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The Quiet Shame of Self-Injury

Self-Injury is a shameful secret many of us hold and we can often see no real way out. If you self-injure, please know that there is hope for you. Click here for more information about coping with self-harm.

This is her story:

i haven’t engaged in self-injury since april 8, 2004.

six months before my wedding years after i started dating my husband. just over three months after my stepfather died.

my soon-to-be husband and i were about to move in with my mom and younger brother to help fix up the house and pay the bills. it was a good arrangement – i was living with my dad for the first time since my parent’s divorce, and it was not an ideal situation.

he didn’t know how to deal with my craziness. he didn’t know what to do with a grown daughter who had trouble holding a job, was a recovering addict, was clinically depressed.

he didn’t know what to do when i would bang my head into the wall, lock myself into a closet, have to walk out of a room in the middle of a sentence. just because i haven’t cut, i don’t think that means i haven’t been involved in self injury, or si, self-harm, self-injurious behavior, as it is also referred to.

self-injury includes many types of injury or mutilation – cutting, burning, picking, biting. some people consider trichotillomania (self-pulling of hair) in the scope of si, even though it has it’s own diagnosis.

self injury

there is no fancy word for cutters. we cut. we burn. we bite. we scratch. we self injure. that’s it. i first identified myself as a cutter when i was 12.


i realized that physical pain of the cut almost released the emotional pain i felt. as i got older, i could look back and see even more instances of it. i remembered biting my fingers and hands until they bled when i was only 5. i can’t remember what made me want to do that, but i remember feelings of emptiness, even then. i remember pulling out my hair around the age of 7 or 8. i remember digging my fingernails into my palm hard enough to break skin. at those ages,

i do not consciously remember why i did what i was doing.

i only remember doing it, and that some how it made me feel better.

i don’t know where i got the idea. i hadn’t seen a television special, i didn’t have any friends cutting. many people think it’s a goth or emo thing, that girls do it to seem cool or special or mysterious. that they do it because their friends do, because it makes them hard or whatever the
fuck stupid people think. i didn’t know anyone who cut or self-harmed in any way.


i do remember taking a pen cap and scraping it back and forth across my arm hard enough and long enough that i drew scraggly lines of blood.


there was this initial release, like the darkness escaping, and then this delicious numbness spread through my body.


before the blood had even dried, i methodically started to clean up with tissues. this would become a ritualistic experience for me.

i stole a paring knife from the kitchen, hid it in a drawer, and knew i had an option at all times. i can’t explain why, but the ritual became almost as important as the cutting.


i would get my secret stash of hydrogen peroxide and gauze. i’d cut, i’d bleed, i’d revel in the numbness. then i’d clean up the blood, clean out the cut, wrap up in bandages. by the time i was around 15, it got worse.


i would enter almost a trancelike state, methodically cutting and bloodletting for hours at a time. i’d make small cuts, long cuts, perpendicular cuts.


instead of using the paper towels to clean up, i’d press them to my cuts so the blood would seep into it, then save them in my notebook. i know, it sounds horrifying. then i decided it would make more sense to do that on the actual paper – i would be able to keep them forever.

i still have them. i cannot get rid of them.

i was always afraid of being discovered.

my scars and cuts were not a badge to show my friends, they did not make me cool. i cut almost everywhere, and had ways to hide everything. i did not want to have to explain how it made me feel.


i cut my forearms rarely, although that is the only place i now have scars. i cut my thighs, my calves, my shoulders, my hips, my stomach, my breasts. i would cut, bleed, mark, clean, wrap. constantly.

i finally got caught out at 16. i had a fight with my boyfriend, went home, got high, and put on hole’s ‘live through this’. i don’t even remember getting my paring knife or other tools.


i do know that i spent almost five hours smoking pot and carving the lyrics from two songs into my legs. i didn’t do my own laundry at the time, and ended up throwing out the sheet i had on my bed at the time because of the blood. i didn’t want anyone to know. i was ashamed and afraid and addicted.

my boyfriend found out.

we were talking about our fight, sitting on his couch. i pulled my leg up under me, and my jeans leg rode up. he saw my calf and made me take off my pants. he then told me he wouldn’t see me anymore unless i told my mother.

i did.

i told my mother, she got me counseling. he did stay with me for a few more months. he tried. i continued cutting on a near-daily basis for years, until i was 20. i moved in with my dad after his second divorce. i still had my knife; i needed to have it. i went almost four years without cutting. i was helping my soon-to-be husband move into my mother’s house. i don’t know what set me off, but i needed my knife and couldn’t find it. this made it worse.


i took out my keychain-sized swiss army knife and dug into my upper arm until i bled.

i haven’t cut since then. but i haven’t stopped self injuring.

i cannot.

i have scratched my face until it bled. i have banged my head on a tile floor hard enough to concuss myself. i have pulled hunks of hair out in frustration. i bite my tongue until it is raw and bleeding at times. i pick and pinch at myself more than i care to admit. i have gone to get a tattoo in desperation to feel something (incidentally, not the right reason for ink).

the worst part is, and i think any cutter will agree with this. the worst part is that we do what we do TO FEEL SOMETHING. but the problem is we already feel too much. we have so much (fill in the emotion) inside us, that we need to feel something else.

is it that we need to feel something we can control?

like eating disorders, is it about having control over something in our lives when it feels like everything else is out of control?

do i cut or self harm so that I AM IN CHARGE OF MY PAIN… at least for a few minutes?

