Self-Harm is the act of intentionally damaging or injuring one’s body. People who self-harm sometimes have low self-esteem or depression. The behaviour can be an attempt to manage difficult emotions, memories or experiences when these become overwhelming. It can be an expression of pain or a need for help.

Causes of self-harm

Social Factors and trauma

• Difficult relationships with friends or partners 
• Difficulties with academic or work performance 
• Being a victim of bullying at school or at home 
• Financial struggles 
• Coming to terms with your sexuality 
• Coping with cultural expectation 
• Experiencing or experienced sexual, physical or emotional abuse 
• Loss of a close family member or friend
• Having a miscarriage

Emotional distress

Self-harm can be a way of releasing these bottled up feelings

• Low self-esteem 
• Self-hatred 
• Anger
• Guilt
• Loneliness
• Numbness or emptiness 

Psychological causes

• You may hear voices telling you to self-harm 
• You may have repeated, intrusive thoughts to self-harm and you may feel compelled to do so.
• You may disassociate and self-harm without realising 
• It can be a symptom of borderline personality disorder 

Behaviours

There is a wide range of behaviours that constitute self-harm. Here are a few: 

1. Cutting the skin
2. Burning the skin
3. Punching your own body 
4. Poisoning yourself with tablets 
5. Misusing alcohol or drugs 
6. Eating disorders 

People who self-harm experience a great deal of shame, guilt or fear over their actions being discovered. They may also feel confused or worried about their own behaviour. Hence they will tend to injure themselves in places that can be easily hidden by clothing. When approaching someone about self-harm, it is important to approach them in a caring and understanding manner. 

Signs to look out for

Here are some signs of self-harm to take note of 

• Unexplained cuts, bruises or cigarette burns. Usually, on their wrists, arms thighs and chest 
• Keeping themselves fully covered at all times even in hot weather
• Showing signs of depression like low mood, tearfulness or a lack of motivation or interest in anything. 
• Changes in eating habits or being secretive about eating
• Unusual weight gain or loss
• Signs of low self-esteem like blaming themselves for problems or doubting their capabilities. 
• Signs of pulling out their hair 
• Signs of alcohol or drug misuse. 

Treatment

If you are self-harming, it is important for you to seek professional help. In treatment, you will be asked about factors that contribute to your self-harming, and your current mood will be assessed specifically if you are feeling hopeless or considering suicide. Your clinician will work with you to create a safety plan and discuss alternative coping strategies to help reduce self-harm. DBT is an evidence-based therapy that can help. Find out more about Sheyla Hardy or Dr Ronina Stevens who are experienced in working in this area