Self-Harming: What to Know, How to Help

The topic of self-harm can be hard to navigate, and it might feel overwhelming at first. Self-harm, or self-injury, involves cutting, hitting, burning or other ways to harm one’s body without necessarily trying to die by suicide. According to the National Institutes of Health, about two in 10 teenagers and young adults have self-harmed at least once. 

teenage girl at therapist

Gaining an understanding of self-harm can help a person struggling with it feel less alone, and make it less scary for people who are worried about a loved one or friend. Self-Injury Awareness Day (SIAD), a grassroots international event, takes place in March to raise awareness and reduce the stigma about self-harm, while giving those who struggle a place to share stories of hope and healing.

Here are five things you may not know about self-harm.

1. The average age of someone who self-harms is 12 to 15. Self-harm behavior can start younger, however. And about 5 percent of those who self-harm are adults.

2. Teens who self-harm are not necessarily suicidal. Self-harming is usually more about a release of tension and stress, of feeling too overwhelmed by emotion and circumstances. Researchers are discovering that self-harm actually makes a person feel better for a short period of time, through a process called "pain offset relief."

However, this only creates temporary relief and as stress builds back up, the cycle repeats. The underlying issues remain unaddressed, along with potential feelings of shame and guilt.

With that said, someone can also have suicidal thoughts at the same time, so it is good to know the signs. The two are intertwined in ways that clinicians and researchers are still trying to understand.

3. Most people who self-harm don't do it for "attention." Most people who cut, hit or burn themselves can go to great lengths to hide their injuries. And people who do this rarely self-report — even to people they trust and love. Conversely, if you think someone is self-harming, confrontational tactics like yelling, lecturing or threatening usually backfire, and can cause the person who is self-harming to withdraw even more. Instead, if someone you know self-harms, it’s important to show empathy, not anger or pity. Be calm and respectful.

4. Self-harm can't be blamed on one single thing. There is almost always an underlying cause, or multiple causes. This might be depression, anxiety or other mental illness, as well as family trauma or violence. Often, figuring out and treating the cause underneath the emotional pain can help reduce the urge to self-harm.

5. Help and healing are available. Along with the treatment of depression, anxiety or other mental health issues underlying the self-harm, therapy like cognitive-behavioral therapy (CBT) might be helpful. Therapy that incorporates mindfulness techniques can also help with reducing the stress that can bring about an episode of self-harm.

This article may elicit complex feelings for some individuals. Please know there is help, support and resources. A doctor or behavioral health specialist may be able to make the best recommendation for a treatment path. But sometimes the first step is a conversation. A strong and compassionate support network can be crucial for healing. 

If you have been self-harming, you can call 1-800-DONTCUT for help.

And if you need someone to talk to if you are feeling suicidal, contact the National Suicide Prevention Lifeline at 1-800-273-8255.

The Self-Injury and Recovery Research and Resources of Cornell University has a wealth of resources if you self-harm, are supporting someone who might be self-harming or if you are a provider.