Coping With Self-Injury Resources

What Is Self Injury?

Self Injury (SI) is the act of deliberately harming one’s own body. People who self-injure often express their inner pain, anger and anguish by cutting or burning, but self-injury is not meant as a suicidal act.

The most common type of self-injury is skin-cutting, but self-harm refers to a wide range of behaviors, including burning, scratching, trichotillomania, poisoning, and other types of injurious behaviors.

Read more about self-injury.

It’s hard to know what to do when someone we love hurts themselves deliberately. It’s even harder when we, ourselves, don’t know why we can’t just “stop” self-injuring. It’s hard to know what the treatment for cutting is, especially when so many people don’t understand reasons for self injury.

You are not alone. Here are some practical tips and advice about self injury for those who self injure and those who love people who self-injure.

If You Self Injure:

If you’re the one who struggles mightily with self-injury, you may not know why you can’t simply stop. Why others don’t raise awareness of self-injury. Why you cut yourself to release your inner pain. Here are some tips for coping with self-injury and the decision to stop self-injuring.

If you’ve decided to stop self-injuring, you may think it’s an easy decision – it’s not. Self-injury is a long-honed coping mechanism for you and stopping SI is similar to stopping any type of addiction: it’s easier said than done.

First, you must determine why you want to stop self-injuring: is it outside pressures? A family member who wants you to stop cutting? Remember: in order for you to be successful, you’re going to have to choose to stop self-injuring for yourself.

If you’re not giving up self-injury for yourself, your decision to stop cutting may fall short.

While it may be easy to stop self-injuring in the short term, you must develop some healthier long-term methods of coping with the urges to SI.

To stop self-injuring, you must first determine why you do it in the first place – is it stress? Anxiety? Anger? Frustration? You must develop other methods of coping with these feelings in order to stop hurting yourself.

If you have a special time and place where you self-injure, change your patterns of activity to reduce the urges to self-injure. Changes in latitude…or something.

Try putting yourself in a place (or situation) in which you can’t engage in self-injury BEFORE the urge to self-injure strikes.

It’s important to get rid of your self-injury tools. Make it a production and use it as a way to say goodbye to your old self and hello to your new self.

Change up your routines – especially the rituals associated with self-injury. Changing a part of your ritual can make SI more uncomfortable for you, and the less comfortable you are while engaging in self-injurious behavior, the less likely you are to want to engage in that behavior at all.

Become aware of your surroundings and your rituals, especially if you dissociate while you self-injure. Increasing awareness conflicts with dissociation and can help reduce the urge to SI. Add or remove steps from your SI ritual to promote awareness of your rituals.

Get some help. No, not necessarily like professional help (like a therapist), but open your mouth and tell others what you’ve been doing.

By telling others that you self-injure, you’re decreasing the social isolation of self-injury and allowing other people the opportunity to support you.

Use that support system when you feel the urge to self-injure. Call a trusted friend. Tell them that you’re feeling the urge to hurt yourself. Ask your friend to come sit with you while you sit through your discomfort.

When breaking the SI habit, try using the rule of two: don’t do anything that you can’t tell at least two people about.

In order to stop self-injuring, you’re going to have to change your thoughts (the ones you have immediately before injuring yourself) about SI.

Challenging the negative thoughts you have right before you self-injure is instrumental – challenge how accurate these thoughts are. Are they really true? Chances are, most of your negative thoughts are just that: thoughts and not reality.

When you start thinking those negative thoughts, one of the ways you can make them stop is to say, “STOP” out loud (or in your mind). It may take awhile to make the thoughts go away, but it can help.

Reframe those negative self-injury spiral thoughts from a negative into a positive. If you think, “I’m so stupid for cutting,” say to yourself, “I did what I had to do to make it through.”

There’s a lot of shame, guilt and secrecy that go along with self-injury. Remember: you were coping with stuff in your life in the best way you knew how. Certainly, you will learn more healthy ways to cope with life stuffs, but tell yourself the truth: you were coping the best you could. That’s not shameful.

Self-injury often occurs in those who have difficulty expressing or regulating their emotions.

It’s not uncommon to have negative thoughts about ourselves in relation to SI. Instead of making a judgmental statement like “I’m so stupid for cutting,” or “I’m so weak for burning myself,” sort out the facts and observe and describe them. “When I get in to a stressful situation, I don’t know how to express my feelings, and when I become overwhelmed I cut to release the pressure.”

You may not know all the words for what you’re feeling, so check with your body – how does this feeling feel inside your body – hot flashes? Fluttering tummy? Learn to describe these feelings so you can recognize them when they occur and stop before you begin self-injury.

Check in with yourself and your body every day to see how often you felt the urge to self injure, how strong the urge to SI was, and whether or not you succumbed to self-injury. This is a good way to make yourself more accountable and in check.

