Self harm is a distressing behaviour where people physically hurt themselves or engage in risky activities as a way of coping with overwhelming emotions. There isn’t a typical profile to identify people more likely to self-harm, or a typical pattern. Some people will self-harm once or a few times, some stop when a specific problem has been resolved, while others use it for years as a coping mechanism whenever they are under pressure.

The one thing that all these people have in common is an emotional pain so deep, so intense, that they cannot regulate it without hurting themselves. It doesn’t mean that they have a mental illness, but that they feel alienated, powerless, alone or angry with circumstances which they perceive as being beyond their control.

The “function” of self harm

Self harm is often misunderstood and can provoke strong reactions from people confronted with it. It is, first and foremost, a strategy to regulate extreme emotions.

It can start in response to traumatic events such as sexual abuse. Cutting, overeating and anorexia, for example, can all be attempts to make oneself less attractive and prevent unwanted attention – although it should be said straightaway that these practices are not systematic evidence of sexual abuse and are used in other contexts too.

Bullying, pressure seen as unbearable at school, at work, within families, can make people feel trapped, and, over time, those feelings build up to the point where they become unmanageable and self-harm is the only release, acting as a safety valve to relieve the tension.

It can also stem from self-hatred, depression or helplessness. Self-harm can be a way to punish oneself, which has, unfortunately, the perverse effect of reinforcing the feelings of self-dislike that often prompted this behaviour in the first place.

Depression can be accompanied by emotional numbness, and the physical pain that comes from self-harm can be a way to feel alive. In the case of cutting, some people self-harming report that, as blood flows out, their anguish seems to slip away too.

People who feel that they have little control over their lives, or suffer in silence in overbearing relationships, can also use self-harm as a way to regain some power over their life. Yes, it is still pain, but at least they are the ones inflicting it upon themselves and making the decision to do so.

How to respond to self harm?

People who self-harm are often accused of being “attention-seekers”, in the negative sense of the term, with the implication that indulging them would only encourage them and that their issues can therefore be dismissed without second thoughts.

Nothing could be further from the truth or less justified however, as self-harm is often done in secret, with all the feelings of shame and guilt that it involves, and people who self-harm go to great lengths to hide it. Self-harm is often a way to express an inner distress which is so great that it can’t be put into words. In addition, it usually happens when people are in a state of high emotional turmoil and in the spur of the moment, and is not staged or planned like attention-seeking for the sake of it would be.

However, self-harm is indeed a way to communicate, and when it becomes apparent or disclosed, it should be met with compassion and respect, no matter which feelings they arise in us. You should always remember that the person self-harming is in so much emotional pain that they genuinely cannot see another way to deal with it.

It can be upsetting to find out that a loved one hurts themselves, but anger, guilt, judgement or panic is often the reason cited by people who self-harm not to talk about it, and it only worsens the situation. It is crucial that you put your own feelings about it aside and focus on the physical well-being of the relative / friend affected, and on the underlying reasons for this behaviour. Concern and being caring will go a long way in alleviating the loneliness and guilt of the person involved.

If you self-harm, as isolated as you may feel, it is important to remember that you are not alone and self-harming is more common that you probably realise, especially in young people. Talking about it with someone you trust and feel comfortable with is an important step, but there is also professional help at hand to put strategies in place so that you can deal with your emotions without having to hurt yourself.

If you are concerned that a loved one is self-harming, or are self-harming yourself, and you are looking for counselling in Auckland City, email the Robert Street Clinic or call us on 09 973 5950 for a confidential and professional conversation about how our team of experienced psychotherapists, psychologists and psychiatrists can help you.