Deliberate self-harm

Deliberate self-harm

Deliberate self-harm (also known as self-injury) is when you deliberately inflict physical harm on yourself, usually in secret and often without anyone else knowing. Some examples are cutting, burning, biting or hitting your body, pulling out hair or scratching and picking at sores on your skin. 

Deliberate self-harm is not necessarily a suicide attempt, and engaging in self-harm may not mean that someone wants to die. Most commonly, deliberate self-harm is a behaviour that is used to cope with difficult or painful feelings.

Why do people deliberately harm themselves?

People who deliberately harm themselves have often had tough experiences or difficult relationships in their lives. You may have:

• been bullied or discriminated against 
• lost someone close to you, such as a parent, brother, sister or friend
• broken up with a boyfriend or girlfriend 
• been physically or sexually abused 
• experienced a serious illness or disability that affects the way you feel about yourself
• experienced problems with family, school or peer groups.

Deliberate self-harm may be used as a way to cope with experiences and the strong feelings associated with it. Self-harm may:

• provide a way to express difficult or hidden feelings: it is not uncommon to feel numb or empty as a result of overwhelming feelings you may be experiencing, and engaging in deliberate self-harm may provide you with a temporary sense of feeling again or a way to express anger, sadness, grief or hurt
• be a way of communicating to people that you need some support: when you feel unable to use words or any other way to do so
• be a way of proving to yourself that you are not invisible
• provide you with a feeling of control: you might feel that self-harm is one way you can have a sense of control over your life, feelings, or body, especially if you feel as if other things in your life are out of control.

Deliberate self-harm can bring an immediate sense of relief, but it is only a temporary solution. It can also cause permanent scarring and damage to your body if you injure nerves. Psychologically, it may be associated with a sense of guilt, depression, low self-esteem or self-hatred along with a tendency to isolate yourself from others. 

Finding help

Although it may seem hard, it is important that you can reach out to someone who can help you to work through some of the reasons for harming yourself, and to find healthier, more positive alternatives for alleviating the pain you feel inside.  It may take time, but it is important to remember that you can move to a happier and healthier outlook.

Speaking to someone about your self-harm may be hard and it is particularly important to trust the person you are speaking with.

If you are having difficulty speaking about what you're going through, you might start with sentences such as 'Right now, I'm feeling...', 'I think it started when...', 'I've been feeling this for...', 'My sleep has been...', 'Lately school/work/college has been...'.

It may be necessary to talk to someone like a counsellor, psychologist, or psychiatrist to help you to work through some of the reasons why you are harming yourself and to find alternative strategies for alleviating the pain you feel inside. 

Like any relationship, building trust with your counsellor, psychologist or psychiatrist may take time and it is important you find someone you feel comfortable with. This may mean seeing several people before finding the one that you 'click' with.

If there is a family member you feel comfortable telling, it may be helpful for you to have their support in finding a counsellor that is right for you.

It's likely that the person you feel comfortable telling will already be worried about you and will be relieved at having the opportunity to listen and help.

If you don't get a positive response, try to remember that it is not because you have done something wrong, but because the person you have told may not know how to respond to what you have told them or may not understand much about deliberate self-harm.

Don't give up!

Either try again or maybe speak to someone else who you think you might receive a more supportive response from.

If talking about it with someone is too overwhelming, an alternative is to email or write down what you want to say. Otherwise, a first step might be to talk to the Samaritans (1850 60 90 90) - which is anonymous, and provides a 24 hour telephone listening service.

If you or a friend are harming yourselves, it is also important that you take care of the injuries caused, and if necessary, seek medical help through your GP or, if it's serious, a hospital's emergency department.

In most situations, doctors and other health professionals must keep information given to them by patients or clients confidential. However, they are required to report information they receive if they have serious concerns about your (or someone else's) safety. See the Confidentiality fact sheet for more information.

Coping without harming yourself

As well as support from a friend, family member and/or health professional, it may also be necessary to create a list of alternative strategies to self-harm for managing your emotions.

If you are feeling like you want to harm yourself there are a number of things that you might try to distract yourself with until the feelings become more manageable. If you can, make sure that you are around other people and remove any sharp objects from the area.

Some ideas for releasing energy or feelings

• Choose to put off harming yourself until you've spoken to someone else or waited for 15 minutes (and see if you can extend it for another 15 minutes beyond that, continue to do it again and so on until the feeling passes).
• Write in a journal - you might like to use an online journal.
• Exercise - Go for a run or walk in the park to use up excess energy.
• Play video games - this may be a good way to distract yourself and may help until the anxiety passes.
• Yell or sing at the top of your lungs, on your own or to music. You might do this into a pillow if you don't want other people in the house to hear. 
• Relaxation techniques - activities like yoga or meditation are often helpful in reducing anxiety. 
• Cry - crying is a healthy and normal way (not weak or stupid) to express your sadness or frustrations.
• Talk to someone - talk with a trusted friends or call a helpline like the Samaritans (1850 60 90 90).

Alternatives to deliberate self-harm

There are some more suggestions below that some people have tried in an emergency if none of the above suggestions have helped. However, these suggestions will not help in the long run as they keep you from addressing the thoughts and feelings that result in this self-harming behaviour. If you are finding that you are often using these suggestions below, or similar ones, please find help and talk with someone.

These suggestions are alternatives to self-harm but they are not a solution to the problem.

• punch a pillow or punching bag 
• squeeze ice cubes till your fingers go numb 
• eat a chilli, or something really hot 
• have a cold shower 
• put vapour rub or deep heat under your nose (it stings and makes you cry)
• wax your legs (or get them waxed)
• draw or write in red over your body (instead of cutting)

Take care of yourself

It is important to eat well, exercise and be kind to yourself. While not a solution in itself, doing all these things contribute to a higher sense of self-worth, increased stability of moods, and a generally better sense of wellbeing - making you feel more happy, on the outside and the inside.