Remember that there is a difference between feelings and thoughts: feelings can be described in “I am” or “I feel” statements. Often, people think they’re describing a feeling, when it’s really thoughts they’re talking about. The phrases “I feel like,” or “I feel that,” are both thoughts, NOT feelings.

Change, don’t deny. You can’t pretend away those ugly negative thoughts. You must express, respect, and honor your feelings in healthier ways. Rather than pretend they don’t exist, remind yourself this:

  • Feelings happen for a reason.
  • Feelings are often illogical.
  • Feelings are transitory – they often change and/or disappear over time.

Once you learn to identify your feelings, one of the easiest ways to change them is to express them. Feelings are often satisfied once expressed. Each feeling has a different way of expressing itself (usually in a physical way) – sadness may be expressed by crying. Self-injury is often the way that people who have difficulties expressing emotions let those feelings out. Learning that there are other ways to express feelings without negative consequences is very important.

Changing the physical sensations. Most people who SI describe the build-up to self-injury as a tension that is released when you hurt yourself. Examine the physical feelings you have before SI and figure out a better way to release the tensions. One such method is exercise.

One method that helps some through a really strong self injury urge is to find something that has a very powerful sensation. For example, really strong mints, something with an interesting texture, a sound you find soothing or interesting – make a little “survival kit” that you can take with you so that if you have the overwhelming urge you can shake your mind out of the SI place more easily.

When you’ve made the decision to stop self-injuring, the most important thing you can do is to tell someone else you’re ready to stop. Telling someone helps with the isolation and the shame associated with self-injury. If you can’t do it face-to-face, do it in a letter or an email.

Self Injury Relapses: they happen. When stressed, your brain will default to the path you’ve taken most often. Your brain is familiar with self-injury so it’s easier for it to go down that connection. Over time, new connections will be made, so keep on recovering from self-injury.

Falling off the wagon and relapsing into self injury doesn’t mean you’ll never quit or that you’re an utter failure. Instead look at it as a learning experience: choose something different next time.

Quitting Self-Injury:

If you’re ready to get help for cutting or self-harm, the first step is to confide in another person. It can be scary to talk about the very thing you have worked so hard to hide, but it can also be a huge relief to finally let go of your secret and share what you’re going through

1) Opening Up:

Choose someone who isn’t going to gossip or try to take control of your recovery.

Who makes you feel accepted and supported? It could be a friend, teacher, religious leader, counselor, or relative. But you don’t necessarily have to choose someone you are close to. Sometimes it’s easier to start by talking to someone you respect-such as a teacher, religious leader, or counselor-who has a little more distance from the situation and won’t find it as difficult to be objective. While you talk:

Focus on your feelings:

Instead of sharing detailed accounts of your self-harm behavior focus on the feelings or situations that lead to it. This can help the person you’re confiding in better understand where you’re coming from. It also helps to let the person know why you’re telling them. Do you want help or advice from them? Do you simply want another person to know so you can let go of the secret?

Communicate in whatever way you feel most comfortable:

If you’re too nervous to talk in person, consider starting off the conversation with an email, text, or letter (although it’s important to eventually follow-up with a face-to-face conversation). Don’t feel pressured into sharing things you’re not ready to talk about. You don’t have to show the person your injuries or answer any questions you don’t feel comfortable answering.

Give the person time to process:

As difficult as it is for you to open up, it may also be difficult for the person you tell-especially if it’s a close friend or family member. Sometimes, you may not like the way the person reacts. Try to remember that reactions such as shock, anger, and fear come out of concern for you. It may help to print out this article for the people you choose to tell. The better they understand cutting and self-harm, the better able they’ll be to support you.

Talking about self-harm can be stressful and stir up a lot of emotions:

Don’t be discouraged if the situation feels worse for a short time right after sharing your secret. It’s uncomfortable to confront and change long-standing habits. But once you get past these initial challenges, you’ll start to feel better.

2) Identify Your Triggers:

Understanding what triggers you to cut or self-harm is a vital step towards recovery. If you can figure out what function your self-injury serves, you can learn other ways to get those needs met-which in turn can reduce your desire to hurt yourself. Self-harm is most often a way of dealing with emotional pain. What feelings make you want to cut or hurt yourself? Sadness? Anxiety? Anger? Loneliness? Shame? Emptiness?

Work on Your Emotional Awareness:

If you’re having a hard time pinpointing the feelings that trigger your urge to cut, you may need to work on your emotional awareness. Emotional awareness means knowing what you are feeling and why. It’s the ability to identify and express what you are feeling from moment to moment and to understand the connection between your feelings and your actions. Feelings are important pieces of information that our bodies give to us, but they do not have to result in actions like cutting or self-harming.

Paying Attention to Feelings Without Releasing Them:

The idea of paying attention to your feelings-rather than numbing them or releasing them through self-harm-may sound frightening to you. You may be afraid that you’ll get overwhelmed or be stuck with the pain. But the truth is that emotions quickly come and go if you let them. If you don’t try to fight, judge, or beat yourself up over the feeling, you’ll find that it soon fades, replaced by another emotion. It’s only when you obsess over the feeling that it persists.

