Self Harm

What is Self Harm

Self-harm is when you hurt yourself as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences. Some people have described self-harm as a way to:

express something that is hard to put into words
turn invisible thoughts or feelings into something visible
change emotional pain into physical pain
reduce overwhelming emotional feelings or thoughts
have a sense of being in control
escape traumatic memories
have something in life that they can rely on
punish yourself for your feelings and experiences
stop feeling numb, disconnected or dissociated (see dissociative disorders)
create a reason to physically care for themselves
express suicidal feelings and thoughts without taking their own life.

After self-harming you may feel a short-term sense of release, but the cause of your distress is unlikely to have gone away. Self-harm can also bring up very difficult emotions and could make you feel worse.

Even though there are always reasons underneath someone hurting themselves, it is important to know that self-harm does carry risks. Once you have started to depend on self-harm, it can take a long time to stop.

Treatment

Online support

Online support is an option if you don't feel ready to see someone face to face.

Email, text, information or forum support is offered by self-harm services – for example National Self Harm Network, Self-injury Support, Lifesigns, The Mix and Sane.
The content on some self-harm sites can be triggering. Make sure the sites you visit are well moderated and that you know how to protect yourself and others while online. See our pages on How to stay safe online for helpful guidance.

Treatment for scars

Some people feel that scars from self-harm are an important part of their journey, while others would prefer not to have them. Treatments are available for covering and reducing scarring. For more information see the Lifesigns pages on scar reduction and skin camouflage.

If you receive NHS treatment, it should be in line with National Institute for Health and Care Excellence (NICE) guidelines.

These say that:

Any health professionals should treat you in a way that is sensitive and non-judgemental.
Ideally, health professionals should be trained in communicating sensitively with people who self-harm, and be aware of potential stigma.
Any treatment you are given should be tailored to your individual needs.

Your GP

Seeing your GP is often the first step to asking for help and discussing your self-harm confidentially.

Your GP may:

assess you and let you know about available treatment
prescribe medication for anxiety or depression, or to help with sleeping
refer to your CMHT (community mental health team) which can include psychiatrists, psychologists, social workers, an occupational therapist and community psychiatric nurse.

If they are concerned that your self-harm is a threat to your life, or if you need medical treatment for your injuries, they may suggest you spend time in hospital.

Talking treatments

Talking treatments involve talking with a professional therapist trained to listen with empathy and acceptance.

Cognitive behavioural therapy (CBT), Dialectical behaviour therapy (DBT) and Psychodynamic therapy have been shown to be helpful for people who self-harm.
If you can afford to, you can pay to see a private, trained and accredited therapist. See BABCP, BACP and UKCP for further details.

See our pages on Talking treatments for more information.

Support groups

Support groups are regular meetings with others who have similar experiences to you.

Support groups can be peer-led or facilitated.
They may focus on specific issues or be more general.

See our Peer support section for more information. You can find out if there are local groups through Mind Infoline or Self-injury Support.

Find out More:

There are organisations that offer support and advice for people who self-harm, as well as their friends and families.

These include:

Samaritans – call 116 123 (open 24 hours a day), email jo@samaritans.org, or visit your local Samaritans branch
Mind – call 0300 123 3393 or text 86463 (9am to 6pm on weekdays)
Harmless – email info@harmless.org.uk
National Self Harm Network forums
YoungMinds Parents Helpline – call 0808 802 5544 (9.30am to 4pm on weekdays)

Find more mental health helplines

Find out More:

Signs & Symptoms

Types of self-harm may include:
cutting the skin
burning the skin
punching your own body
poisoning yourself with tablets
misusing alcohol or drugs
eating disorders, such as deliberately starving yourself (anorexia nervosa), binge eating or bulimia

Unexplained cuts and bruises on the body.
Wearing long sleeves and pants, even in warm weather.
Secrecy, such as keeping a specific drawer locked or hiding specific items.
A breakdown in typical communication.
Mood changes or mood swings.
Changes in eating patterns.
Changes in sleeping patterns.
Changes in socialising patterns.
Evidence of drug or medical paraphernalia.
Evidence of carrying unnecessary sharp objects, matches or lighters.
Poor performance or results at school or work.
Loss of interest in favourite hobbies or sports.

Self - Help

The main way people help themselves when they want to self-harm is through distraction.
Different distractions work for different people, and the same distraction won't necessarily work for you every time. For example, distracting yourself from anger feels very different to distracting yourself from fear, so it's important that you have a few different strategies to choose from.
The following are simply suggestions. See if you can write your own table of distractions that you've found helpful or that you would like to try out.
If you're feeling anger and frustration
Here are some distractions you could try:
exercise
hit cushions
shout and dance
shake
bite on bunched up material
tear something up into hundreds of pieces
go for a run
Expressing your anger physically, or by doing things like shouting, won't work for everyone and could intensify feelings. Try things out and continue with any that have a positive effect.

If you're feeling sadness and fear

Here are some distractions you could try:
wrap a blanket around you
spend time with an animal
walk in nature
let yourself cry or sleep
listen to soothing music
tell someone how you feel
massage your hands
lie in a comfortable position and breathe in – then breathe out slowly, making your out-breath longer than your in-breath. Repeat until you feel more relaxed. (See our pages on relaxation).

If you're feeling a need to control

Here are some distractions you could try:
write lists
tidy up
have a throw-out
write a letter saying everything you are feeling, then tear it up
weed a garden
clench then relax all your muscles

If you're feeling numb and disconnected

Here are some distractions you could try:
flick elastic bands on your wrists
hold ice cubes
smell something with strong odour
have a very cold shower

If you're feeling shame

Here are some distractions you could try:
stop spending time with anyone who treats you unkindly
recognise when you are trying to be perfect and accept that making mistakes is part of being human
remind yourself that there are reasons for how you behave – it is not because you are 'bad'

If you're feeling self-hatred – wanting to punish yourself

Here are some distractions you could try:
write a letter from the part of you that feels the self-hatred, then write back with as much compassion and acceptance as you can
find creative ways to express the self-hatred, through writing songs or poetry, drawing, movement or singing
do physical exercise (like running or going to the gym) to express the anger that is turned in on yourself

Emergency Action plan:

Carry out a primary survey

Calm the Person
Ask the person what you can do to help.
Stop Bleeding. Apply direct pressure on the cut or wound with a clean cloth, tissue, or piece of gauze until bleeding stops. ...
Clean Cut or Wound. Gently clean with soap and warm water. ...
Protect the Wound. Apply antibiotic cream to reduce the risk of infection and cover with a sterile bandage. ...
If unable to calm the person, take him or her to see a health care provider right away.