For many, self-harm is a coping mechanism used in an attempt to regulate
strong emotions. This is what’s called “non-suicidal self-injury,” meaning the
individual using self-harm to cope does not necessarily intend to
permanently harm themselves or end their life.
While it can feel effective in the moment, self-harm is a poor strategy for
overall well being and can lead to long-term consequences like serious injury
Treatment for self-harming behavior aims to equip individuals with more
effective coping skills that, unlike self-harm, do not result in guilt and shame
or physical wounds and scarring. To engage in treatment, or to support
someone who self-harms, it is important to understand the function it serves
and the cycle of these behaviors.
The cycle, while unique to each individual, can include the following:
occurrence of a trigger event
self-harming action, followed by relief
experience of guilt and/or shame about self-harm
build up of tension and emotion
occurrence of trigger event that causes the need to relieve themselves through self-harm
Many can feel powerless over this cycle, hopeless, and out of control.
Treatment and support can help individuals regain their sense of safety and
build confidence in their ability to break the cycle.
The key to this process is understanding and communicating one’s triggers.
Triggers frequently occur in subtle or subconscious ways, causing individuals
who self-harm to not always understand why they are feeling the need for
relief through pain. Working with a trained therapist can help individuals
identify and track their triggers so that they regain that sense of awareness and agency.
Once triggers are recognized, individuals have the opportunity to avoid or
cope through triggers using self-soothing strategies they’ve been practicing
in therapy. Practicing new coping strategies allows individuals who self-harm
to build new neural pathways in their brain so that self-harm no longer feels
necessary or helpful. This is how the cycle is broken.
How to support a loved one through self-harm
Recognize self-harm as an attempt to take care of themselves
Never punish or shame someone for self-harm. Shaming can result in them pulling away from you.
Self-harm causes enough shame and guilt on its own.
Praise them for the healthy coping strategies they use, even very minor ones
Encourage them (gently) to consider treatment
Ask how you can help: are they willing to discuss the cycle of self-harm with you? Would they like to confide in you what their triggers are so that you can help them cope through difficult moments?
Continue to educate yourself so that you can be there for them when/if they are ready
About the author:
Savannah Betancourt, PsyD, has worked with patients and families who are struggling with self-harm behaviors.