3) Replace Old Coping Mechanisms With New Ones:

This may be the hardest step for people who self-injure as it can be very challenging to find what works for you – what appears below are suggestions, and they are not one-size-fits-all solutions. You may have to experiment to find out what works best for you.

If you self-harm to release tension or vent anger, you could try:
  • Exercise vigorously run, do major housework, dance, anything to get your body moving.
  • Punch a cushion or mattress or scream into your pillow
  • Squeeze a stress ball or squish Play-Doh or clay
  • Rip something up (sheets of paper, a magazine)
  • Make some noise (play an instrument, bang on pots and pans)
If you self-harm because you feel disconnected or numb, you could:
  • Call a friend (you don’t have to talk about self-harm)
  • Take a cold shower
  • Hold an ice cube in the crook of your arm or leg
  • Chew something with a very strong taste, like chili peppers, peppermint, or a grapefruit peel
  • Go online to a self-help website, chat room, or message board
If you self-harm to express pain and intense emotions, you could:
  • Paint, draw, or scribble on a big piece of paper with red ink or paint
  • Start a journal in which to express your feelings
  • Compose a poem or song to say what you feel
  • Write down any negative feelings and then rip the paper up
  • Listen to music that expresses what you’re feeling
If you self-harm to calm and soothe yourself, you could:
  • Take a bath or hot shower
  • Pet or cuddle with a dog or cat
  • Wrap yourself in a warm blanket
  • Massage your neck, hands, and feet
  • Listen to calming music
Substitutes for the cutting sensation
  • Use a red felt tip pen to mark where you might usually cut
  • Rub ice across your skin where you might usually cut
  • Put rubber bands on wrists, arms, or legs, and snap them instead of cutting or hitting

Why Does My Loved One Self-Injure?

As cutting and self-harm tend to be taboo subjects, many people harbor serious misunderstandings about their loved one’s state of mind. Ignore these common myths about self-injury

Myth : People who self-injure are crazy and/or dangerous.

Fact: It is true that many people who self-harm suffer from anxiety, depression, eating disorders, or a previous trauma-just like millions of others in the general population, but that doesn’t make them crazy or dangerous. Self-injury is how they cope. Sticking a label like “crazy” or “dangerous” on a person isn’t accurate or helpful.

Myth: People who self-injure want to die.

Fact: When people self-harm, they are usually not trying to kill themselves—they are trying to cope with their problems and pain. In fact, self-injury may be a way of helping themselves go on living. However, there is always the risk of a more severe injury than intended and, in the long-term, people who self-injure have a much higher risk of suicide, which is why it’s so important to seek help.

Myth: If the wounds aren’t bad, it’s not that serious.

Fact: The severity of a person’s wounds has very little to do with how much they may be suffering. Don’t assume that because the wounds or injuries are minor, there’s nothing to worry about

Myth: People who cut and self-injure are trying to get attention.

Fact: On the surface, this sounds like a reason, however, the painful truth is that people who self-harm generally hurt themselves in secret. Think about it – if they really wanted attention, they’d do something flashy and showy to gain attention. They aren’t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help

If Your Loved One Self Injures:

Learning that someone you love dearly struggles with hurting him or herself can be hugely shocking. Here are some tips for loved ones of self-injurers.

While the temptation to tell your loved one that he or she should stop self-injuring comes from a good place, adding the pressure of your judgment can hurt someone who engages in self-harm.

Support your loved one who uses SI – which is often used as an unhealthy coping mechanism – by letting them know you love them NO MATTER WHAT.

Learning that someone you love self-injures can bring up a lot of conflicting emotions.

If someone you love confides in you that he or she self-injures, it may be a great emotional shock to you. Most who self-injure do so in secret, so while the SI behavior may have gone on for a long while, you may never have suspected it: you may not have known why your loved one refused to wear short-sleeved shirts or shorts in hot weather.

You may want to deny that your loved one cuts – this is a common reaction to learning that someone you love self-injures. However, denial is extremely harmful for someone who self-injures, as it denies the emotional pain your loved one is.

While you do not have to dwell on it, it’s important to acknowledge that your loved one has a problem – a serious problem – and needs help.

You may be angry when you learn that your loved one hurts his or herself. Especially once you connect the dots and see the lies that your loved one told you to cover up his or her behavior.

You may feel frustrated – self-injury isn’t something you can control or necessarily feel as though you can help with. You cannot control the behavior of another, no matter how you’d like to. This may make you feel helpless.

Make sure that you keep SI an open dialog between you and your loved one who self-injures. Ignoring self-injury does NOT make it go away, and can reinforce feelings of isolation and shame.

If your loved one opens up about self-injury to you, know that it was an incredible burden for them to share. Thank them for trusting you with this information.

Be available to your loved one within limits (limits YOU can handle) – tell them that if they feel the urge to cut or burn coming on, to call you so you can sit with them.

Spend more time with your loved one – most people who self-injure do so while alone. Keeping them occupied can help reduce the self-injuring behavior.

