May

18

2023

Why do People Self-harm and how can Therapy Help?

Self harm is when a person causes pain or injury to their own body. It is often used as a way of coping with difficult emotions, life situations or memories.

People who self-harm often describe the act as giving them a short-term release from their difficulties.

However, after self-harm the difficult feelings, memories or situations are still there. This can lead to a reliance on self-harm as a coping mechanism, to further pain and to other risks associated with self-harm.

Typical reasons someone might self-harm include:

  • To create a sense of being in control
  • As a distraction from painful memories
  • As an escape from a difficult life situation
  • As self-punishment
  • To break free of a feeling of ‘numbness’
  • To channel suicidal ideation

This video explains more about the meaning behind self-harm.

Misconceptions

There is a misconception that people who self-harm are simply ‘attention seekers’. But they also often experience shame for the behaviour.

People who self-harm may indeed crave human connection and support, but to brush self-harm off as trivial is a mistake.

People also often associate self-harm with someone cutting themself, but the behaviour can come in many forms. Self-injury can be anything which causes a person physical or emotional distress. This could include substance misuse, overeating or undereating or repeatedly seeking out situations which cause emotional distress.

Young People

Self-harm is on the rise, and is particularly prevalent in young people. One study in the US found that 8% of young people reported self-harming (Barroccas et al, 2012).

In England, the 2014 Adult Psychiatric Morbidity Survey reported:

  • The proportion of people aged 16–74 years who reported having ever self-harmed increased from 2.4% in 2000, to 3.8% 2007, to 6.4% in 2014
  • Around one in every four 16 to 24-year-old women (25.7%) reported having self-harmed at some point; more than twice the rate for men in this age group (9.7%). The rate in women aged 25–34 years was 13.2%.

This video shares a story of a young person who self-harmed, and ways of getting support.

Counselling and psychotherapy

While many mental health services prioritise minimising risk when it comes to self-harm, counselling and psychotherapy offers additional support to work through the feelings and behaviours of self-harm.

The counselling relationship provides the perfect space for each person to share their unique experience and explore the meaning behind self-harm.This building of self-awareness can bring relief to those who self-harm. By understanding the root of the behaviour and working through the associated feelings, people who self-harm can find new and safer ways to self-soothe.

Therapists

For therapists, working with self-harm is a complex process with many important considerations to attend to, including:

  • managing confidentiality while protecting a client from harm
  • the impact of self-harm disclosure on the therapist
  • safety planning
  • ensuring a client’s capacity to engage with therapy
Services

For help with self-harm in the UK, you can call 116 123 to talk to Samaritans.
You can also message ‘SHOUT’ to 85258 or ‘YM’ if you’re under 19 to contact the Shout Crisis Help Line.
People under 19 can also call 0800 1111 to talk to Childline.
Web chat is available to support those who self-harm. Webchat Self Injury Support is open for women and girls, and CALM webchat is available for men.
Talking to your GP can also be a good place to get initial support. They can direct you to support groups and talking therapies such as Cognitive Behavioural Therapy, and can also help to deal with any injuries. The NHS website gives more information about how a GP can help with self-harm.

There are many other charities and organisations which support those who self-harm, including:

 

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