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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.

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.

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:

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

  1. Calm the Person

  2. Ask the person what you can do to help.

  3. Stop Bleeding. Apply direct pressure on the cut or wound with a clean cloth, tissue, or piece of gauze until bleeding stops. ...

  4. Clean Cut or Wound. Gently clean with soap and warm water. ...

  5. Protect the Wound. Apply antibiotic cream to reduce the risk of infection and cover with a sterile bandage. ...

  6. If unable to calm the person, take him or her to see a health care provider right away.

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