If you’re having challenges with coping with the self-injury of a loved one, don’t hesitate to talk to a therapist about your feelings.

Ask how you can help your loved one – often, it’s hard to know HOW to help. Instead of guessing, ASK!

Keep the negative thoughts and judgment to yourself – you’re certainly entitled to your feelings, but the person who self-injures doesn’t need more shame heaped upon him or her.

You must put up some emotional boundaries between yourself and your loved one, especially if the person who engages in SI has issues setting boundaries him or herself. Be clear and consistent with your support as well as make sure that he or she knows that you have your limits and what they are.

What To Say To Someone Who Self Injures:

“I support you no matter what.”

“How long have you been hurting yourself?”

“Thank you for trusting me enough to tell me.”

“How can I help?”

“How did you learn how to hurt yourself?”

“What makes you want to hurt yourself?”

“Do you want to stop self-injuring?”

What NOT To Do If Your Loved One Self Injures:

Sometimes, despite our very best intentions, we say or do something to make our loved ones hurt more than they already are. Here are some things to avoid doing if you have a loved one who self-injures.

Do not pressure your loved one to stop injuring. SI is an intensely shameful way of coping and adding the pressure of your judgment will likely serve to increase the self-injurious behavior.

Don’t issue an ultimatum – you must stop hurting yourself or ELSE. This will only make your loved one want to hide his or her shameful secret.

Don’t scold your loved one for injuring him or herself – he or she already feels shame for his or her behavior.

Don’t press the issue – if you’ve tried talking to your loved one who self-injures and he or she doesn’t want to continue the conversation, don’t force them.

Don’t make judgmental remarks about self-injury to your loved one. If you haven’t walked around in their shoes, you don’t know what it’s like to be them.

Don’t discourage the self-injury (this is a hard one). SI is a way that many people cope with emotional pain; they may not have other, healthier ways of coping. Making comments like this may make the person who engages in SI retreat further into isolation and despair.

Don’t assume that the person who self-injures is suicidal. Self-injury is not a suicidal act.

Don’t take your feelings out on your loved one – that’s for a therapist, not you, to handle.

What Not To Say To Someone Who Self Injures:

“Why don’t you just STOP?”

“You’re just doing it for attention.”

“You’re crazy.”

“You’re trying to manipulate me.”

“You’re not the same person I thought you were.”

“How could you do this to me?”

Page last audited 8/2018

Self-Injury & Self-Harm Resources

What is Self-Injury?

Self-Injury (SI) (also called self-harm, self-inflicted violence, or non-suicidal self-injury) is the act of deliberately harming one’s own body, such as by cutting or burning, that is not meant as a suicidal act. Self-injury is an unhealthy way to cope with emotional pain, anger, and frustration. Self-harm is the deliberate infliction of damage to your own body and includes cutting, burning, and other forms of injury. While cutting can look like attempted suicide, it’s often not; most people who mutilate themselves do it as a way to regulate mood. People who hurt themselves may be motivated by a need to distract themselves from inner turmoil or to quickly release anxiety that builds due to an inability to express intense emotions.

Self-harm or self-injury means hurting yourself on purpose. One common method is cutting yourself with a knife. But any time someone deliberately hurts herself is classified as self-harm. Some people feel an impulse to burn themselves, pull out hair or pick at wounds to prevent healing. Extreme injuries can result in broken bones.

Hurting yourself—or thinking about hurting yourself—is a sign of emotional distress. These uncomfortable emotions may grow more intense if a person continues to use self-harm as a coping mechanism. Learning other ways to tolerate the mental pain will make you stronger in the long term.

Self-harm also causes feelings of shame. The scars caused by frequent cutting or burning can be permanent. Drinking alcohol or doing drugs while hurting yourself increases the risk of a more severe injury than intended. And it takes time and energy away from other things you value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting work and relationships.

The most common type of self-injury is skin-cutting, but self-harm refers to a wide range of behaviors, including burning, scratching, trichotillomania, poisoning, and other types of injurious behaviors.

There is a complex relationship between self-injury, which is not a suicidal act, and suicide. Self-harming behavior may be potentially life-threatening. There also exists a higher risk of suicide in those who self-injure.

The DSM-IV lists self-injury as a symptom of Borderline Personality Disorder; however, people who suffer depression, stress, anxiety, self-loathing, eating disorders, substance abuse, additional personality disorders, and perfectionism may also engage in self-injurious behavior.,

Who Self-Injures?

Self-harm is most common in adolescence and teen years, usually beginning between the ages of 12 and 24; however, self-injury is not limited to the teen years. Self-injury can start at any age. It’s estimated that two million people from all races and backgrounds in the US injure themselves in some way. Young women are more likely than young men to engage in self-injurious behavior.

Why Do People Self-Injure?

Self-harm is not a mental illness, but a behavior that indicates a lack of coping skills. Several illnesses are associated with it, including borderline personality disorder, depression, eating disorders, anxiety or post-traumatic stress disorder.

Self-harm occurs most often during the teenage and young adult years, though it can also happen later in life. Those at the most risk are people who have experienced trauma, neglect or abuse. For instance, if a person grew up in an unstable family, it might have become a coping mechanism. If a person binge drinks or does drugs, he is also at greater risk of self-injury, because alcohol and drugs lower self-control.

