As of writing this, a week has passed since “Self-Injury Awareness Day”, which lands on March 1st. While self-harm is a hot topic within the psychology and counseling fields, there are still a lot of myths and unknowns that are spoken between folks not working in those fields. Self-harm, or nonsuicidal self-injury (NSSI) is the “intentional destruction of one’s own body tissue without suicidal intent and for purposes not socially sanctioned” (Klonsky et al., 2014). There are a multitude of ways individuals partake in NSSI. Perhaps the most well-known method is cutting, but others may burn themselves, scratch themselves, bite themselves, hit themselves, and more. NSSI is most common among adolescents and young adults, most commonly starting at the age of 13 or 14 (Klonsky et al., 2014). With that, rates of self-harm appear to be equal between cisgender men and women. Rates of NSSI for those within the LGBTQIA+ community are exponentially higher than heterosexual and cisgender identifying folks (Jadva, et al., 2023).
A common question surrounding NSSI is “why?”. “Why do people physically harm themselves?”, “Why are they damaging their bodies?”. The answer is different for each person who partakes in it. The most common reason is that an individual uses it to temporarily ease “an overwhelming negative emotion” (Klonsky et al., 2014). Others may use it as self-punishment, and others may use it to alert others and receive attention and aid. A common misconception regarding NSSI is that everyone who does it is “doing it for attention”, and while it is a reason, it is seemingly the least common reason individuals self-harm (Klonsky et al., 2014); more people are likely to be doing it to relieve their overwhelming negative feelings or to punish themselves.
And, just to be extra clear, NSSI is not at all the same as suicide, suicidal behaviors, or suicidal ideation. While NSSI can be a strong predictor of suicidal ideation or behaviors, not everyone who harms themselves experiences suicidal ideation or partakes in suicidal behaviors.
You may now be thinking about the treatment for NSSI. While research on treatments for NSSI is slim, the research that has been done strongly supports individuals participating in psychotherapy, especially for adolescents. There are different methods that all yield positive results regarding self-harm. Dialectical-behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based treatment (MBT) have all shown to be successful in reducing rates of NSSI for the adolescents treated in their respective studies (Klonsky et al., 2014). As with any other reason for going to therapy, different techniques will work for different people. DBT may work for one individual while CBT or MBT works for another. No studies suggest one form of treatment is superior to another. Researching each form and understanding how they approach treatment is the best way to determine what form of treatment would work for an individual.
While this blog post is not an intense discussion on self-harm behaviors and suicidality, it is my hope to have cleared some misconceptions regarding these behaviors that are often seen in adolescents.
If you or someone you know is in danger or experiencing an emergency, please call 911. If you or someone you know is partaking in NSSI or experiencing suicidal ideation, please contact a mental health professional or medical professional. Below, you will find hotlines individuals can call if experiencing a mental health crisis:
988: Suicide and Crisis Hotline. You can call or text this number and be connected with a trained crisis worker
Text CONNECT to 741741: Self-harm crisis hotline
Written by,
Annika Bushman, Intern