Self-harm can be a confronting notion to face and hear about and can be misunderstood. Self-harm can be a repeatedly occurring behaviour or a one off act that impacts the individual who is self-harming but also the family, friends and people close to the individual. It can be used to help cope with emotional turmoil and pain or distress and even be used as an alternative to suicide by achieving temporary relief from distress.

What is it non suicidal self-harm?

Non suicidal self-harm is the deliberate and direct physical harm to one’s own body without the intention of suicide.

Non suicidal self-harm can take many forms including: cutting, burning, overdosing, use of alcohol or drugs, piercing, restrictive or overeating, scratching, reckless behaviour, tattooing, biting, slapping or punching and more. As confronting as self-harming measures may seem, the underlying notions of self-harm are to achieve relief from overbearing distress and emotional pain.

Who is most likely to engage in self-harm?

Studies have shown that self-harm is more common in females than males and numerous risk factors for self-harm exist. Risk factors include

• Someone who has an existing or a history of mental illness

• Someone who has eating disorders

• Someone who is engaging in substance use

• Someone who has a history of physical and or sexual abuse

• Someone who is experiencing family dysfunction

• Someone who is experiencing hopelessness

Myths about self-harm

“You have to be mentally ill to self-harm”

While being mentally ill is a risk factor for self-harming, someone doesn’t have to have a mental disorder in order to self-harm.

“Self-harming is attention seeking, they just want attention”

While self-harm can be a way of seeking help it is certainly not just a way of attention seeking. In fact, self-harm is commonly hidden from view of other people (such as family or friends) in attempt to hide the behaviour, consequences and pain of what’s going on for a person.

“If someone is self-harming they will definitely act on suicide”

While self-harm has been correlated with suicide, it is not a definite indication that someone will act on suicide. In fact, self-harming can often be an alternative to suicide in which people might engage in to avoid death.

10 reasons why people self-harm?

Research has shown that self-harm can occur co-morbidly with mental disorders such as Depression and other mood disorders, anxiety disorders, substance use disorders, and eating disorders.

There are many different reasons why a person might engage in self-harm including:

1. Release from pain and tension

2. Attempt to communicate

3. Enhance defectiveness/unattractiveness

4. Anger and frustration

5. Cognitive restriction

6. Punishment (to both self and others)

7. To feel something (emotionally and physically)

8. Control

9. Avoidance

10. Psychotic beliefs and orders

How to manage self-harm

There are a few ways to manage self-harm including Inpatient hospital admissions, psychological interventions (Dialectical behaviour therapy [DBT], Cognitive behavioural therapy [CBT] and family interventions) and medication together with psychological interventions.

The goal of psychological interventions is to address the self-harm risk factors which may be modified, build resilience, address and target the functions of the self-harm and treat any co-existing and contributing mental illness.

Among other therapies, DBT mindfulness skills teach individuals to adjust the way they manage their self-harm. It teaches people how to be mindful in order to simply observe their thoughts and emotions rather than acting on them in a harmful way. Examples of DBT mindfulness include going for a walk, listening to music, colouring a mandala, doing a body scan and breathing awareness.

How can I stop or resist the urge to self-harm?

There are so many alternatives to self-harm including:

• Exercise (e.g. walking, running, swimming, boxing, punching pillows)

• Use freezing cold water or ice on your wrists, in your hands or on your neck (the ice can cause pain but won’t cause any damage)

• Use red washable skin safe markers to draw “cuts” on your skin

• Clean a space or your home

• Cook something

• Try not to be alone (reach out to a friend or go to the shops)

• Watch a movie

• Listen to music

• Write in a journal

• Massage the area of your body that you want to harm with massage oil or creams and remind yourself that your body deserves love, care and respect

• Wear a rubber band on your wrist and snap it (this will cause pain but will not cause damage)

• Tear up pieces of paper, cloth or blu tac.

Final words

It can be hard to reach out or even know what to do to seek help. But there are a number of avenues that you can take to reach out and talk to someone about how you’re feeling. This might be a friend, family member, therapist, trusted teacher or colleague, or emergency services (000, Lifeline, Headspace or Kids Helpline).

And most importantly, when seeking help for self-harm, you should be treated with respect and without judgement.