The urge to hurt yourself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, injuring yourself stimulates the body’s endorphins or pain-killing hormones, thus raising their mood. Or if a person doesn’t feel many emotions, he might cause himself pain in order to feel something “real” to replace emotional numbness.

Once a person injures herself, she may experience shame and guilt. If the shame leads to intense negative feelings, that person may hurt herself again. The behavior can thus become a dangerous cycle and a long-time habit. Some people even create rituals around it.

Self-harm isn’t the same as attempting suicide. However, it is a symptom of emotional pain that should be taken seriously. If someone is hurting herself, she may be at an increased risk of feeling suicidal. It’s important to find treatment for the underlying emotions.

There’s no single cause that leads to self-injurious behavior. The mixture of emotions that trigger one to self-injure is complex. Generally, self-injury is the result of an inability to cope with deep psychological pain. Physical pain distracts the sufferer from painful emotions or helps the person who self-injures to feel a sense of control over an otherwise uncontrollable situation.

Emotional emptiness – feeling empty inside – may lead to self-harm, as it allows the sufferer to feel something – anything. It’s an external way to express inner turmoil.

Self-injury can be a way to punish the self for perceived faults.

Risk Factors for Self-Injury:

There are certain factors that may increase the risk for self-injury. These include:

  • Most people who self-injure begin as teenagers. Self-injury tends to escalate over the years.
  • Having friends who self-injure increases the likelihood that someone will begin to self-injure.
  • Having gone through sexual, emotional, physical child abuse or neglect.
  • Drug or alcohol use – many of those who self-injure do so under the influence of drugs and/or alcohol.
  • Being overly self-critical, lacking impulse control, having poor problem-solving skills.
  • Mental illnesses such as depression, borderline personality disorder, anxiety problems, PTSD, eating disorders, and drug or alcohol abuse.

Common Traits And Signs of Self-Injurers:

While cutting and self-harming occurs most frequently in adolescents and young adults, it can happen at any age. Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury in a friend or family member can be hard to detect. In any situation, you don’t have to be sure that you know what’s going on in order to reach out to someone you’re worried about. Of course not everyone who self-injures will display all of the following characteristics. Some may identify with one or two; some may identify with none at all. Here are some common characteristics of those who self-injure, and red flags you can look for:

Blood stains on clothing, towels, or bedding; blood-soaked tissues

Childhood trauma or significant parenting deficits. Many adapt to the trauma by developing unhealthy fantasies about being being rescued from their grief.

Difficulties in impulse control, like eating disorders or drug abuse. 

Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.

Engaging in Magical Thinking: physical wounds make you immune to other, greater harm.

Fear of changes – everyday changes or any kind of new experience – people, places, and things. This may include the fear of getting well or stopping the self-injurious behavior.

Feel undeserving of proper self-care. Many people who self-injure ignore their own needs, like a good diet, enough sleep, and exercise. They may be apathetic to their appearance or feel undeserving of such care.

Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.

Growing up in an environment where intense emotions weren’t allowed.

History of childhood illness or severe illness and/or disability in a close family member.

Isolation and irritability. Your loved one is experiencing a great deal of inner pain—as well as guilt at how they’re trying to cope with it. This can cause them to withdraw and isolate themselves.

Limited social support network, due to shame of self-harm or because they have poor social skills. These social skills may include being hypersensitive and an inability to tune into the needs of others.

Low self-esteem coupled with a powerful need for love and acceptance by others. They may adopt an unhealthy care-taking role or take on too much responsibility for what happens in a relationship.

Needing to be alone for long periods of time, especially in the bedroom or bathroom.

Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.

Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest

What Are Some Forms of Self-Injury?

While self-injury may take on many different forms, most people who self-injure stab or cut their skin with a sharp object. However, self-injury types are only limited to the individual’s inventiveness and determination to harm themselves

Self-harm is a way of expressing and dealing with deep distress and emotional pain. It includes anything you do to intentionally injure yourself. Some of the more common ways include:

  • Cutting or severely scratching your skin
  • Burning or scalding yourself
  • Hitting yourself or banging your head
  • Punching things or throwing your body against walls and hard objects
  • Sticking objects into your skin
  • Intentionally preventing wounds from healing
  • Swallowing poisonous substances or inappropriate objects
  • Carving words/symbols on skin
  • Interfering with wound healing
  • Biting
  • Head banging
  • Pulling out hair
  • Piercing skin with sharp object

Self-harm can also include less obvious ways of hurting yourself or putting yourself in danger, such as driving recklessly, binge drinking, taking too many drugs, and having unsafe sex.

Regardless of how you self-harm, injuring yourself is often the only way you know how to:

  • Cope with feelings like sadness, self-loathing, emptiness, guilt, and rage
  • Express feelings you can’t put into words or release the pain and tension you feel inside
  • Feel in control, relieve guilt, or punish yourself
  • Distract yourself from overwhelming emotions or difficult life circumstances
  • Make you feel alive, or simply feel something, instead of feeling numb

How Do I Know if I Self-Injure?

