Often starting as an impulse to cope with feelings of sadness, anxiety, or anger, cutting and other forms of self-harm behavior are used to feel better. Pulling hair and hitting the body as well as biting, carving, picking, and burning skin may be performed for a variety of reasons. For example, individuals may associate self-harm behavior with feeling more alive and less numb while others may engage in such acts for self-punishment or to attain a sense of control over a devastating life event (e.g., death, trauma). In order to reduce self-harm behavior among children, students, athletes, friends, colleagues, or patients, it is important to learn how to identify, respond, and share positive coping strategies.
What to Look For: 4 Warning Signs of People Who Self-Harm:
- Keeping razors, knives, or scissors in unusual places (e.g., backpack, under the bed, drawers)
- Wearing long-sleeved and baggy clothing to cover skin and wounds
- Having fresh cuts on the wrists, stomach, arms, or legs—especially when excuses are made and defenses are high
- Isolating and spending more time in the bathroom or bedroom
- Don’t panic! Stabilize your emotions and feelings before starting a dialogue
- Hit your pause button and brainstorm what you want to say
- Do be gentle and express care; lock-up dangerous and unsafe items; discuss alternative behaviors; do seek professional help and assistance; be direct and concise; consistently check-in with how the individual is feeling
- Do not judge, punish, discipline, or berate the individual; do not expect the behavior to change over night; do not push too hard or too fast!
- Examples: “I am concerned because I see cuts on your arm.” “Can you help me understand or talk to me about what you are feeling in this moment?” “This may be difficult and uncomfortable, but I’ve noticed you spending more time in the bathroom. How can I help support you?” “Were you trying to hurt yourself to feel better or trying to kill yourself?”
What to Do: 10 Strategies For Combatting Self-Harm Impulses
- Replace the destructive behavior with a non-harmful behavior that also strongly activates senses (e.g., holding an ice cube in your palm)
- Squeeze a rubber ball until the urge diminishes or pop a rubber band
- Talk to friends, family members, or other people you trust about your feelings
- Call 1-800-DON’T-CUT or 1-800-273-TALK, both 24/7 hotlines for self-injury
- Use distractions and behaviors incompatible with self-harm, such as drawing, writing, exercising, playing an instrument, or singing
- Practice yoga, meditation, or deep breathing to re-connect with your body
- Create a safety plan
- Avoid triggers that increase impulsive behaviors (e.g., alcohol)
- Join a local support group where feelings can be discussed in a safe space
- Seek counseling, where insight is gained and healthier strategies addressed
Remember, self-harm behavior is a symptom and secondary to a core problem. Often self-harm (75%) is not linked or associated with suicide and wanting to die. It is more about feeling better and gaining control over an emotional crisis. It focuses on temporary relief and often does not require medical intervention or involve alcohol, unlike suicide. Early intervention is crucial so that it doesn’t eventually escalate, leading to suicide behavior or accidental death.