What is Self-Harm?

Self-harm is the act of intentionally inflicting harm to self, often using whatever is available at the time.  People typically engage in self-harm by scratching, burning, cutting, biting, peeling, picking at skin, or overdosing on medication. However, engaging in other high-risk or dangerous behaviours can be considered self-harm, such as binge drinking, unsafe sex or reckless driving.  

People often self-harm in response to unpleasant emotions that they experienced historically or are experiencing in the moment.  Research shows that people of all ages and backgrounds self-harm, which means that there is no singular explanation, as it can affect anyone.  Common risk factors for self-harm include experiences of:

• Trauma
• Bullying
• Loss
• Stress and Anxiety
• Depression (particularly feelings of apathy or numbness)
• Anger
• Eating disorders
• Stigma and/or discrimination (Racial, LGBTIQ, gender identity, ability) 
• Interpersonal or relationship issues
• Poor self-esteem or self-image
• Financial issues
• Physical, sexual or emotional abuse 
• Existential crisis

Why do people self-harm?

If you have experienced one or more of the above, you may already know how difficult it is to process distress both physically and mentally, as well as understand that everyone responds differently.  People who self-harm in response to negative affect often describe it as:

• A way of changing their emotional pain into a physical pain which improves their sense of being in control, especially when feeling overwhelmed.
• A means of expression or feeling something that they cannot describe verbally, especially if having trouble connecting to the world and people around them and are prone to episodes of ‘dissociation’ (sense of detachment from body or reality).
• An escape or means of punishment in relation to specific situations or experiences.  

In any case, those who self-harm typically develop unhelpful associations between physical pain or discomfort and positive feelings of release or relief.  This is defined as ‘maladaptive coping’, which is the use of unhealthy mechanisms to deal with distress.  As the frequency of maladaptive coping increases, behaviours are reinforced and strengthen the unhelpful association.  Therefore, people may start to engage in self-harm more habitually and in response to various emotions or experiences which were not initial triggers.  Theory suggests that once reinforced behavioural patterns are established, it becomes increasingly difficult to break a cycle independently.  Therefore, if you have related to any of the above, you may find it useful to visit your GP or arrange an appointment for psychological assessment to review some support options available to you.  

How online therapy can help with self-harm

You and your online therapist can explore the nature of your self-harm together in a safe, non-judgmental environment.  In sessions, you may increase your understanding of self-harm behaviours and learn ways of recognising and responding healthier to your specific triggers.  Developing an increased awareness of motivations to self-harm may help prepare you for certain experiences, for example, you might start implement a self-care plan months before exam season to prevent the build-up of stress and anxiety.

However, in some cases, there may be more complex motivations to self-harm such as trauma and suicidal ideation, which can develop into suicidal intent.  Therefore, it is important to discuss underlying thoughts, feelings and behaviours early on, to establish an appropriate therapeutic plan and pace of intervention.  In cases where there is significant risk of harm to self, other appropriate agencies may be involved with your consent, to safeguard your wellbeing.  

There are various therapeutic approaches that demonstrate effectiveness in reducing episodes of self-harm, which your therapist can go through with you to find out which is most suited to your individual needs.  Most individuals benefit from Cognitive Behavioural, Distress Tolerance and Compassion Focussed techniques, which can facilitate new ways of coping, for example, replacing urges to self-harm with self-soothing.  

In addition to focussing on impulse control, you can learn to enhance emotional regulation and interpersonal effectiveness skills. A harm-minimisation approach may also be useful for people who self-harm recurrently; this can help to manage scarring and help those who feel compelled to self-harm stay safe whilst doing it.  Whatever your therapeutic aims are, please remember that there are multiple ways of working with you to support your pathway to recovery and wellbeing.  

Free initial telephone discussion

If you are looking for online therapy please contact Teresa Lewis for a 15 minute no-obligation discussion. Teresa is a BACP Senior Accredited Counsellor and Psychotherapist so she will be able to briefly discuss your issues, answer questions and explain more about how online therapy can address self-harm.  At this time you can decide whether you would like to book an appointment. The discussion is conducted without any obligation to book an appointment.

Make an appointment for online therapy

If you would like to speak to one of our therapists regarding online therapy for self harm please call: 01902 827808.  Alternatively, fill out our online contact form and we will contact you within 24 hours.

Medical disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice by a qualified doctor.