NHS Lothian

Understanding Self-harm

2 min read

What is self-harm? 

It’s common for people to harm themselves in some way, by smoking, drinking, eating too much or not enough, exercising too much, or working too hard. But for some people, self-harm is more severe and can become a problem 

Self-harm is also sometimes called self-injury and it refers to someone harming themselves without wanting to die. While many people who harm themselves also have suicidal thoughts, theres a difference between suicidal acts and acts of self-harm. Usually, people self-harm to get rid of terrible feelings, not to end their life 

Some people may self-harm several times a day and often theres a ritual around these behaviours. Others may self-harm only occasionally, particularly when they’re feeling very distressed 

Who self-harms?

People who self-harm may feel distressed a lot of the time. They may have very strong emotions (including a strong sense of feeling numb) and no other ways of coping with them. 

Theres no age, race, education or social group that is specifically linked to self-harm, however existing research suggests that its more common for women to harm themselves than men. Men may express their feelings and their distress in other ways.  

 Often, self-harm begins in adolescence and tends to decrease or disappear in a person’s thirties, although this isn’t always the case and people can begin later in life. Some people start to self-harm following difficult life event, such as bereavement, bullying, debor a relationship breakdown.  

 Some people who harm themselves have experienced traumatic events in their lives. [Link to trauma content] 

 Why do people self-harm? 

 People don’t always know why they self-harm. Research based on talking to people who harm themselves has helped us to understand some of the reasons: 

To manage moods or feelings
  • To escape feelings of emptiness, depression or shame 
  • To change emotional pain into physical pain 
  • To stop feeling spaced out, disconnected or unreal 
  • To relieve tensions, pressures or anger 
  • To feel something – to know you still exist 
  • To feel in control 
  • To express or stop sexual feelings 
  • To forget something. To escape traumatic memories 
  • To get an adrenaline rush  
To fit in beliefs or thoughts
  • To punish yourself for being ‘bad’ 
  • To maintain a negative belief about yourself ‘I am flawed worthless, weird’ 
  • To escape feelings of guilt 
  • To cope with others’ expectations of your sexuality 
To communicate
  • To express anger towards yourself or others, but on your own body 
  • To make your body show your feelings 
  • To look for a response from others you feel you won’t get otherwise 
How do people self-harm?

Self-harm can take lots of different forms. People sometimes cut themselves, burn themselves, bite themselves, poison themselves, pull their own hair, pluck or scratch their skin. People can also take risks more.  

People often self-harm in secret, in dramatic or ritualistic ways. The scars and the damage caused by self-harming can be long-term.  

Why can self-harm be a problem?  

When people self-harm, theyre at risk of serious physical damage and infection. In the longer term, therealso a risk of permanent damage and scarring. People who self-harm usually feel ashamed, guilty and disgusted about their behaviour  

With time, self-harm may become a bit of a habit. The initial urge might not be there any more and it can become very hard to stop. People can be left with a vicious cycle of feeling bad, self-harming, feeling bad, self-harming.  

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