Self-Harm

Self-harm, also known as non-suicidal self-injury (NSSI), is when someone intentionally hurts their body, like cutting, scratching, burning, or hitting, often without wanting to end their life. It’s most common in teenagers and young adults aged 12 to 24, with females generally engaging in it more often than males. While self-harm isn’t usually meant to be suicidal, it can lead to serious medical issues and does increase the risk of suicide.

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Causes of Self-Harm

Despite the common belief that self-harm is an attention-seeking behaviour, this is usually an inaccurate or insufficient explanation. Most people who self-harm are actually very self-conscious about their wounds and scars and may try to conceal them with clothing.

Self-harm may be used to fulfil a number of different functions, including:

  • To manage negative emotions such as anger, depressed mood, anxiety, etc.
  • To end periods of dissociation or depersonalisation
  • To avoid suicide
  • To communicate a need for help and support
  • To deal with poor body image, low-self-esteem or self-hatred
  • To punish themselves for something they’ve done
  • To get a feeling of ‘high’ (versus emotional numbness)
  • To feel more in control

Self-harm has been associated with other psychological problems, such as depression, anxiety disorders, post-traumatic stress disorder, eating disorders, personality disorders (especially borderline personality disorder), a history of physical, emotional or sexual abuse, substance abuse, and interaction problems with peers and family.

Although the motivations to self-harm can be varied, individuals who self-harm appear to have one or more of the following in common:

  • A tendency to use avoidant strategies to cope with problems
  • Difficulties tolerating strong emotions
  • Problems with regulating and manage emotions

Experts believe that self-harm is a response for managing intense aversive emotions and this represents a dysfunctional emotion regulation strategy.

Treatment for Self-Harm
Given that emotion dysregulation is believed to be the primary mechanism behind self-harm, psychological treatments such as Dialectical Behaviour Therapy (DBT) have focused on improving emotion regulation in individuals who self-harm.

Emotion regulation involves:

  • An awareness, understanding and acceptance of one’s emotions
  • The ability to inhibit impulsive behaviours (such as self-harm, reckless behaviours or physical aggression) and to engage in goal-directed behaviours (e.g. attend classes, go to work, engage in social relationships) when distressed
  • Use of appropriate strategies to manage the intensity and/or duration of emotional responses
  • Willingness to experience negative emotions as part of pursuing meaningful activities in life

In addition to emotion regulation skills, DBT also teaches mindfulness, distress tolerance skills and interpersonal effectiveness skills. The efficacy of DBT with individuals who self-harm is now well-established.

It is important to note that some injuries resulting from self-harm may require immediate medical attention, and presentation to the Emergency Department may be necessary.

If you are concerned that you may seriously harm yourself it is recommended that you call Lifeline on 13 11 14, speak to another responsible adult, or take yourself to the Emergency Department at your nearest hospital, rather than wait for an appointment.

Our Psychologists are highly qualified with Masters or Doctorate degrees in Clinical Psychology. They
use Cognitive Behaviour Therapy (CBT), the gold standard for many psychological issues, along with
other evidence-based treatments like Mindfulness and Dialectical Behaviour Therapy (DBT).