About self harm

Some people think of self-harm as a continuum, with suicide at one extreme and no self-harm at the other end, while in between is serious harm, moderate and minor harm. However, other people think of self-harm as quite different from suicide or attempted suicide.

This difference in approach seems to be because they think of the reasons for self-harm as different to the reasons for suicide, or perhaps that people who commit suicide have sought to end all feeling, while people who have self-harmed have just tried to make themselves feel better.

Here, self-harm is considered distinct from suicide - we use the term self-harm to refer to deliberate harm, but where the aim is not death.

Who self harms?

An estimated 1 % of people in developed countries self-harm. In the UK alone 170,000 cases of self-harm need hospital attention. Some people are more likely to self-harm than others groups at higher risk include:
young people between 15 and 25 years, women, people of Asian origin, people who are dependent upon alcohol or street drugs

There is also a number of psychological risk characteristics linked with self-harm:

  • people with psychiatric disorders including depression, bipolar disorder, personality disorder and schizophrenia
  • people who have a strong dislike of themselves
  • people who are very sensitive to rejection
  • people who have a lot of pent-up anger
  • people who tend to be impulsive
  • people who have few effective coping strategies
  • people who feel that their lives are out of control
Why do more women than men self harm?
Many people who self harm feel extreme rage and anger. One theory about self harm is that society sees it as less acceptable for women to express violence externally and when confronted with feelings of rage or anger, women tend to take it out on themselves. The phrase "Men act out. Women act out by acting in" describes this very well.

Why do people self harm?

There are many reasons why people self harm. Each person who self-harms has his or her own reasons for doing it. Often the reasons people give for their self harm behaviour is different from the professionals.

The reasons that people who self harm give for their behaviour can be broadly grouped into three categories:

Affect regulation
is the ability to deal with emotions and feelings. Specifically, if you are aroused by turbulent or unsettling feelings, it is the ability to regulate those feelings so that you are not overcome.

Affect regulation includes recognising emotions and being able to deal with them in a productive way. Often people who self harm cannot deal with strong and powerful emotions; they feel that they will be overwhelmed or unable to control themselves. In order to deal with the emotions they harm themselves. Self harm can lead to dissociation, a temporary leave of the feelings while at the same time releasing positive brain chemicals which can bring about improved mood.

Communication
 Some people use self harm as a way to express things they cannot speak about. Some professionals see this as attention-seeking. When the communication is directed at others, self harm is often seen as manipulative.

People who self harm for this reason have often tried many other more acceptable ways of communicating and have been ignored, or received an inappropriate response.

Self harm gets the attention of people but often in an unhelpful way. Understanding what an act of self harm is trying to communicate can be crucial to dealing with it in an effective and constructive way.

Control/punishment
 People who self harm have often experienced traumatic experiences in their lives. This can include emotional, physical or sexual abuse.

Self harm can lead to trauma re-enactment bring about the feelings the person felt when they were first traumatised, bargaining and magical thinking (if I hurt myself I will prevent the thing I fear about). Self-control overlaps somewhat with affect regulation

National Advice Service Factsheets

The information in this section is taken from the NAS factsheet, which you can download in pdf format and print for individual use.

Self harm factsheet