how to tolerate and channel any feelings of anger at others in a healthy way by asserting herself. She eventually built up her access to and tolerance of the full spectrum of core emotions and their accompanying physical sensations.

After about six months of treatment, Renee grew much more compassionate to herself. She was able to better tolerate her core emotions and came to understand how her traumas affected her. As a result, her self-harming behaviors were no longer needed. She appreciated them for how they helped at one time. She still had painful and powerful feelings like we all do, but now Renee was relieved and proud that she had new and much better ways to cope.

(Patient details have been changed to protect confidentiality).