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What is self harm?

Self harm can take many different forms and as an individual act is hard to define. However in general self harm (also known as self injury or self mutilation) is the act of deliberately causing harm to oneself either by causing a physical injury, by putting oneself in dangerous situations and/or self neglect.

The National Institute for Clinical Excellence describes self harm as
"Intentional self poisoning or injury, irrespective of the apparent purpose of the act "
NICE 2004
Some forms that self harm can take include:
  • Cutting, burning, biting
  • Substance abuse
  • Head banging and hitting
  • Taking personal risks
  • Picking and scratching
  • Neglecting oneself
  • Pulling out hair
  • Eating disorders
  • Over dosing and self-poisoning
There is no '€˜typical' person who self harms. It can be anyone. An individual who self harms can not and should not be stereotyped; they can be of all ages, any sex, sexuality or ethnicity and of different employment status etc.
The UK has one of the highest rates of self harm in Europe at 400 per 100,000 population
Horrocks, J. Self Poisoning and Self Injury in Adults, Clinical Medicine, 2 (6), 509-512 (2002)
Cited in Samaritans information sheet, Self Harm and Suicide March 2005

Each individuals relationship with self harm is complex and will differ. There can be many reasons behind self harm such as childhood abuse, sexual assault, bullying, stress, low self esteem, family breakdown, dysfunctional relationships, mental ill health and financial worries.

Self harm is primarily a coping strategy and can provide a release from emotional distress and enable an individual to regain feelings of control. Self harm can be a form of self punishment for feelings of guilt. It can also be a way to physically express feelings and emotions when individuals struggle to communicate with others. It is therefore important that individuals that self harm are able to express these feelings, thoughts and emotions in other ways whenever possible. It can be difficult to share the reasons behind the self harm with others and to gain the help and support that may be needed.

In the majority of cases self harm is a very private act and individuals can go to great lengths to hide scars and bruises and will often try to address physical injuries themselves rather than seek medical treatment. Whilst some individuals who self harm may have suicidal feelings, those feelings are likely to originate from the experiences and traumas behind their self harm rather than being influenced by self harm itself.

Below are some actual quotes from individuals who self harm about how they feel self harm helps them at the time. It is not uncommon for self harm to be followed by feelings of guilt and shame which can often perpetuate a vicious cycle.
A release of tension, frustration and distress:

"I think it’s somewhat of a release when you do it, you know you've not really dealt with your feelings properly but you have dealt with them in a way that's possibly the only way you can see at the time."
To feel and regain control:

"When things were happening to me that I had no control over I started hurting myself, this was something that I could control, I could do as much or as little damage as I wanted, it only involved myself and I could care for the wound after."
To punish:

"I would say there is a definite punishment element involved in my self harm, a feeling that I have to take things out on myself, to drive the bad feelings away, punish myself for what I let happen to me, and to get the badness out."
To feel, to ground oneself:

"When I feel numb or go to the place where I disconnect from reality I need to feel pain to bring me back to the here and now, nothing else will ground me. The pain makes me realise that I am really here."
A way to express:

"It's a way of expressing negative feelings about myself that build up inside me. As someone who finds it difficult to put things into words, it can at times be the only way of expressing how I am feeling."
"When things were happening to me that I had no control over I started hurting myself, this was something I could control, I could do as much or as little damage as I wanted, it only involved myself and I could care for the wound after"