It is often seen as only a symptom of an underlying disorder,  though many people who self-harm would like this to be addressed. Although some people who self-harm do not have any form of recognised mental disorder,  many people experiencing various forms of mental illnesses do have a higher risk of self-harm.
The key areas of disorder which exhibit an increased risk include autism spectrum disorders ,   borderline personality disorder , bipolar disorder ,  depression ,   phobias ,  and conduct disorders. Those diagnosed with schizophrenia have a high risk of suicide, which is particularly greater in younger patients as they may not have an insight into the serious effects that the disorder can have on their lives.
Abuse during childhood is accepted as a primary social factor increasing the incidence of self-harm,  as is bereavement ,  and troubled parental or partner relationships. The most distinctive characteristic of the rare genetic condition, Lesch—Nyhan syndrome , is self-harm and may include biting and head-banging.
However, the link between genetics and self-harm in otherwise healthy patients is largely inconclusive. Substance misuse, dependence and withdrawal are associated with self-harm.
Benzodiazepine dependence as well as benzodiazepine withdrawal is associated with self-harming behaviour in young people. Self-harm is not typically suicidal behaviour, although there is the possibility that a self-inflicted injury may result in life-threatening damage.
The motivations for self-harm vary, as it may be used to fulfill a number of different functions. There is also a positive statistical correlation between self-harm and emotional abuse. Other motives for self-harm do not fit into medicalised models of behaviour and may seem incomprehensible to others, as demonstrated by this quotation: This may sound strange.
Assessment of motives in a medical setting is usually based on precursors to the incident, circumstances, and information from the patient. It may also be an attempt to affect others and to manipulate them in some way emotionally. Many people who self-harm state that it allows them to "go away" or dissociate , separating the mind from feelings that are causing anguish. This may be achieved by tricking the mind into believing that the present suffering being felt is caused by the self-harm instead of the issues they were facing previously: Alternatively, self-harm may be a means of feeling something , even if the sensation is unpleasant and painful.
Those who self-harm sometimes describe feelings of emptiness or numbness anhedonia , and physical pain may be a relief from these feelings. They may then recognise the need to function more, or have a desire to feel real again, and a decision is made to create sensation and 'wake up'. Those who engage in self-harm face the contradictory reality of harming themselves while at the same time obtaining relief from this act. It may even be hard for some to actually initiate cutting, but they often do because they know the relief that will follow.
For some self-harmers this relief is primarily psychological while for others this feeling of relief comes from the beta endorphins released in the brain. As a coping mechanism, self-harm can become psychologically addictive because, to the self-harmer, it works; it enables them to deal with intense stress in the current moment.
The patterns sometimes created by it, such as specific time intervals between acts of self-harm, can also create a behavioural pattern that can result in a wanting or craving to fulfill thoughts of self-harm. Emotional pain activates the same regions of the brain as physical pain,  so emotional stress can be a significantly intolerable state for some people.
Some of this is environmental and some of this is due to physiological differences in responding. The sympathetic nervous system innervates e. Studies of adolescents have shown that adolescents who self-injure have greater physiological reactivity e. There is considerable uncertainty about which forms of psychosocial and physical treatments of people who harm themselves are most effective. There is no well-established treatment for self-injurious behaviour in children or adolescents.
Dialectical behaviour therapy DBT can be successful for those individuals exhibiting a personality disorder, and could potentially be used for those with other mental disorders who exhibit self-harming behaviour. Diagnosis and treatment of the causes of self-harm is thought by many to be the best approach to treating self-harm. People who rely on habitual self-harm are sometimes hospitalised, based on their stability, their ability and especially their willingness to get help.
A meta-analysis found that psychological therapy is effective in reducing self-harm. In individuals with developmental disabilities, occurrence of self-harm is often demonstrated to be related to its effects on the environment, such as obtaining attention or desired materials or escaping demands.
As developmentally disabled individuals often have communication or social deficits, self-harm may be their way of obtaining these things which they are otherwise unable to obtain in a socially appropriate way such as by asking. One approach for treating self-harm thus is to teach an alternative, appropriate response which obtains the same result as the self-harm. Generating alternative behaviours that the person can engage in instead of self-harm is one successful behavioural method that is employed to avoid self-harm.
Any avoidance or coping strategy must be appropriate to the individual's motivation and reason for harming. It is difficult to gain an accurate picture of incidence and prevalence of self-harm. The World Health Organization estimates that, as of , , deaths occur as a result of self-harm. Many adolescents who present to general hospitals with deliberate self-harm report previous episodes for which they did not receive medical attention. Current research suggests that the rates of self-harm are much higher among young people  with the average age of onset between 14 and In general, the latest aggregated research has found no difference in the prevalence of self-harm between men and women.
However, this discrepancy has been known to vary significantly depending upon population and methodological criteria, consistent with wide-ranging uncertainties in gathering and interpreting data regarding rates of self-harm in general. For example, feminist author Barbara Brickman has speculated that reported gender differences in rates of self-harm are due to deliberate socially biased methodological and sampling errors, directly blaming medical discourse for pathologising the female.
