Learn how to reduce self-harm in yourself and others.
Self-harm is the deliberate damaging of one’s own body tissue (Whitlock et al., 2008). It is important to note that when people self-harm, they may or may not want to die because of their actions. Accordingly, care providers and researchers alike often distinguish between what they call non-suicidal and suicidal self-injury. For our purposes, it is enough to know that any harm that we intentionally cause ourselves, which results in damage to the body, counts as self-harm.
All human behaviors can be said to have a function, but this may be difficult for us to understand with certain behaviors, such as self-harm. Even though around 10 and 15 percent of teenagers and as many as one in three college students have engaged in self-harm, self-harm remains a stigmatized topic and behavior (Gratz, 2001; Hawton & Rodham, 2006; Whitlock et al., 2006).
Much psychology research has been conducted to understand who is most likely to self-harm and why. Psychologists have chosen to divide motives for self-harm into internal motives, which are about dealing with one’s own state of mind, and external motives, which are about changing one’s environment (Chapman & Dixon-Gordon, 2007). Let’s look at some examples.
Internal motives
A common “internal” reason for self-harming is to “self-medicate” intense emotions; in other words, for some people, self-harming is a coping mechanism, similar to drinking alcohol after a stressful day (Turner, 2002). Many people who have experienced traumatic events will self-harm to handle their dissociation or to deal with traumatic memories or flashbacks (Linehan, 1993). Another “internal” reason for self-harming is that punishing oneself can be a way of expressing negative feelings toward oneself (Zila & Kiselica, 2001).
External motives
External motives for self-harm usually focus on generating the desired response from the people in the person’s life (Kovacs et al., 1975). The self-harming person may want others to recognize their pain, feel pain themselves, or care for and help them (Crowe & Bunclark, 2000; Favazza, 1996).
How to Stop Self Harm
If you or somebody you know is repeatedly hurting themselves, getting support from a therapist or other medical professional should be the top priority. While this article will discuss ways that you can help yourself or somebody else stay safe, please remember that the most responsible thing to do when self-harm is occurring is to connect the person in danger to a trained professional. Somebody with an active plan and strong intention to hurt themselves, particularly in a way that could result in their death, should be brought to the attention of emergency medical services as soon as possible.
So, with the emphatic disclaimer that the risk for self-harm should always be assessed by a medical professional whenever possible, here are some things you can do to help somebody who is self-harming:
Check in about how they’re feeling right now. Do your best to listen without trying to fix anything. Gently try to find out when the last time was that they wanted to or actually hurt themselves. See if they are willing to tell you how strong their intention is to hurt themselves right now, if they have a plan for how to do it, and if they have the ability to make that plan happen right now.
If they are very motivated to hurt themselves – they have a plan and intend to do it now, or soon – have somebody stay with them and call emergency services. The goal is to keep the person safe until professionals who can ensure their longer-term safety are present to take care of them. Although it is good if the person wants the help of medical professionals, you can do them a great favor by making sure they get that help if they are this distressed. (And if you are a mandatory reporter because of your professional or volunteer work, know that you are obligated to make sure that person gets help.)
Offer to help them get resources or other help. Make sure they know it’s their decision, and you just want to support them in following through on whatever they decide. Resources might look like the phone number to a hotline (1-800-273-8255), contact information for a therapist or psychiatrist, or anything else the person in distress believes would help them want to hurt themselves less.
Remove access to objects the person might use to hurt themselves. Ask a loved one of the person in danger to hold on to their medication, put knives and razors in a locked drawer, or take their lighters away.
Show your love. Tell the person why you care about them. Don’t use it as a reason to compel them to give up the idea of hurting themselves. Just make it clear that you care for them, want the best for them, and will keep supporting them and working to make sure they are safe.
In Sum
This article has mainly discussed addressing self-harm, not suicidal thoughts or behaviors. However, even if you know that an individual doesn’t intend to kill themselves at this time, be aware that many people hurt themselves because they would like to die (Klonsky et al., 2013), and also that some people start out self-harming for other reasons, but become suicidal later (Bryan & Bryan, 2014). In other words, if a person is engaging in self-harm, be aware that they may become suicidal in time and take their behaviors seriously (Kapur et al., 2013).
References
Bryan, C., & Bryan, A. (2014). Nonsuicidal self-injury among a sample of United States military personnel and veterans enrolled in college classes. Journal of Clinical Psychology, 70, 874-885.
Chapman, A. L., & Dixon-Gordon, K. L. (2007). Emotional antecedents and consequences of deliberate self-harm and suicide attempts. Suicide and Life-Threatening Behavior, 37, 543–552.
Crowe, M., & Bunclark, J. (2000). Repeated self-injury and its management. International Review of Psychiatry, 12(1), 48-53.
Favazza, A. R. (1996). Bodies under siege: Self-mutilation and body modification in culture and psychiatry. Baltimore, MD: Johns Hopkins University Press.
Gratz, K. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253–263.
Kapur, N., Cooper, J., O’Connor, R. C., & Hawton, K. (2013). Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy? The British Journal of Psychiatry, 202, 326-328.
Klonsky, E. D., May, A. M., & Glenn, C. R. (2013). The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. Journal of Abnormal Psychology, 122, 231-237.
Kovacs, M., Beck, A. T., & Weissman, A. (1975). The use of suicidal motives in the psychotherapy of attempted suicides. American Journal of Psychotherapy, 29, 363–368.
Whitlock, J., Eckenrode, J., & Silverman, D. (2006). Self-injurious behaviors in a college population. Pediatrics, 117, 1939-1948.
Whitlock, J., Muehlenkamp, J., & Eckenrode, J. (2008). Variation in nonsuicidal self-injury: identification and features of latent classes in a college population of emerging adults. Journal of Clinical Child & Adolescent Psychology, 37(4), 725-735.
Zila, L. M., & Kiselica, M. S. (2001). Understanding and counseling self-mutilation in female adolescents and young adults. Journal of Counseling and Development, 79(1), 46-52.
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