Self Harm: the Ultimate Guide

08 Apr 2015

Self-harm is unfortunately, rather common amongst teens and adults alike. It is usually used as a coping mechanism or as a means of communicating anxiety and distress and is not necessarily linked to suicide or suicidal thoughts. In this guide, we look at how self harm can manifest, why people do it, how to understand your own emotions, how to recognize if somebody is self harming, how you can help them and then finally – our top safe alternatives to self harm.

If you are having suicidal thoughts/considering suicide please seek help immediately: There are a number of helplines that you can contact 24-7/365.
In the UK, call the Samaritans on 116 123.
In the USA, call the National Suicide Prevention Lifeline on 1-800-273-TALK (8255)

What Is It?

Self-harm is when a person abuses or injures themself on purpose. It is usually a way of coping with or expressing, overwhelming anxiety and emotional distress.

Self-harm can manifest in various ways, including:

  • Cutting, picking or burning the skin
  • Banging or scratching the body
  • Pulling out hair
  • Misusing prescribed or ‘over-the counter’ medications
  • Abusing alcohol and/or illegal drugs
  • Eating disorders such as anorexia, binge eating and bulimia.

Self-harm is not recognized as an illness in itself, but it is often a sign of another mental health problem such as depression and anxiety.

Why Do People Self Harm?

Although sometimes misunderstood as attention seeking, those who self-harm usually do so as a way to cope with deep emotions, distress or traumatic experiences. It can sometimes be a way to try and show how they are feeling; a ‘cry for help’ if they are unable to voice this. It can be a way to relieve unbearable tension, take control of their life and to handle scary emotions, moods and feelings.

Another misconception is that it is an attempt to end their life. Whilst it is true that people who self-harm are at a high risk of taking their lives, it is more commonly recognized as a coping strategy; a way of stopping this from happening.

People who self-harm may feel self-hatred and have very low self esteem. They may also feel sad, anxious, angry, lonely, guilty, numb, disconnected, empty, hopeless, unworthy or trapped. Sometimes the act of self-harming temporarily provides a respite and relief from these feelings.

Bullying is a major cause of self-harming, with other causes including:

  • Worrying about school and college work
  • Difficult relationships with friends or family
  • Money worries
  • Issues around coming to terms with sexuality
  • Alcohol or drug misuse
  • Living up to cultural expectations
  • Traumatic experiences such as sexual, physical or emotional abuse
  • Bereavement or miscarriage.

Sometimes psychological illness can be the cause of self-harm such as hearing voices telling them to do it, repeated negative thoughts urging them to self-harm or a symptom of a personality disorder which causes instability in thought processes.

How To Understand Your Emotions

Sometimes it can be incredibly difficult to figure out how we are feeling and the route behind those emotions. A good starting point could be:

  • Write down every single thing that is troubling you and then go through each individual point and see if there are any ways in which you could improve that situation.
  • Write a letter to somebody that has upset you, explaining how they have made you feel and how you would like to see things change. It may not be possible, or even necessary to post it as just writing it can be a very helpful process.
  • Make a list of all the good things in your life; your achievements and of all the things that you do well. The people that you love and care about.
  • Allow yourself to process your emotions; to be upset, be angry and cry. This is perfectly normal and healthy
  • Talk everything through with someone that you trust about how you are feeling. This can be incredibly helpful in gaining insight and perspective on situations.

How To Know If Someone Is Self-Harming

Those who self-harm will usually try and hide it from others, so it can be difficult for friends and family to know it is happening and to help. It is important to be aware of some common signs if you suspect that someone you know is self-harming. Look out for: Cuts, bruises, scratches or burns on wrists, arms, thighs or chest

  • Keeping fully covered up, even in hot weather
  • Low moods, sadness, lack of interest or motivation, sudden tearfulness
  • Being withdrawn and not ‘joining in’ or speaking to others
  • Significant weight loss, weight gain, a change in, or being secretive about eating habits
  • Low-esteem and confidence such as blaming themselves for anything that goes wrong, or saying that they are not good enough
  • Hair being pulled out
  • Drug or alcohol abuse

How to help someone who Is Self-Harming

  • It is essential that you approach them in a caring and understanding way and remember that self-harming is a sign of emotional distress. It is likely that the person feels deep shame and guilt about being ‘found out’ and they themselves may not fully understand why they are doing it.
  • Make time to listen and be sympathetic to what they say. Do not judge them or offer criticism. Try hard to understand how difficult they are finding life.
  • Never react in a negative way or get angry – this will only serve to make the problem worse
  • It is important to be aware that they may not want to discuss it with you and the reasons why they are self-harming, but do suggest they seek professional help. In the first instance urge them to make an appointment with their GP who can offer referrals to counsellors or mental health professionals.
  • Alternatively they may initially feel more comfortable approaching an anonymous helpline such as the Samaritans on 116 123
  • Do seek urgent medical help if their injuries are serious

Top Alternatives to self-harm

Self-harm can be an incredibly dangerous way of dealing with things so we always advise that you speak up about how you are feeling with a trusted adult. Whilst seeking support, you may still get urges to self-harm and there are several alternatives that are safe that you could try.

  • Squeeze ice in your hands really hard
  • Scream as loudly as you can (into a pillow or cushion if you don’t want to be heard)
  • Punch a pillow, cushion or a punch bag
  • Throw a cushion as hard as you can against a wall as often as you need to
  • Squeeze a stress ball
  • Exercise; especially activities where you exert upper body strength like boxing and swimming
  • Tear up an old phone directory, catalogue or magazine
  • Play loud music and dance as energetically as you can (use earphones if you don’t want to be heard)
  • Use a marker pen to draw or write words on the place where you want to cut
  • Go for a bike ride or long walk
  • Write down exactly how you are feeling in a diary

Look after and be kind to yourself; it doesn’t have to be something active. You could try meditation, aromatherapy oils or bath products, paint your nails, massage your hands or feet, watch a film and eat some chocolate. Play with and cuddle a pet. Check out this article for more ways to cope with urges to self-harm.

Getting Further Support

We have a ton of support available here or join our community to talk to a digital mentor who can help you without judgment.

If you are feeling suicidal or are in a potentially dangerous situation, we strongly advise you either speak to an adult or call 999.

In the UK, call the Samaritans on 116 123, they are there 24 hours a day, every day. If you are in the USA call The NSPL on 1-800-273-TALK (8255)

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