This gender discrepancy is often distorted in specific populations where rates of self-harm are inordinately high, which may have implications on the significance and interpretation of psychosocial factors other than gender.
There does not appear to be a difference in motivation for self-harm in adolescent males and females. For example, for both genders there is an incremental increase in deliberate self-harm associated with an increase in consumption of cigarettes, drugs and alcohol. Triggering factors such as low self-esteem and having friends and family members who self-harm are also common between both males and females. In New Zealand, more females are hospitalised for intentional self-harm than males.
Females more commonly choose methods such as self-poisoning that generally are not fatal, but still serious enough to require hospitalisation. In a study of a district general hospital in the UK, 5. The male to female ratio was 2: Only recently have attempts to improve health in the developing world concentrated on not only physical illness but also mental health.
Research into self-harm in the developing world is however still very limited although an important case study is that of Sri Lanka, which is a country exhibiting a high incidence of suicide  and self-poisoning with agricultural pesticides or natural poisons. The improvement of medical management of acute poisoning in the developing world is poor and improvements are required in order to reduce mortality. Some of the causes of deliberate self-poisoning in Sri Lankan adolescents included bereavement and harsh discipline by parents.
The coping mechanisms are being spread in local communities as people are surrounded by others who have previously deliberately harmed themselves or attempted suicide. Great potential for the reduction of self-harm lies in education and prevention, but limited resources in the developing world make these methods challenging. Deliberate self-harm is especially prevalent in prison populations.
A proposed explanation for this is that prisons are often violent places, and prisoners who wish to avoid physical confrontations may resort to self-harm as a ruse, either to convince other prisoners that they are dangerously insane and resilient to pain or to obtain protection from the prison authorities.
Self-harm was, and in some cases continues to be, a ritual practice in many cultures and religions. The Maya priesthood performed auto- sacrifice by cutting and piercing their bodies in order to draw blood. Self-harm is practised in Hinduism by the ascetics known as sadhu s. In Catholicism it is known as mortification of the flesh. Some branches of Islam mark the Day of Ashura , the commemoration of the martyrdom of Imam Hussein, with a ritual of self-flagellation , using chains and swords.
Dueling scars such as those acquired through academic fencing at certain traditional German universities are an early example of scarification in European society. Constance Lytton , a prominent suffragette , used a stint in Holloway Prison during March to mutilate her body.
Her plan was to carve 'Votes for Women' from her breast to her cheek, so that it would always be visible. But after completing the "V" on her breast and ribs she requested sterile dressings to avoid blood poisoning , and her plan was aborted by the authorities. Kikuyu girls cut each other's vulvas in the s as a symbol of defiance, in the context of the campaign against female genital mutilation in colonial Kenya.
The movement came to be known as Ngaitana "I will circumcise myself" , because to avoid naming their friends the girls said they had cut themselves. Historian Lynn Thomas described the episode as significant in the history of FGM because it made clear that its victims were also its perpetrators.
The term "self-mutilation" occurred in a study by L. Emerson in  where he considered self-cutting a symbolic substitution for masturbation. The term reappeared in an article in and a book in when Karl Menninger refined his conceptual definitions of self-mutilation. His study on self-destructiveness differentiated between suicidal behaviours and self-mutilation. For Menninger, self-mutilation was a non-fatal expression of an attenuated death wish and thus coined the term partial suicide.
He began a classification system of six types:. Pao differentiated between delicate low lethality and coarse high lethality self-mutilators who cut. The "delicate" cutters were young, multiple episodic of superficial cuts and generally had borderline personality disorder diagnosis. The "coarse" cutters were older and generally psychotic. After the s the focus of self-harm shifted from Freudian psycho-sexual drives of the patients. If you don't learn other ways to deal with emotional pain, you increase your risk of major depression, drug and alcohol addiction, and suicide.
Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop. The bottom line is that cutting and self-harm won't help you with the issues that made you want to hurt yourself in the first place. No matter how lonely, worthless, or trapped you may be feeling right now, there are many other, more effective ways to overcome the underlying issues that drive your self-harm.
If you're ready to get help for cutting or self-harm, the first step is to confide in another person. It can be scary to talk about the very thing you have worked so hard to hide, but it can also be a huge relief to finally let go of your secret and share what you're going through.
Deciding whom you can trust with such personal information can be difficult. Choose someone who isn't going to gossip or try to take control of your recovery. Ask yourself who in your life makes you feel accepted and supported. It could be a friend, teacher, religious leader, counselor, or relative. But you don't necessarily have to choose someone you are close to.
Sometimes it's easier to start by talking to someone you respect-such as a teacher, religious leader, or counselor-who has a little more distance from the situation and won't find it as difficult to be objective. Focus on your feelings. Instead of sharing detailed accounts of your self-harm behavior focus on the feelings or situations that lead to it.
This can help the person you're confiding in better understand where you're coming from. It also helps to let the person know why you're telling them. Do you want help or advice from them? Do you simply want another person to know so you can let go of the secret? Communicate in whatever way you feel most comfortable. If you're too nervous to talk in person, consider starting off the conversation with an email, text, or letter although it's important to eventually follow-up with a face-to-face conversation.
