![\"\"](\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/optimized/3e6614c23a1205b91bc9e56a.jpg\")
Erin L. George![\"An](\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/optimized/a13a3fa744a33f0f1f02a638.webp\")
Key takeaways
- Self-injury may function as an attempt to manage overwhelming emotion, tension, numbness, or self-critical beliefs.
- Temporary relief can reinforce a cycle of repeated injury followed by shame or guilt.
- Compassionate support and professional treatment can help identify these functions and develop safer coping strategies.
Why Do People Self-Harm?
People may harm themselves to cope with or temporarily alleviate distressing feelings or situations. Self-injury for these individuals may cause relief or feelings of calm. Additionally, people report that they engage in self-harm as a form of self-punishment. Overall, self-harm is common among people who struggle with emotional dysregulation, anxiety, depression, negative emotionality, and self-criticism.[1],[2]
Self-injury, on its own, is different from suicidality because people who self-harm do so as a coping mechanism, typically without the desire to kill themselves. On the other hand, suicidal intent specifically refers to the desire to end their life.Self-injury occurs when someone cuts, burns, or otherwise harms themselves. They typically don’t intend to kill themselves, but they do have an increased risk of dying by suicide. [1] Self-harm is one of the harder behaviors associated with mental illness for people to fathom.
People mostly seem to understand when someone gets stuck in a deep depression or has mood swings. These are exaggerations of normal states of mind—everyone has felt blue at some time or another—and everyone has felt euphoric or energized at least once.[/lead]
Though loose, psychotic-style thinking is not something that everyone has experienced directly, the idea that people can experience hallucinations and delusions is familiar to most.
This basic understanding is not often there when people are confronted with someone who is cutting, burning, or otherwise traumatizing themselves. People don’t have good reference points to use to understand what motivates self-injury or what people who self-injure are trying to accomplish. And this can lead to stigma and shaming behaviors.
Immediate Support Information
Beyond 911 and the National Suicide Prevention Lifeline, there are other crisis hotlines you can contact if you are struggling with self-harm, including:
- \n
- The Trevor Project: Call 1-866-488-7368 or text START to 678-678 (for LGBTQ+ youth and young adults) \n
- Crisis Text Line: Text “Youth” to 741741 \n
- Your Life Your Voice: Call 1-800-448-3000 or text “Voice” to 20121 (for young adults, teens, and preteens) \n
- National Domestic Violence Hotline: Call 1-800-799-7233 \n
- Boys Town National Hotline: Call 1-800-448-3000 \n
- National Runaway Safeline: Call 1-800-786-2929 \n
- 988 Suicide & Crisis Lifeline: Call or text 988 (press 1 for veterans, 2 for Spanish, and 3 for LGBTQ+) \n
If you discover that someone you love is engaging in self-harm, try not to overreact, blame, or shame them. Erin L. George, MA-MFT, says, “It can be frustrating and even a helpless feeling to see someone you love hurting themselves, but one of the best things you can do for them is to listen and try to understand while empowering them to get help.”
Stop, take a deep breath, and remember that your loved one is going through a difficult and distressing time and that self-injury does not necessarily mean someone is suicidal. No matter what, approach their self-harm with compassion and empathy—avoid being judgmental, as that will just push them away. Let them know that you are there to listen to them, support them, and help them seek support or care if they are interested.
Trying to Understand Someone Who Self-Injures
It can be hard for people to be thoughtful about what self-injury acts mean. There’s a tendency to panic when you see someone you care about bleeding from self-inflicted wounds or covered with scars. Such panic interferes with thinking and makes it harder for people to understand the motives behind self-injury. Erin L. George, MA-MFT, says, “Panic can also lead to shame. Shame can trigger someone to self-harm again. It can quickly become a vicious cycle without professional help to understand both the behaviors and what’s motivating them.”
Further complicating the matter is the way that self-injury looks like it must be a suicide attempt, even though it usually isn’t. An act of self-injury, which might make sense if understood as a suicide attempt, becomes all the more difficult to comprehend when the self-injurious person denies that they are trying to kill themselves and is telling the truth.
So, why do people self-injure? What are they trying to accomplish when they harm themselves? The following list of six motivations covers most of the common scenarios that people who self-injure describe.
Understanding the Reasons Behind Self-Harm
Self-injury, which is often diagnosed as Nonsuicidal Self-Injury (DSM-5), is caused and influenced by many different intersecting factors.
Some psychological reasons for self-injury include:[2],[3]
- \n
- Coping with emotional pain \n
- Gaining a sense of control \n
- Inducing a positive feeling, such as calm or relief \n
- Self-punishing or expressing self-anger \n
Some social reasons behind self-harm include:[2],[3]
- \n
- Desiring to influence others \n
- Producing a physical sign of emotional distress \n
- Seeking help \n
Intentional self-harm is typically associated with:[2]
- \n
- Depression \n
- Anxiety \n
- Tension \n
- Anger \n
- Distress \n
- Self-criticism \n
- A preoccupation with self-harm that’s difficult to control \n
- Constant thinking about self-injury \n
The 6 Reasons
- \n
- Distract themselves, alter the focus of their attention, or regain control over their minds when experiencing pressing, unavoidable, and overwhelming feelings or thoughts \n
- Release tension associated with strong emotions or overwhelming thoughts \n
- Feel something physical when they are otherwise dissociated and numb \n
- Express themselves or communicate and/or document strong emotions they are feeling and cannot otherwise articulate \n
- Punish themselves \n
- Experience a temporary but intense feeling of euphoria that occurs in the immediate aftermath of self-harm \n
6 Reasons Explained
Let’s unpack these 6 reasons why people self-injure.
