Self-harm is the deliberate injuring of one’s own body. It is a way of articulating very serious personal distress, and is sometimes referred to as ‘an inner scream’. The most common forms of self-harm are cutting or burning, although people have also been known to:

The mental health charity Mind also suggests that self-harm may take less obvious forms, such as taking unnecessary/excessive risks, staying in an abusive relationship, developing an eating disorder, becoming addicted to alcohol or drugs, or simply not looking after one’s own emotional or physical needs.

Some people self-harm on a regular basis while others do it just once or twice. A few people who self-harm may go on to commit suicide, but in general suicide is rarely the aim or the intention.

Also referred to as ‘deliberate self-harm’, ‘self-mutilation’ and ‘self-injury’, self-harm is more common than most people would imagine. It is difficult to say exactly how many people self-harm because many do so in private and many never seek counseling or medical help. Subsequently, there are no reliable national statistics on self-harm currently available. However, it is known that:

Causes

People self-harm for different reasons. For some people self-harm is a means of coping with a specific, one-off problem. Once that problem is resolved, the self-harming stops. For others, self-harm goes on for years, occurring whenever they are confronted with certain kinds of feelings or pressures. Self-harm can be a means of self-punishment. It can also be a cry for help.

Essentially, self-harm is a means of communicating what can’t be expressed in words, and controlling externally what cannot be controlled internally. People who self-harm may be experiencing painful emotions, such as sadness, rage, self-hatred, emptiness, grief, fear, loneliness or guilt. Often, these feelings can be difficult to make sense of and deal with. Self-harm can serve to focus the mind on visible (and therefore knowable and controllable) pain and injury, rather than the nebulous inner turmoil that someone might be experiencing. When emotional pressure gets too much, self-harm is often said to act as a ‘valve’, regulating and releasing that pressure and relieving built-up tension.

People who self-harm may well have gone through traumatic or painful experiences earlier on in life (abuse, neglect, homelessness, assault), and may well have lacked the emotional support needed to get through those episodes unscathed. As a result, their emotions relating to these incidents could have become buried – locked away deep inside. Self-harm can be the only outlet for these complicated and unresolved emotions.

Individuals who have been deeply traumatised by an episode or event can also become quite detached from their emotions and physical feelings. In these instances, self-harm is used as a counterbalance to that numbness; as a way of confirming sensation, of reminding people that they are responsive, living beings who bleed and feel pain.

Signs and symptoms

The obvious outward signs of self-harm are physical: bruises, cuts, burns and slashes on the body – often on the arms and wrists. However, attempts to conceal these marks can also be telling: numerous and permanently worn bangles or bracelets, or long-sleeves in warm weather, can be a sign that someone is trying to hide scarring.

Self-help: controlling self-harm

Here are some self-help tips and techniques that could help address the underlying problems causing self-harm.

1. Distraction

There is strong evidence – mostly from young people – that finding ways to distract from, or finding alternatives to, self-harm can be very important for many young people.

Distraction techniques help to take your attention and thoughts away from anxious/disturbing thoughts:

Try to visualise a pleasant scene in your mind; perhaps somewhere you’ve been where you felt calm and happy – or an object, like a flower or your favourite car. Really concentrate on it, bring it to life in your mind

Try counting down slowly from 10 to 1

Try focusing on objects around you and, using your senses, concentrate on how they look, sound, smell, taste or feel like

If you still want to hurt yourself:

Put your hands in to a bowl of ice cubes for a short time, or rub ice on the part of your body you feel like injuring

Use a red felt-tip marker or lipstick to mark your body instead of cutting it

Put a rubber band around your wrist and flick it

Put sticking plasters on the parts of your body you want to injure

Find a safe punch-bag (some pillows, for example)

2. Identify and understand the feelings that lead to self-harm

This can make it easier to find other ways of expressing or coping with your feelings and in turn help you to stop self-harming. Lots of people don’t know why they hurt themselves, so it may be useful to think about:

What was going on in your life when you first began to harm yourself

How you feel just before you want to hurt yourself. Some people find it useful to keep a mood diary and write down how they’re feeling at different times

Are you always in the same place or with a particular person when you self-harm?

Do you have any bad memories or thoughts that you can’t tell to anyone?

Quite often, when our thoughts have been identified, we can find that we are making some common thinking errors. For more information on this, click here.

3. Get creative: a good outlet for negative feelings

Many people find that creative activity, such as painting, writing, listening to or playing music, can help to lift their mood. Creativity can be a great outlet for frustration, anger or sadness and can help combat negative feelings that might otherwise be expressed through damaging gestures or actions. Try writing your feelings down (in a diary or in the form of a poem). To find out about creative workshops and the kit home loan scheme click here.

4. Improve communication

Self-harm can be really hard to stop and it may be a process that takes some time. Sometimes, however hard you try on your own, you may find you can’t cope with your feelings. If you can’t stop wanting to hurt yourself it’s best to get help from someone you trust. The first step is finding someone who you can talk to about your problems and who can give you emotional support and/or practical help.

Talking things over with family, friends and loved ones, or other people that you trust, can be a very helpful process. Whatever you’re going through, open and honest communication can lift the burden and make you feel a whole lot better. Certainly don’t bottle things up. Talk to people about how you feel. If you find this difficult, your GP/doctor may be able to recommend a counsellor. Alternatively, try contacting one of the telephone/email support agencies listed below and in the Useful Contacts section of this website.

There are probably many people out there who are experiencing similar feelings to you. If you think you would benefit from talking to them, there may be a local group in your area, or a website forum where you can chat online. Call First Steps to find out what’s available locally.

5. Harm minimisation

Until you are ready/able to stop self-harming, it’s important that you take care of your injuries. If self-harm has become part of your life and helps you deal with your feelings it may be difficult to imagine coping without it. But it is important to minimise the risk of infection:

If you are cutting yourself, use something clean and preferably sterile

Never share needles or cutting implements with anyone else

Clean any wounds, no matter how small, to stop them becoming infected – just ordinary tap water will do

If you think a wound might infected – if the skin around the wound becomes tender and painful, red or swollen – or an injury won’t heal, see a doctor or nurse as soon as possible