What is Non-Suicidal Self-Injury?
Non-suicidal self-injury refers to any deliberate, non-suicidal behaviour that is intended to cause physical harm or pain to one's body, for the purpose of coping with emotional distress. Self-injury can come in many forms, including: cutting, scratching, interfering with wound healing, burning, biting, hitting, hair pulling, severe nail biting and/or nail injuries, piercing skin with sharp pointy objects, piercing of body parts, breaking bones, head banging, taking too much medication, taking too little medication, abusing alcohol or drugs, over-eating or under-eating, and eating or drinking things that are not food. People may self-injure on different parts of their bodies (e.g., wrist, thighs, face, abdomen, etc.) and they likely conceal their injuries.
Although self-injury may provide temporary relief of difficult emotions, it does not deal with the underlying issues. People who self-injure often begin to turn to this behaviour more often to cope with their day-to-day stress and find that it can quickly escalate in both frequency and severity. Self-injury often becomes difficult to resist even when a person wants to stop.
Although self-injury may provide temporary relief of difficult emotions, it does not deal with the underlying issues. People who self-injure often begin to turn to this behaviour more often to cope with their day-to-day stress and find that it can quickly escalate in both frequency and severity. Self-injury often becomes difficult to resist even when a person wants to stop.
Why do People Self-Injure?
People self-injure primarily to cope with emotional distress; they find it easier to deal with physical pain than their emotional pain.
The term “emotional distress” is a broad term that refers to a range of emotions that a person finds difficult to manage. The following is a list of distressing emotions that have been linked with self-injury: unbearable tension, anger, feeling alone and empty, feeling “down”, feeling numb and “unreal”, sadness, and frustration. The Ottawa Self-Injury Inventory provides a list of other reasons that people may self-injure, including: experiencing a “high” that feels like a drug high, to stop others from being angry at them, to get care or attention from others, to punish themselves, to avoid getting into trouble, to distract from unpleasant memories, to belong to a group, to communicate pain to others, to stop others from expecting so much of them, to stop thoughts of suicide or to stop themselves from acting out ideas of killing themselves, and to prove to themselves how much they can take.
Although we know the general reasons that people self-injure, each person has their own unique combination of reasons that leads them to this behaviour and the reasons may be different from each occasion. After engaging in this behavaiour for a while, it can become an automatic response to day-to-day stress. Thus, it can be difficult for people who engage in this behaviour to identify the exact triggers or emotions linked to each instance. One of the first interventions in treating self-injury is helping the client identifying the triggers and then helping them find other methods to manage distressing emotions. Treatment also involves discovering the underlying causes of emotional distress and targeting these issues in sessions. Some common underlying issues linked with self-injury include: perfectionism and high achievement, poor body image, low self-esteem, depression, family conflict, borderline personality disorder, trauma and abuse.
The term “emotional distress” is a broad term that refers to a range of emotions that a person finds difficult to manage. The following is a list of distressing emotions that have been linked with self-injury: unbearable tension, anger, feeling alone and empty, feeling “down”, feeling numb and “unreal”, sadness, and frustration. The Ottawa Self-Injury Inventory provides a list of other reasons that people may self-injure, including: experiencing a “high” that feels like a drug high, to stop others from being angry at them, to get care or attention from others, to punish themselves, to avoid getting into trouble, to distract from unpleasant memories, to belong to a group, to communicate pain to others, to stop others from expecting so much of them, to stop thoughts of suicide or to stop themselves from acting out ideas of killing themselves, and to prove to themselves how much they can take.
Although we know the general reasons that people self-injure, each person has their own unique combination of reasons that leads them to this behaviour and the reasons may be different from each occasion. After engaging in this behavaiour for a while, it can become an automatic response to day-to-day stress. Thus, it can be difficult for people who engage in this behaviour to identify the exact triggers or emotions linked to each instance. One of the first interventions in treating self-injury is helping the client identifying the triggers and then helping them find other methods to manage distressing emotions. Treatment also involves discovering the underlying causes of emotional distress and targeting these issues in sessions. Some common underlying issues linked with self-injury include: perfectionism and high achievement, poor body image, low self-esteem, depression, family conflict, borderline personality disorder, trauma and abuse.
Are People Who Self-Injure Trying to Kill Themselves
Although there is a complicated relationship between self-injury and suicide, people who self-injure do not intend to kill themselves. Rather they are using self-injury as a way to cope with the challenges they are facing in their lives. On the other hand, people who want to kill themselves have given up hope that they will find ways to cope and are turning to suicide as their last resort. However, self-injury is a risk factor for suicide in the future (e.g., Boscia, 2012).
Click on the following links to find more information about the similarities and differences between suicide and self-injury:
Click on the following links to find more information about the similarities and differences between suicide and self-injury:
Is Self-Injury Dangerous
Self-injury can start as superficial injuries that, with time, become more serious. Injuries can become so severe that they require emergency medical attention. Although it may be difficult to tell others about your self-injuries due to fear of judgement or fear of upsetting family members, it is crucial to tell someone when you have severely injured yourself and to connect with the appropriate medical professionals. If you have severely injured yourself and need immediate help, go to your closest hospital emergency room or call 911. Below are some contact numbers that may also be helpful:
Services |
Contact |
Police/Fire/Ambulance |
911 |
Kids Help Phone |
1-800-668-6868 |
Vancouver Crisis Line (24 hrs) |
604-872-3311 |
Vancouver After Hours (MCFD) |
604-660-4927 |
Suicide Hotline |
1-800-784-2433 (1-800-SUICIDE) |
Mental Health Emergency Services |
604-874-7307 |
How to Talk to Someone About Their Self-Injur
If you suspect that someone you love is engaging in non-suicidal self-injury, calmly ask them if they are harming themselves. Some people worry that if they ask the question, it will lead someone to self-injure, but this is not the case. It is important to be able to openly talk about what they are going through.
If they are self-injuring, tell them that you are there to help and share your concerns in a nonjudgmental way. It is important to let them know that you understand that they are experiencing emotional distress and that you are sorry they have felt the need to turn to self-injury as a means to cope. Allow them to talk to you about their struggles, but be prepared for them to share things that may be difficult to hear. You can help them by sharing the coping resources below and/or helping them connect with a mental health professional.
If they are self-injuring, tell them that you are there to help and share your concerns in a nonjudgmental way. It is important to let them know that you understand that they are experiencing emotional distress and that you are sorry they have felt the need to turn to self-injury as a means to cope. Allow them to talk to you about their struggles, but be prepared for them to share things that may be difficult to hear. You can help them by sharing the coping resources below and/or helping them connect with a mental health professional.
Resources for Self-Injury:
General Resources:
- Self-Injury Outreach and Support was developed through a collaboration between McGill University and the University of Guelph. It is a non-profit outreach initiative that provides information for those who self-injure, their families, their friends, and their partners. It also provides coping strategies and research on self-injuring.
- The Cornell Research Program on Self-Injury and Recovery website presents research, information, resources and links related to self-injury.
- Distraction Techniques and Alternative Coping Strategies (Kilburn & Whitlock, 2009) from the Cornell Research Program on Self-Injury and Recovery.
- Emotion Regulation Strategies (Rolston & Llody-Richardson) from the Cornell Research Program on Self-Injury and Recovery.
- Coping with Urges from Self-Injury Outreach and Support.
