On a regular basis, I am presented with folks who are bewildered when faced with a loved ones self-harming behaviors.

“Why would they do this to themselves?” 
“Why won’t they just stop?”
“This type of behavior just doesn’t make any sense!” 

These are all questions and exclamations I hear on a regular basis.  Thus, I would like to attempt to provide a bit of insight into what self-harm is and why someone may choose to self-harm.

Self-harm involves deliberate, purposeful injury to one’s own body. Self-harm includes anything you do to intentionally injure yourself.  Some of the more common ways to self-harm include cutting, burning or scalding, hitting, head-banging, hair-pulling, punching things (or throwing your body against hard objects), compulsive skin picking, sticking objects into the skin and intentionally preventing wounds from healing (interference).

Why would anyone engage in these types of activities?  The most common reasons I see for engaging self-harm are maladaptive coping (coping, but in an unhealthy way), emotion regulation, punishment, and/or communication.  What???  Let me explain further.

For blog length purposes, I’m going to combine coping and emotion regulation…In this arena, self-harm can act as a distraction from other disturbances.  Oftentimes, I’ve learned that someone prefers the physical pain to the emotional pain they are experiencing and/or prefers that they can “control” the level of physical pain through self-harm (while they do not yet have the skills to handle their emotional pain).  If an individual has a long-standing practice of self-harm, they may also take solace in the rituals they create with their self-harming behaviors.

Another (super nerdy) way of explaining this is via a neurochemical understanding of the brain.  Beta Endorphins are released with injury in the brain when you cut and bleed.  Beta Endorphins give a sense of an initial high and then a calming effect.  (This experience can be the experience a self-harming individual would prefer.)  Unfortunately, some folks can become addicted to their own brain chemistry and can struggle to quit self-harming behaviors even when they are not stressed.

Ok, but why would anyone want to “punish” themselves?  Interestingly, for they same reason parents choose to punish their children. A negative association is a reminder “not to do that again.”  Sometimes, an individual who self-harms will use this negative association as a way to adjust their own behavior.

Ok, now on to communication.  This is the one that I see most often misunderstood as “attention seeking.”  Sometimes, a person may choose to self-harm so that their “outsides match (their) insides.”  There are times when a person may feel horrible on the inside and feel that the outside of their body needs to be more in alignment (ie. demonstrating wounds).

THE MOST COMMON REASON CITED FOR SELF-HARMING BEHAVIORS ARE: To get relief from a terrible state of mind or intense feelings of tension and/or anxiety.

So, what’s the good news?  The good news is that self-harm and suicide attempts are NOT the same thing.  Although there is an increased likelihood that someone who self-harms will, at some point, consider a suicide attempt, the self-harming behaviors themselves are actually meant to be coping mechanisms.  Also, another piece of good news is that self-harming behaviors can be replaced with alternative, effective and healthy coping mechanisms!!

This post is, by no means, an all-inclusive explanation for all self-harming behaviors. However, I do hope that it has provided, for some, a little more understanding.

by Bree Emery MSW, LCSW