What it is:
Self-harm (also known as non-suicidal self-injury (NSSI) is a broad term that includes any behavior that intentionally causes damage to the body. Common self-harm behaviors include cutting, burning, and head-banging. Self-harm behaviors can range in severity from scratching or pinching to cutting or burning that requires medical attention (e.g., stitches or wound care).
Though harm to self is also the goal of a suicide attempt, non-suicidal self-injury (NSSI) is self-injury without the intent to die. Adults engage in non-suicidal self-injury for a variety of reasons, including to regulate their emotions, as self-punishment, to distract themselves from painful feelings, to communicate the severity of their pain to others, or to feel pain in order to reduce feelings of numbness or detachment.
Self-harm is not a diagnosis, but rather a coping strategy for other concerns or diagnoses. It was originally most linked to emotion dysregulation and borderline personality disorder (BPD). However, it is also reported in adults that struggle with depression, anxiety, shame, or trauma and PTSD. Rates of self-harm are also higher in people diagnosed with autism (though it is important to distinguish between self-harm and stimming behaviors, which may require a careful assessment).
Though self-harm typically provides some relief in the short-term, it tends to cause more problems in the long-term. These problems can include needing hospitalization or medical care, creating distress in relationships, or needing to engage in more and more intense self-harm to get the same effects. Some people will even describe self-harm as starting to feel addictive or compulsive. Self-harm also tends to exacerbate experiences of self-hatred and shame.
One of the biggest problems with self-harm is that engaging in it often results in individuals not learning other ways to regulate their emotions. Treatment for self-harm often involves learning alternative strategies to regulate emotions that are less likely to cause problems with relationships, intensify self-hatred, or cause long-term physical damage.
Does This Sound Familiar?
Self-injury is a very individualized behavior and therefore the experiences of it range widely. However you might identify with one or more of the below:
- When I feel extremely upset or overwhelmed, hurting myself is the only thing that calms me down.
- Self-harm is the only way to get other people to take me seriously or stop stressing me out.
- I self-injure because I deserve to be punished.
- My self-harm scars are physical proof of how bad things are or how much pain I am in.
- I am always alert for things that I can use to hurt myself later.
- There is something about seeing my own blood that makes me feel better.
Associated Concerns:
- Suicidality and self-injury often co-occur with anxiety and stress, PTSD, emotion dysregulation, emotional avoidance, Borderline Personality Disorder, depression, autism.
- When individuals have trouble coping with these symptoms, they may also develop difficulties with substance abuse or anger management.
Specialty Services at TAP:
Below are a list of empirically supported assessments or therapies that one or more of our specialists could provide. Click on an intervention to learn more!