Understanding Self Harm

Realising that your friend, child or partner is self-harming can come as a great shock. Common questions we are asked as treating professionals involve: Why are they hurting themselves? Are they just doing this for attention? Do they want to die? Why didn’t I know sooner? This article is written to support more understanding around self-harm behaviour and how you may be able to help a loved one who self-harms.

Self-harm (or self-injury) is a term to mean any behaviour that deliberately causes physical pain or injury. Self-harming behaviours usually indicate a personal difficulty in coping with painful emotions, memories and thoughts, or as a way of communicating distress to others. Someone who is so numbed by depression that they feel nothing might cut themselves to feel something, even if it’s pain.

The physical pain of self-harm provides short-term relief from difficult or distressing thoughts and emotions. It does not resolve them however and can become a compulsive, dangerous activity. While self-harming behaviours typically commence in adolescence, we also see instances in adult (18+ years), and child (under 12 years) age groups.

Types of self-harming behaviour may include cutting, burning or hitting, binge-eating, starvation, or the abuse of drugs, alcohol, prescription medications or other toxins (i.e. household cleaning products, excessive intake of over-the-counter medication, etc.). Reckless behaviours such as erratic driving or sexual promiscuity are also signs of self-injurious activity.

Self-harming behaviours are habitual and may cause serious injury over time. There is usually no intent to end one’s life, however, hospitalisations are common with longer-term self-harming behaviour. That said, if the presence of suicidal ideation (thinking about death or dying) is evident alongside self-harming behaviour, this is a significant risk factor and you should strongly encourage your loved one to seek immediate support from a health professional.

Individual reasons for self-harming behaviour are varied. Generally, they reflect a short or long-term response to mental health issues (i.e. depression, stress, anxiety), social isolation or loneliness, low self-esteem, anger and frustration, grief, family difficulties, or traumatic life experiences (i.e. sustained bullying, emotional, physical or sexual abuse).

Because the behaviour is often hidden, the signs may not be obvious. If you find out a loved one is self-harming, they may want you to maintain the secrecy of their actions or feel ashamed about their behaviour. It is important to ask about the reasons why they are self-harming and listen without judgement. It is best to support them to connect with a GP or Psychologist who is able to help them recognise why they are doing it and to learn new skills and behaviours for managing their compulsion to self-harm.

Remember, it is very important to look after yourself and ensure that you don’t get stuck in trying to counsel someone who self-harms if you don’t feel you have the right skills or training. You are not responsible for someone else self-harming you can only do your best to encourage them to get help.

Written by Kasia Gordon (Psychologist) of Cause Effect Psychology

References:
• Auseinet. (2007). Australian Self-harm Statistics: Key Findings. Adelaide, SA: Australian Network for Promotion, Prevention and Early Intervention for Mental Health.
• Farrand, J., & Solomon, Y. (1996). ‘Why don’t you do it properly? Young women who self-injure. Journal of Adolescence, Vol. 19(2), pp. 111-119.
• Hodgson, S. (2004). Cutting through the silence: A sociological construction of self-injury. Sociological Inquiry, 74(2), 162-179.
• Martin, G., Swannell, S., Harrison, J., Hazell, P., & Taylor, A. (2010). The Australian National Epidemiological Study of Self-Injury (ANESSI). Brisbane, QLD: Centre for Suicide Prevention Studies. Accessed November 23, 2012 from
• Muehlenkamp, J. J. (2005). Self-injurious behaviour as a separate clinical syndrome. American Journal Orthopsychiatry, Vol. 75, pp. 324-333.

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