1. To Regain Control; To Shift Attention
People sometimes harm themselves because, by doing so, they are able to gain a subjective sense of control over chaotic internal emotions and thoughts. Seizing this control involves shifting the focus of their attention away from something more troubling toward something less troubling. Cutting or burning yourself causes physical pain, which is a very compelling and strong sensation.
Self-injurers sometimes use this pain sensation to override painful background chatter that fills their minds. For example, they may have been traumatized by a rape experience such that they have post-traumatic stress disorder (PTSD) symptoms and constantly replay that rape in their minds.
By cutting themselves, they are able to refocus their attention on the pain of the cut and, for a short while, experience relief from the rape trauma.
2. To Release Tension
A variation on the theme of regaining control is the idea that people self-injure as a means of releasing tension. Sometimes, feelings and thoughts build up a subjective state of tension or arousal that motivates people to do something to take action to reduce that tension or arousal. Cutting or burning reduces that tension.
3. To Return From Numbness
Traumatized people sometimes cope with their trauma by dissociating. Dissociation is a mental and emotional state where the normal unitary experience of consciousness gets chopped up into disconnected parts.
So, a person who dissociates may not remember something very painful that happened to them because, through the process of dissociation, they were able to store that painful memory in a section of their mind that the rest of themselves doesn’t know how to find.
Feelings can also be dissociated or detached from the events that provoked them. So, a painful feeling associated with a traumatic memory might be detached from that memory such that the traumatized person remembers the event as though it happened in a movie, as though it happened to someone else, and they were just watching it unfold and were numb to the experience.
We’re all familiar with the idea that it is difficult to experience pain sensations. What people may not realize is that it is also painful not to feel anything.
Dissociated people who feel largely emotionally numb are often in great pain of a sort. Pain is caused by loneliness or feeling like you’re on the outside looking in. Some of them will self-injure to generate a strong sensation that is capable of bringing them back to feeling something again. There are variations on this theme. Not all numb, dissociated people will use physical pain to “return.” Some will use other strong sensations, such as drugs or sex, etc. But some use physical pain.
4. To Express/Communicate/Document Pain
Sometimes, people who self-harm are not skilled at using language to describe their inner experiences. This can be because they are not particularly good with words.
It can be because they never learned (for whatever reason) what words to use to describe emotion. It can be because what they experience inside their minds is overwhelming to them (due to trauma or abuse), and words can’t do justice. Particularly with regard to severe trauma and abuse, words fail to capture the magnitude of internal reactions.
In such cases where words are not available or are inadequate to contain emotional experience, the only thing left is to express it physically. This process of physical expression of inner experience is sometimes called “acting out.”
One rather impulsive and aggressive form of acting out involves inflicting wounds on yourself with the intention of using these physical wounds as a communication device.
People who self-injure as a means of communication may be doing it to draw attention to themselves, or they may simply be trying to document to themselves that their internal experience of pain is valid and worthy. Some people who have been abused or neglected may not take their own emotional pain seriously until it has been rendered as physical damage.
5. To Self-Punish
Some people who self-injure do so because they seek to punish themselves. Often, when this occurs, people who harm themselves with intent to self-punish are also people who have survived substantial abuse.
For some people, one of the lasting long-term effects of abuse is that the voice or perspective of the abuser gets implanted into the minds of the victims in such a way that the victim starts to judge themselves in the same way that the original abuser did and then starts to be motivated to punish themselves.
There’s nothing magical about how this abuse implantation process works. In any relationship, each partner builds a mental model of the other partner in their own mind and uses this model to predict what the other will do.
In the case of the abuser-victim relationship, the victim builds a model of the abuser. The abuser’s words become a rationale for the abuse. It’s not long before those words resonate in the victim’s head without them being said by the abuser. Then, they start attacking themselves in the absence of the abuser.
People who self injure do not walk around all the time judging themselves from the hostile value system that has been introduced into them. Most of the time, they are able to view the world from their own, more organic perspective.
However, there are times when they get overwhelmed, and that introjected perspective takes over, and then the need to self-punish as compensation for being such a bad person gets expressed. Sometimes, this need is expressed physically through actual self-injury.
6. To Experience Euphoria
The final reason I’m aware of that people who self-injure describe has to do with feelings of euphoria or at least pleasant feelings that some self-injurers report occur right after they have finished cutting or burning or otherwise damaging themselves.
I think it’s like what happens after you exercise vigorously—you get a “runner’s high,” a temporary feeling of bliss that occurs right after you’ve worked out. Only in this case, the feeling of bliss happens in the aftermath of damaging yourself.
Some self-injurers have described this feeling as having addictive qualities. They remember how good that feeling felt and become motivated to self-injure to recreate that feeling.
The Emotional Cycle of Self-Harm
A main facet of self-harm is that it often becomes a vicious cycle. According to the DSM-5, people can become dependent on the temporary relief they experience right after engaging in self-harm. It becomes the maladaptive coping mechanism that they turn to whenever they are distressed, demonstrating a lack of emotional regulation skills. People can get caught in the cycle of distress and relief or control even though it’s not a sustainable solution or a healthy way to cope.
And when they engage in self-harm, such as by cutting or burning themselves, they often experience profound feelings of shame and guilt that they want to relieve, creating a detrimental pattern of negative feelings, self-harm, guilt and shame, and repeated self-injury. This is why professional treatment is so essential—therapy and counseling can help people break this cycle and develop healthier coping strategies.
![\"\"](\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/optimized/8e1ee0ec187d4c3ff0be4ad3.jpg\")
![\"\"](\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/optimized/7713bcd5449515f7e5815374.webp\")