Don't feel pressured into sharing things you're not ready to talk about. You don't have to show the person your injuries or answer any questions you don't feel comfortable answering. Give the person time to process what you tell them.
As difficult as it is for you to open up, it may also be difficult for the person you tell-especially if it's a close friend or family member. Sometimes, you may not like the way the person reacts. Try to remember that reactions such as shock, anger, and fear come out of concern for you. It may help to print out this article for the people you choose to tell. The better they understand cutting and self-harm, the better able they'll be to support you.
Talking about self-harm can be very stressful and bring up a lot of emotions. Don't be discouraged if the situation feels worse for a short time right after sharing your secret. It's uncomfortable to confront and change long-standing habits. But once you get past these initial challenges, you'll start to feel better. If you're not sure where to turn, call the S. Alternatives information line in the U.
For helplines in other countries, see Resources below. For a suicide helpline outside the U. Understanding what triggers you to cut or self-harm is a vital step towards recovery.
If you can figure out what function your self-injury serves, you can learn other ways to get those needs met-which in turn can reduce your desire to hurt yourself.
Self-harm is most often a way of dealing with emotional pain. What feelings make you want to cut or hurt yourself? If you're having a hard time pinpointing the feelings that trigger your urge to cut, you may need to work on your emotional awareness.
Emotional awareness means knowing what you are feeling and why. It's the ability to identify and express what you are feeling from moment to moment and to understand the connection between your feelings and your actions.
Feelings are important pieces of information that our bodies give to us, but they do not have to result in actions like cutting or self-harming. The idea of paying attention to your feelings-rather than numbing them or releasing them through self-harm-may sound frightening to you. You may be afraid that you'll get overwhelmed or be stuck with the pain. But the truth is that emotions quickly come and go if you let them.
If you don't try to fight, judge, or beat yourself up over the feeling, you'll find that it soon fades, replaced by another emotion. It's only when you obsess over the feeling that it persists. Self-harm is your way of dealing with unpleasant feelings and difficult situations. If you're going to stop, you need to have alternative ways of coping so you can respond differently when you feel like cutting or hurting yourself.
Using Your Senses to Alleviate Stress. The help and support of a trained professional can help you work to overcome the cutting or self-harming habit, so consider talking to a therapist. A therapist can help you develop new coping techniques and strategies to stop self-harming, while also helping you get to the root of why you hurt yourself.
Emotional and Psychological Trauma: Healing and Moving On. Remember, self-harm doesn't occur in a vacuum. It exists in real life. It's an outward expression of inner pain-pain that often has its roots in early life.
There is often a connection between self-harm and childhood trauma. Self-harm may be your way of coping with feelings related to past abuse, flashbacks, negative feelings about your body, or other traumatic memories-even if you're not consciously aware of the connection.
Finding the right therapist may take some time. It's very important that the therapist you choose has experience treating both trauma and self-injury. But the quality of the relationship with your therapist is equally important. Your therapist should be someone who accepts self-harm without condoning it, and who is willing to help you work toward stopping it at your own pace.
You should feel at ease, even while talking through your most personal issues. While cutting and self-harming occurs most frequently in adolescents and young adults, it can happen at any age. Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury in a friend or family member can be hard to detect.
In any situation, you don't have to be sure that you know what's going on in order to reach out to someone you're worried about. However, there are red flags you can look for:. Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest. Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person's belongings. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
Needing to be alone for long periods of time, especially in the bedroom or bathroom. Your loved one is experiencing a great deal of inner pain—as well as guilt at how they're trying to cope with it.
This can cause them to withdraw and isolate themselves. Because cutting and self-harm tend to be taboo subjects, many people harbor serious misunderstandings about their friend or family member's motivation or state of mind. Don't let these common myths get in the way of helping someone you care about. The painful truth is that people who self-harm generally hurt themselves in secret.
SELF-HARM The thrill of the blade cutting through my veins; gone are those days of self harm and pain. I thought it made me happier, thought it made me strong.
In her book The Curse of Time Book 1 Bloodstone, Marjorie Mallon addresses the issue of self harm. Here is her guest post on this important topic.
During my self-harming years, writing was my main outlet and focus. All my life, I’ve been writing, but as a teenager dealing with deep depression and a parent’s divorce, writing became more than just a hobby. It became the one coping skill I could really count on. Well, until my floppy disk. The bottom line is that cutting and self-harm won't help you with the issues that made you want to hurt yourself in the first place. No matter how lonely, worthless, or trapped you may be feeling right now, there are many other, more effective ways to overcome the underlying issues that drive your self-harm. Write down any negative feelings.
Do not use this list to self-harm. If you do, you will make my puppy very sad: And no one wants to make puppies sad. What are the different methods of self harm? Update Cancel. There is help. or you are writing a book about someone who self-harms. Do not betray my trust, friend. I also leave the warning that this is honest and possibly. Self Harm Worksheets - showing all 8 printables. Worksheets are The hurt yourself less workbook, Gabriela zapata alma lcsw cadc harm reduction strategies, Onthecuingedge.