Cutting is not the only way that someone can self-injure. Picking scabs compulsively, pulling out hair, burning, punching, hitting your head against the wall, and many other methods are considered self-injury. Sometimes, people drink harmful substances like bleach or detergent if they are self-injuring.

If you use one of these methods or a similar method, especially when in emotional conflict, you likely self-injure.

You don’t have to require stitches or a trip to the emergency room to self-injure. Even if you think it isn’t “bad enough,” it is.

Help is out there, regardless of your situation.

 Does Self-Harm Help?

It’s important to note that those who self-injure do so for many reasons – and self-injury often helps to soothe these issues. Understanding the reasons that one self-injures can help to ascertain ways to stop the self-harming.

Emotional Reasons for Self-Injuring:

  • Self-soothing to calm intense emotions
  • To punish yourself or express self-loathing
  • Exerting control over your own body
  • Express things that cannot be put into words
  • Distraction from emotional pain
  • Regulate strong emotions

Okay, So If Self-Harm Helps, Why Bother Stopping?

The relief that comes from cutting or self-harming is only temporary and creates far more problems than it solves.

Relief from cutting or self-harm is short lived, and is quickly followed by other feelings like shame and guilt. Meanwhile, it keeps you from learning more effective strategies for feeling better.

Keeping the secret of self-harm is difficult and lonely. Maybe you feel ashamed or maybe you just think that no one would understand. But hiding who you are and what you feel is a heavy burden. Ultimately, the secrecy and guilt affects your relationships with friends and family members and how you feel about yourself.

Self-harm may provide a temporary relief from the turbulence inside, but it comes at a steep price. In the long run, self-injury causes more problems than it stops. It makes it almost impossible to learn healthy coping mechanisms.

You can hurt yourself badly, even if you don’t mean to. It’s easy to end up with an infected wound or misjudge the depth of a cut, especially if you’re also using drugs or alcohol.

You’re at risk for bigger problems down the line. If you don’t learn other ways to deal with emotional pain, you increase your risk of major depression, drug and alcohol addiction, and suicide.

Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.

The bottom line is that cutting and self-harm won’t help you with the issues that made you want to hurt yourself in the first place. No matter how lonely, worthless, or trapped you may be feeling right now, there are many other, more effective ways to overcome the underlying issues that drive your self-harm.

What Self-Injury Is Not:

There exist many myths surrounding self-injury. We’re here to try and dispel some of these commonly held, but wrong, beliefs about self-injury.

  • Self-Injury is not suicidal behavior. While people do occasionally die from self-injurious behavior, it is by accident. Generally, those who self-injure are not suicidal.
  • Self-Harm is not a cry for attention. While many people – family, friends, even doctors – may believe that self-injury is attention-seeking behavior, those who self-harm generally try to hide what they are doing because they are ashamed.
  • People who self-injure are not crazy. Those who self-injure are trying to deal with trauma, not mental illness. These people are simply trying to cope the only way they know how.

What Do I Do If I Am Self-Injuring?

Acknowledge the problem. You are probably hurting on the inside which is why you self-injure.

Talk to someone you trust. It could be anyone. A doctor, a counselor, a friend, a parent. Just confide in them.

Identify your self-injury triggers. If you know what your triggers are, you can learn to avoid or address these triggers.

Recognize that self-injury is an attempt to soothe yourself. Develop better, healthier ways to calm and self-soothe.

Figure out what function self-injury is serving. Replace self-injury by expressing your emotions in healthy ways.

Treatment for Self-Injury:

There is no golden standard of treatment for self-injury; rather, treatment is tailored to the specific reasons behind the self-injury and treating any underlying psychological conditions. Successful treatment for self-injury is possible but may take time and work to learn more appropriate coping mechanisms.

The help and support of a trained professional can help you work to overcome the cutting or self-harming habit, so consider talking to a therapist. A therapist can help you develop new coping techniques and strategies to stop self-harming, while also helping you get to the root of why you hurt yourself.

Remember, self-harm doesn’t occur in a vacuum. It exists in real life. It’s an outward expression of inner pain-pain that often has its roots in early life. There is often a connection between self-harm and childhood trauma. Self-harm may be your way of coping with feelings related to past abuse, flashbacks, negative feelings about your body, or other traumatic memories-even if you’re not consciously aware of the connection.

Treatment options include:

Therapy (also known as “talk therapy”) can help identify and manage underlying issues that trigger self-injury. Therapy can help build skills to tolerate stress, regulate emotions, boost self-image, better relationships, and improve problem solving skills.

  • Finding the right therapist may take some time. It’s very important that the therapist you choose has experience treating both trauma and self-injury. But the quality of the relationship with your therapist is equally important. Trust your instincts. Your therapist should be someone who accepts self-harm without condoning it, and who is willing to help you work toward stopping it at your own pace. You should feel at ease, even while talking through your most personal issues.

Medications. While there are no medications that specifically treat self-injury, doctors often prescribe anti-depressants or other medications to treat any underlying mental illnesses. Treatment of those conditions may lessen the desire to self-injure.

