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Self-Harm: Definition, Types, and How to Stop It

By Charlie Huntington, M.A., Ph.D. Candidate
​Reviewed by Tchiki Davis, M.A., Ph.D.
Learn the definition of self-harm, types of self-harming behaviors, and how to reduce self-harm in yourself and others.
Self-Harm: Definition, Types, and How to Stop It
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All human behaviors can be said to have a function, but this may be difficult for us to understand with certain behaviors, such as self-harm. Even though somewhere between 10 and 15 percent of teenagers and as many as one in three college students have engaged in self-harm, self-harm remains a stigmatized topic and behavior (Gratz, 2001; Hawton & Rodham, 2006; Whitlock et al., 2006). 
However, many of us will have a friend or family member who engages in self-harm at some point (Andriessen et al., 2017). People who are self-harming are generally experiencing a lot of emotional distress and may have a hard time discussing their behaviors with other people. Being aware of the facts about self-harm and how you can help will increase your chances of effectively supporting a loved one should they ever disclose that they are self-harming. This information can also be helpful if you are engaging in self-harm yourself. Read on to learn about the definition and types of self-harm, as well as what you can do about it.

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What Is Self-Harm? (A Definition)

Self-harm is the deliberate damaging of one’s own body tissue (Whitlock et al., 2008). It is important to note that when people self-harm, they may or may not want to die because of their actions. Accordingly, care providers and researchers alike often distinguish between what they call non-suicidal and suicidal self-injury. For our purposes, it is enough to know that any harm that we intentionally cause ourselves, which results in clear damage to the body, counts as self-harm.

Why Do People Self-Harm?

Much psychology research has been conducted to understand who is most likely to self-harm and why. Psychologists have chosen to divide motives for self-harm into internal motives, which are about dealing with one’s own state of mind, and external motives, which are about changing one’s environment (Chapman & Dixon-Gordon, 2007). Let’s look at some examples. 

Internal motives for self-harm​
A common “internal” reason for self-harming is to “self-medicate” intense emotions; in other words, for some people, self-harming is a coping mechanism, similar to drinking alcohol after a stressful day (Turner, 2002). Many people who have experienced traumatic events will self-harm to handle their dissociation or to deal with traumatic memories or flashbacks (Linehan, 1993). Another “internal” reason for self-harming is that punishing oneself can be a way of expressing negative feelings toward oneself (Zila & Kiselica, 2001). 

External motives for self-harm
External motives for self-harm usually focus on generating a desired response from the people in the person’s life (Kovacs et al., 1975). The self-harming person may want others to recognize their pain, feel pain themselves, or care for and help them (Crowe & Bunclark, 2000; Favazza, 1996). 

While external motives are a common reason for self-harming, it is important not to consider somebody’s actions simply a “cry for attention”. Anyone who is willing to inflict significant pain and damage to their body is experiencing real distress and should be taken seriously. It is important that they have ways of getting help other than harming themselves, but shaming them for self-harming will only make things worse.

Certain people are at greater risk, on average, of intentionally hurting themselves. People high in personality traits such as impulsivity and neuroticism are more likely to self-harm (Zlotnick et al., 1997), as are people who were abused or experienced traumatic events and people who experience more negative emotions (Fliege et al., 2009). I imagine this might make intuitive sense to you: people with difficult life experiences, who have fewer positive emotions, and who act because of their emotions are at greater risk of self-harming.
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Types of Self-Harm

The most common self-injurious behaviors include cutting or scratching, hitting, burning, or doing things to stop one’s wounds from healing (Nock & Favazza, 2009). Behaviors such as banging one’s head against a wall, hitting oneself with a fist, or pinching oneself to feel pain may also occur. All of these behaviors are consistent with the definition provided at the start of this article, which focused on behaviors that cause harm to bodily tissue. Given this definition, behaviors such as eating too little or too much, or subjecting oneself to sleep deprivation, although often harmful, are not considered self-harm.
​

Some research suggests that girls and women engage in self-harming behaviors more frequently and are more likely to cut or scratch themselves, while boys are more likely to hit themselves and to self-harm less often (Whitlock et al., 2006). Self-harming behaviors occur more often among teenagers than among adults (Nock & Favazza, 2009).

Self-Harm: Cutting

Self-harm cutting typically consists of using a sharpened edge to cut the skin. Instruments used to cut include scissors, razor blades, and knives, and commonly targeted body parts include the forearms, wrists, stomach, and thighs. A less common form of cutting is intentionally piercing body parts. People may also pick at their skin or at scabs on their bodies.

Self-Harm: Burning

People who self-harm by burning typically burn their skin with a lighter. However, some people may touch hot surfaces, such as fireplaces or stovetops.

​Self-Harm Scars

Self-harm often results in scars that remain visible on the skin. Some people who have self-harmed do not want other people to notice or ask about these scars and may hide them (Turner, 2002). Some people have medical procedures to remove or minimize the appearance of their scars, while others say that keeping their scars is meaningful and gives them valuable perspective.
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Self-Harm in Movies and TV

Perhaps you are aware of recent popular media, such as the TV shows 13 Reasons Why and Euphoria, that have depicted self-injury and suicide attempts. Approximately one in four teenagers has seen self-harm in movies or on TV (Mars et al., 2015), which may put them at risk of “suicide contagion”, the phenomenon wherein a person becomes more likely to think about or engage in self-injury when they know a friend has done it or they see it in the media (Jarvi et al., 2013). 

