What is Self-Harm?

Self-Harm, also know as Non-Suicidal Self-Injury, Deliberate Self-Harm, or just Self-Injury, is the deliberate harm to one’s own body. The injury is done to oneself, without the aid of another person, and the injury is severe enough for tissue damage (such as scarring) to result. Self-harm is one of the most misunderstood, mythologized, and ignored mental health issues we face.

Self-harm is common throughout human history and in the animal kingdom, for example; caged birds will pluck out their own feathers when highly stressed.

Almost everyone knows the relief of self-harm but may not realize it. If you’ve ever had a strong itch, such as eczema or a mosquito bite that you scratched until it hurt or bled and experienced blissful feelings, then you’ve had a small taste of how good the relief of self-harm feels.

Who Self-Harms?

Self-harm is more common than people realize. Statistics in North America indicate that close to 20% of people between the ages of 13-18 will self-harm for an average of 20 months and 42% will continue to self-harm into adulthood.

About 76% of people who self-harm are female and 70% use cutting as a method. Although 50% use self-harm to avoid suicide or suicidal thoughts, sadly, suicide is common amongst those who self-harm who do not receive the help they need.

What causes someone to Self-Harm?

People who self-harm do so for many different reasons, but the most common is to regulate sometimes overwhelming emotional distress. Many describe the build-up of tension - both emotional and physical - at times reaching unbearable levels that are relieved almost instantly when they self-harm.

Another significant reason for someone to self-harm is dissociation. Some people who have been physically or sexually abused as children will dissociate to the extent that they become numb both emotionally and physically. Their dissociation can be so severe that the can no longer hear or feel their own heartbeat and begin to doubt if they are still alive. The act of self-harm - seeing the blood and feeling the pain - brings them back and helps them reground themselves in their own body.

Other reasons for self-harm include genetic predisposition, brain chemistry imbalances, congruity (“making my outside look like my inside”), validation (“what I feel IS important), punishment, and (rarely) using it to show someone the level of distress they feel.

What treatments work for Self-Harm?

The key to helping someone who self-harms is to treat the underlying issues and to support the person while they increase their tolerance of distress and triggers. Taking away the tools people use to self-harm, shaming or guilting them, or; forcing them to agree to a no-harm contract does not work and can make things worse. Self-harm is a tool that has worked for the person and should be honoured. Therapy consists of replacing the function self-harm has served.

Treatment for self-harm is two-fold;

  1. Help the person learn distress tolerance while working to resolve the underlying problems that drove them to self-harm in the first place. For this, a good therapist will work with you to find the therapy that fits your own unique strengths, needs, abilities, and preferences.
  2. Treat self-harm as any other addiction; The act of self-harm triggers the release of endorphins which are our body’s natural heroin. When endorphins are released it results in a decrease in pain, instant relaxation and calm, a sense of well-being, and sometimes feelings of euphoria. People who self-harm can become addicted to endorphins.

What Is Expected of You as a Client?

Overcoming self-harm will require you to gradually learn new strategies and methods to regulate the strong emotions you feel. You should let your therapist know which situations or things are triggering, what kinds of thoughts you have about those things, and whether you are willing to experience some anxiety in order to overcome your fears. Your therapist will help guide you through gradual exposure to these situations and have you carry out some self-help homework between therapy sessions, with which you will practice many of the same things that you are learning in the sessions with your therapist.

If your self-harm arose from abuse or sexual abuse, your therapist can gently guide you through your journey to free yourself from the lingering trauma that impacts your life. Please be assured that anything about your past experiences shared in your therapy sessions will be held in the strictest confidence.


The information on this page is provided for informational purposes only and does not replace in any way a formal medical or psychiatric evaluation or suggest a diagnosis. If you suspect you may be experiencing any of the above symptoms we would recommend you seek an evaluation by a psychiatrist or medical practitioner. All therapy should begin with seeking any medical reasons for the presenting problem.