Hospitalization. If injury is severe or repeated, an in-patient hospitalization may be necessary to provide a safe environment and intense treatment to get through a crisis.

What Do I Do if a Friend is Self-Injuring?

  • Talk to this person privately about your suspicions about their self-injury.
  • Be supportive of your friend, and don’t tell them to just “get over it” or that they’re “doing it for attention.” This is a very real and serious problem.
  • If you believe that your friend is in danger, or that he or she has a plan for suicide, notify your parents, a teacher, a pastor, or any other trusted adult immediately. This is not your fault, and it is not on your shoulders to fix it.
  • If you offer to listen to your friend, be prepared that their feelings might be overwhelming. You may not understand, and you might want to talk them out of it. You might want to make them stop, to threaten to withhold your friendship or caring if they don’t. Please don’t. This will only add to the shame they already feel.
  • Respect the fact that a self-injurer can only stop when he or she is ready. Stopping for anyone but themselves will not work.
  • Validate their feelings. “I understand how tough of a time this is for you.”
  • Do not judge his or her experiences with self-injury or reasons for it.
  • Offer specific forms of help, like finding a counselor.
  • Make sure that your friend knows that you do not think he or she is a bad person for self-injuring. It is a coping mechanism like any other, and while it’s hard to understand, your friend is doing his or her best to stay alive

Self-Injury Hotlines:

National Suicide Prevention Hotline: 1-800-273-TALK (8255)

National Self-Injury Helpline: 1-800-DONT-CUT (366-8288)

24-hour Crisis Hotline: 1-800-273-TALK

Self-Injury Foundation: 1-800-334-HELP

Additional Resources for Self-Injury:

S.A.F.E. Alternatives: a program that offers resources, referrals for therapists, and tips on how to end self-injury.

Adolescent Self Injury Foundation: an organization that works to raise awareness about adolescent self-injury and provides education, prevention tips, and resources for self-injurious adolescents and their families.

Self-Injury Support: a charity group that provides referrals and support for patients in the UK.

Page last audited 8/2018

A Letter to My Younger Self

This month on the Band, we’re sending letters to our younger selves – it’s important and it’s freeing. So please, go ahead and submit your own! (you can even do it anonymously)

We are ALSO looking for stories of brain injuries and other problems with the brain, by request, so please, let us know if you’d like to share.

Dear Younger Me,

I can see you so clearly in my memory. Snuggling up with him in a bean bag chair, watching Duck Tales. Making Chewbacca noises at each other, louder and softer, higher and lower, but always laughing about it. Chocolate pudding to get him to take his medicine. Stroking his hair while he seized, and he seized a lot.

I can see it change you. It made you resilient. It made you strong. It made you selfish and afraid. It made you paralyzed damn near thirty years later when your own daughter had a seizure. Even after helping through thousands of them, you panicked. It’s okay, you told yourself, and you meant it. It’s still okay, with hindsight. I would still panic now. You never wanted children because of him. You were afraid of what you would have to do if they were like him. But his wasn’t a genetic condition. It was the result of a brain injury either shortly before or after birth. Maybe it was a stroke before he was even born. Or the high fever after one of his vaccinations. All theories welcome, because we’ll never actually have the answer.

You lived in anticipation of the next Big Bad, and while you had many good things happen, you can’t shake that feeling. Waiting for the next thing to happen. It’s okay. They will, you know, they will happen. And you will meet them all as they do.

Loved you then, love you now, love you always (even when we forget for a minute).


Hi, I Used To Cut Myself

Clench my teeth
brief sensation of pain
Wait for it to come
it takes a second
Bringing with it relief
here it comes
Pain flows out
trickling down my arm
In little red rivulets
so warm and wet
I have no problems

That cheery little poem is mine. Oh, it’s from many years ago. Back when I was still living with my parents, in fact. That last line? Is total crap. Yes, the blood brought relief of some feelings, but the guilt and anxiety that was left every time I looked at the scars….yeah, sometimes even THAT was enough of a trigger.

I’ve been pretty up-front about dealing with Postpartum Depression, Generalized Anxiety Disorder and major depressive disorder.

But, to add to the list of things that I don’t talk about, I’m also a cutter.

I probably ought to say “was”…..because I haven’t actually cut myself in years. But you know how some people say that they will always be a recovering alcoholic, and never recovered. It’s like that.

The urge to give in is there. It’s not my first reaction to bad news, anymore, but when I’m at my lowest, or most anxious, I still want to.

There are certain movies that I couldn’t watch all the way through for a long time, like Thirteen or Girl, Interrupted because they make me want to cut myself.

This is a big step for me. Other than my parents, one or two friends from way back then, and my husband and now half-the-freaking-internet, no one knows this. Come to think of it, I don’t know if I bother to tell my therapists. Yes, I know. I’m a horrible patient.

After I decided to stop, which wasn’t until I was pregnant with my first, AND it was totally selfish at first; too many doctor’s exams that required getting naked. I kept waiting to outgrow the feelings. You know, the way I outgrew angsty poetry, and emo-ish music? But I’m still waiting.

Still fighting.

Still coping.