Unfortunately, this seems to have happened with 13 Reasons Why – there were more self-harming behaviors and more Internet searches related to suicide after the show came out (Ayers et al., 2017; Niederkrotenhaler et al., 2019). In general, people are more likely to think about killing themselves, hurt themselves, or attempt suicide when they are exposed to media content discussing or showing self-harm (Kirtley et al., 2021; McMahon et al., 2013; Muehlenkamp et al., 2008). If you are a parent, I encourage you to carefully review the content of the media your children watch. As an adult, too, if you have self-harmed before or considered it, you may want to avoid media that includes this kind of content.

How to Stop Self Harm

If you or somebody you know is repeatedly hurting themselves, getting support from a therapist or other medical professional should be the top priority. While I will discuss ways that you can help yourself or somebody else stay safe, please remember that the most responsible thing to do when self-harm is occurring is to connect the person in danger to a trained professional. Somebody with an active plan and strong intention to hurt themselves, particularly in a way that could result in their death, should be brought to the attention of emergency medical services as soon as possible.

So, with the emphatic disclaimer that risk for self-harm should always be assessed by a medical professional whenever possible, here are some things you can do to help somebody who is self-harming:
​
  • Check in about how they’re feeling right now. Do your best to listen without trying to fix anything. Gently try to find out when the last time was that they wanted to or actually hurt themselves. See if they are willing to tell you how strong their intention is to hurt themselves right now, if they have a plan for how to do it, and if they have the ability to make that plan happen right now. 
  • If they are very motivated to hurt themselves – they have a plan and intend to do it now, or soon – have somebody stay with them and call emergency services. The goal is to keep the person safe until professionals who can ensure their longer-term safety are present to take care of them. Although it is good if the person wants the help of medical professionals, you can do them a great favor by making sure they get that help if they are this distressed. (And if you are a mandatory reporter because of your professional or volunteer work, know that you are obligated to make sure that person gets help.)
  • Offer to help them get resources or other help. Make sure they know it’s their decision, and you just want to support them in following through on whatever they decide. Resources might look like the phone number to a hotline (1-800-273-8255), contact information for a therapist or psychiatrist, or anything else the person in distress believes would help them want to hurt themselves less.
  • Remove access to objects the person might use to hurt themselves. Ask a loved one of the person in danger to hold on to their medication, put knives and razors in a locked drawer, or take their lighters away.
  • Show your love. Tell the person why you care about them. Don’t use it as a reason to compel them to give up the idea of hurting themselves. Just make it clear that you care for them, want the best for them, and will keep supporting them and working to make sure they are safe.
  • Offer a safe alternative. Given self-harm is often used as a coping strategy, guiding the person to engage in other healthy coping strategies can be helpful. You might engage in physical activity with them—tennis, swimming, walking, etc…—or do some arts and crafts to help them reduce their emotions without engaging in self-harm.

For a summary of self-harming behaviors and more examples of how you can help somebody else, please watch the video below.

Video: Cutting & Self-Harm

More Tips To Stop Self-Harm

You might be wondering what somebody who is hurting themselves – whether that’s you or somebody you know – can do to resist the urge to self-harm. In a research study that focused on exactly this question, individuals with a history of self-harm reported how often they used any of several dozen coping behaviors (Klonsky & Glenn, 2008).

Participants in this study said that they most often used activities such as “keeping busy”, “being around friends”, and “talking to someone” about their feelings. By contrast, the options they thought were most helpful were activities such as “doing sports” or exercising, “finding someone who is understanding”, and removing access to the things they can self-harm with.

I think it is useful to reflect on how the coping methods people find most effective and use the most (1) involve other people and (2) often take them outside of their home. The negative feelings that often trigger the desire to self-harm, such as ​fear, anxiety, and sadness, are hardest to shake when we are alone. Somebody who is thinking about self-harming may be best served by getting out of situations that involve isolation.

Klonsky and Glenn (2008)’s study had another positive finding: nearly everybody in the study used many coping methods, and they were able to resist the urge to self-harm most of the time. So whether it is you that is self-harming or somebody that you know, remember that the person in question probably knows some effective ways to cope with those urges. Even if it is hard to remember those options in the moment, or it seems like they won’t help, try to keep in mind that they have helped before.
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Articles Related to Self-Harm

Want to learn more? Here are some related articles that might be helpful.
  • Guilt: Definition, Types, & Differences Versus Shame
  • Shame: Definition, Causes, and Tips
  • Self-Loathing: Definition, Signs, & How to Stop
  • ​Emotional Dysregulation: Definition, Examples, And Tips​​​

Books Related to Self-Harm

To keep learning, here are some books to explore:​​
  • ​The DBT Skills Workbook for Teen Self-Harm: Practical Tools to Help You Manage Emotions and Overcome Self-Harming Behaviors 
  • The Mindfulness Workbook for Teen Self-Harm: Skills to Help You Overcome Cutting and Self-Harming Behaviors, Thoughts, and Feelings​
  • ReWrite: The Journey from Self-Harm to Healing
  • Treating Suicidal Clients & Self-Harm Behaviors: Assessments, Worksheets & Guides for Interventions and Long-Term Care
  • ​Freedom from Self-harm: Overcoming Self-Injury with Skills from DBT and Other Treatments

Final Thoughts on Self-Harm

In this article, I have mainly discussed addressing self-harm, not suicidal thoughts or behaviors. However, even if you know that an individual doesn’t intend to kill themselves at this time, be aware that many people hurt themselves because they would like to die (Klonsky et al., 2013), and also that some people start out self-harming for other reasons, but become suicidal later (Bryan & Bryan, 2014). In other words, if a person is engaging in self-harm, be aware that they may become suicidal in time and take their behaviors seriously (Kapur et al., 2013).

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References

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  • Ayers, J. W., Althouse, B. M., Leas, E. C., Dredze, M., Allem, J. P. (2017). Internet searches for suicide following the release of 13 Reasons Why. JAMA Internal Medicine, 177(10), 1527-1529.
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