Self-Harm Causes and Treatment
If you have found your way to this blog, you or someone you love may be harming themselves. This information may help you understand why someone self-harms and what you can do to support them.
Self-harm is a term used to describe a person that deliberately hurts their bodies. Common types of self-harm include cutting, burning, picking at wounds or scars, self-injurious behaviours such as head banging, or deliberately overdosing on medication, drugs, alcohol and other substances that can cause harm.
About 10% of teenagers reported they have self-harmed at some point in their lives. Self-harm behaviour is more common among teenagers than adults and affects both girls and boys in different ways for different reasons. Girls who experience suicide attempts are two times more likely than boys to have a history of hurting themselves and boys who self-harm have more unplanned suicide attempts. Other factors that increase self-harm risk are reactive temperaments, depression, anxiety and people who felt victimised because of their health, skin colour, sexual orientation, language, culture or religion. People who have experienced trauma (e.g., physical, sexual, or emotional abuse and neglect) or had other adverse childhood experiences are more likely to engage in self-harm as well as people with mental health issues such as depression.
Some people find strong emotions difficult to express and this can lead to unhealthy behaviours such as hurting their bodies. Usually a person self-harms in response to intense emotional pain or a sense of being overwhelmed by negative feelings, thoughts or memories. Self-harm offers a distraction by transferring emotional pain into physical pain or acts as a stress relief that helps the person to just keep going and get through the day. Some people may harm themselves only once when feeling overwhelmed or very stressed and never harm again; while others may repeat the behaviour regularly making it difficult to change. Self-harm offers a temporary relief as the person feels better in the moment but over the long time it is damaging as the underlying problems are never resolved.
The most common self-harm behaviour is cutting and this is often done using razor blades, scissors, or the blade out of a pencil sharpener. The area of the body most likely to be cut are the thighs or wrists and in areas that can be covered by clothing. Cutting is often superficial, similar to a paper cut or a scratch. If you notice repeated paper like cuts on your loved ones’ body that are excused away by statements such as “I fell into the bushes”, or “the cat scratched me”, try to investigate further by asking questions about how they feel and what is going on for them right now. Things that you think are insignificant as a parent or adult may be huge for a teenager.
The term trigger refers to sensations, images, or experiences that reminds a person about a difficult time they have experienced at some point in their life. When something negative happens in your life this may trigger the memory of a bad experience in the past causing negative thoughts and feelings in the present that then makes you feel overwhelmed and leads to self-harm. A build-up of negative and stressful life events usually triggers self-harm rather than a one-off negative incident; however, a one-off negative experience such as sexual assault may lead to self-harm behaviour.
Some people who self-harm may have suicidal thoughts, however not everyone who self-harms is suicidal. Self-harm behaviours are a risk factor in suicide and attempted suicide, so if you or someone you know is harming themselves, it is important to get them to a mental health professional for a chat. Sometimes self-harm can also lead to people engaging in other high-risk behaviours such as substance misuse that accidentally leads to serious injury or death.
You are not alone! Many people engage in self-harm behaviours when overwhelmed with intense emotion. Seeking help as soon as you notice the first signs of feeling overwhelmed is very important to maintaining good mental health. The first step is reaching out to a friend or family member who you trust to let them know what is going on for you and how it is affecting your thoughts, feelings and behaviours. If you are not ready to talk to family or friends, or you have a limited support network, you can speak with your doctor who will assess your risk and refer you to a mental health professional for support.
Cognitive Behaviour Therapy (CBT) and Dialetical Behaviour Therapy (DBT) have great success in the treatment of self-harm behaviours. CBT focuses on solutions and encourages you to identify your feelings and challenge your faulty thinking that leads to destructive behavioural patterns. Treatment of self-harm involves developing healthier coping skills leading to better regulation of your emotions so that they don’t feel as intense and uncontrollable. These skills help you tolerate distressing experiences and cope better with negative setbacks in the future.
The most important way to support someone who is engaging in self-harm is to listen to them and encourage they seek help from a mental health professional. It is important to remain open minded and non-judgemental as the person may feel ashamed of their feelings and behaviours. If you stay calm and validate their feelings, they are more likely to feel safe and open up. If you become angry, judgmental or give ultimatums, it may make the situation worse.
It can be very stressful supporting someone with self-harming behaviours so self-care is very important. Consider seeking help yourself for advice and support, engage in activities that feel good and talk to family and friends about what you are going through. Relaxation strategies are also helpful and calming during difficult times.
If you are in crisis right now, you can attend the emergency department at your local hospital. The following organisations offer support during crisis:
Kids Helpline: 1800 55 1800
Parentline: 1300 30 1300
This blog was written by our psychologist, Corrine Scott. Corrine has experience working with teenagers who self-harm and works at our Coomera clinic. If you or someone you love is self-harming, please see your GP for a long consultation and discuss a referral to see a psychologist. To facilitate a referral to our service, please take with you to your GP appointment our Referral Fact Sheet.