Self-Harm
Self-harm can take on many forms, all of which share the common element of intentionally causing physical harm to ourselves, usually over a period.
Despite the injury to ourselves and our bodies, the intent is usually not suicidal. Instead, it is an attempt to cope with significant difficulty or distress that we don’t know how to handle.
Turning Emotional Pain into Physical Pain
Self-harm is often intended to turn emotional pain- which we may not know how to handle, into physical pain that we can control. In self-injury, we have control over when the pain starts and when it stops.
It is a way to cope with emotions that are difficult for us to feel and also difficult to stop. These emotions and feelings can follow traumatic events, a feeling of loneliness or shame, or difficulty coping with challenging situations: social, emotional, academic, and more.
Self-Harm Can Feel Very Lonely
Self-injury is often accompanied by feelings of shame, guilt, and a desire to hide it. Self-harm provides a momentary relief, after which the need for self-injury or self-harm returns, leading to a recurring cycle. Generally, self-harm includes one or more of the following behaviors:
- Cutting the skin (especially on the hands)
- Scratching or rubbing the skin
- Self-stabbing (with a needle, pencil)
- Self-burning
- Pulling out hair
- Scratching and reopening wounds
- Self-hitting or banging the head against a wall or hard objects
- Engaging in risky behavior with others, such as fights or unsafe sexual activity
- Intentionally swallowing harmful substances
- Excessive physical activity and eating disorders
Prevalence of Self-Harm
Studies from the last decade indicate that the prevalence of self-harm among adolescents is around 20%, and among adults is about 5%.
Self-harm is more common in women than in men. The assumption is that when in distress, women tend to direct the difficulty inward, causing self-harm, while men are more likely to direct the difficulty outward, through violence and aggression toward others.
Why Do We Self-Harm?
Although self-harm hurts and injures the body, the goal is often not necessarily to cause damage, but to create instantaneous relief. It is an attempt to exchange the psychological pain, against which we feel helpless, for a physical pain that has a beginning and an end.
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Self-harm can provide relief from a deep emotional pain that we don’t always manage to identify, contain, or express in words. Self-harm can also be a distraction from feelings of emptiness, sadness, or anguish. The physical pain also manages to provide a feeling of presence and connection to reality.
Self-harm often involves an attempt to regain a sense of control when we are in great difficulty or distress, feeling helpless and not knowing how to cope.
The Difference Between Self-Harm and Suicidality
Even though self-harm injures and wounds the body, its purpose is usually not suicidal. Self-harm is an attempt to regulate and cope with difficulties and distress and to regain control over the pain we feel, by turning psychological pain into physical pain.
However, even though self-harm is generally not suicidal, there can be a connection between the two. Sometimes, self-harm is accompanied by suicidal thoughts, and self-harm can be a mechanism for coping with these thoughts and feelings.
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Therefore, it is very important not to dismiss or ignore self-harm behaviors, as in any case they point to significant distress and difficulty.
What Can I Do to Avoid Self-Harming?
There are several techniques you can use when there is a strong urge to self-harm. These techniques also create strong sensations, but do not cause injury or a lasting result like a wound.
Instead of self-harming, you can crush ice cubes in your hand until they melt, smell something with a very strong scent, take a cold bath or shower, and so on.
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These techniques allow you to replace the act of self-harm, which often leads to guilt, shame, and a need to hide it, with an alternative action. However, these replacement actions do not address the root of the need for self-harm, but allow you to get through moments of crisis in a way that will not leave scars for the future.
Self-harm is a response to great difficulty, distress, or pain. Therefore, it is advisable to address both stopping the self-harm itself and the reasons why it is happening. Give space and validation to the difficulty and find other ways to deal with it.
It is important to remember that the journey of each person is unique and different, and it is possible and worthwhile to find what can support and strengthen us.
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Self Help Tips
Breathing and Grounding
Deep breathing exercises, grounding, and meditation can help calm the body and mind and reduce the pressure that leads to the urge to self-harm. You can practice deep breathing (for example, inhaling for 4 seconds, holding for 4 seconds, and exhaling for 4 seconds). Grounding can also relieve tension, for example, by finding 5 green objects in your surroundings.
Distraction and Focusing on Other Activities
Sometimes the urge to self-harm is momentary; there is a peak moment of difficulty and pressure. Distraction through other activities can help you ride out the wave: writing, drawing, walking, playing computer games, or watching a movie. Talking to a friend or engaging in something you love can also help.
Sharing and Talking
Support from friends, family, or a professional: Sharing with a close person can provide a feeling of relief, understanding, and support. Talking to someone you trust can change the feeling of loneliness and offer you new solutions. You can also reach out to us, to ERAN Helplines.
Alternative Actions to Self-Harm
There are actions that can help us release the feeling of internal pressure without causing physical harm, such as:
- Drawing red lines on the skin instead of cutting and harming ourselves.
- Holding an ice cube in your hand.
- Using a rubber band on your wrist to feel the snap without causing injury.