Talking about self-harm is hard. It's a topic surrounded by taboo, misunderstanding, and fear. But it is precisely silence and stigma that prevent so many people — especially adolescents — from receiving the help they need. As a licensed health psychologist, I firmly believe that understanding self-harm is the first step to being able to help. This article is aimed both at people who self-harm and at families who want to understand and support their children.
What is self-harm?
Self-harm (also known as non-suicidal self-injury) is the deliberate damaging of one's own body without suicidal intent. The most common forms include cutting the skin, scratching to the point of breaking the skin, hitting oneself, burning, or pulling out hair. It's important to clarify from the outset: self-harm is NOT a suicide attempt, although it does constitute a risk factor that must be taken seriously.
The data indicates that between 15% and 25% of adolescents have engaged in some form of self-harm at least once. The most frequent age of onset is between 12 and 15 years old, although it can appear earlier or later. It is not exclusive to adolescence: adults of all ages can also display self-injurious behaviors.
Why do people self-harm?
Self-harm as emotional regulation
The main function of self-harm is emotional regulation. When a person experiences emotional pain so intense that they feel overwhelmed — extreme anxiety, deep sadness, uncontrollable anger, a sense of emptiness — self-harm can act as a "release valve" that provides temporary relief. Physical pain activates neurochemical mechanisms (endorphins) that momentarily reduce emotional distress.
Other functions of self-harm
In addition to emotional regulation, self-harm can serve other functions: feeling something when there is a sense of emptiness or emotional disconnection, expressing pain that cannot be put into words, punishing oneself for feeling "bad" or "unacceptable", feeling control over at least something when everything feels chaotic, or communicating to others the seriousness of one's distress when words don't seem enough.
Myths about self-harm that need dispelling
Many myths make it harder to understand and help people who self-harm:
- "They do it for attention": This is the most damaging myth. Most people who self-harm hide their wounds out of shame. And even when self-harm has a communicative element, that doesn't make it any less real or any less painful. If someone needs to hurt themselves to "get attention", their need for help is urgent.
- "If they self-harm, they want to commit suicide": As we've explained, self-harm generally does not have suicidal intent. However, it is a risk factor that requires professional attention.
- "It's a teenage trend": Self-harm is not a fad but a manifestation of real suffering. Trivializing it stops people who are affected from seeking help.
- "If it were serious, the wounds would be worse": The severity of self-harm is not measured by the depth of the wounds, but by the emotional pain behind it. Any form of self-harm deserves attention and care.
- "It's a girl thing": Although statistics show a slightly higher prevalence in girls, boys also self-harm. The added gender stigma means that boys tend to hide it even more.
Warning signs in adolescents
As parents, educators, or people close to a teenager, it is important to be alert to certain signs:
- Always wearing long sleeves or clothing that covers the arms and legs, even in hot weather.
- Wounds, scars, bruises, or burns that have no clear explanation.
- Finding sharp or pointed objects hidden in their room.
- Progressive social isolation and loss of interest in activities they previously enjoyed.
- Sudden mood swings, irritability, or persistent sadness.
- Avoiding activities that involve showing the body (going to the pool, changing in front of others).
- Unexplained bloodstains on clothes or sheets.
How parents and family members can help
Discovering that a son or daughter is self-harming is one of the most distressing experiences for a family. The natural reaction may be fear, anger, or despair. However, the way we respond is crucial:
Stay calm: However hard it is, avoid reacting with panic, anger, or punishment. Your reaction will determine whether your child will feel safe enough to talk to you about what is happening or whether they will close down even further.
Listen without judging: Don't say "I don't understand why you do this to yourself" or "with everything you have". Try: "I can see you're going through a hard time and you matter a lot to me. I want to help you."
Don't force a promise: Asking your child to promise they won't hurt themselves again creates more pressure and guilt. Instead, focus on finding professional help.
Don't simply remove objects: Confiscating all sharp objects without addressing the underlying emotional problem solves nothing: the person will find other ways to harm themselves. The important thing is to treat the causes.
Child and adolescent therapy is essential in these cases, as it offers a safe space where the adolescent can explore their emotions and learn alternative regulation strategies.
Therapeutic approaches for self-harm
Treatment of self-harm focuses on addressing the underlying emotional causes and teaching alternative regulation strategies:
- Cognitive behavioral therapy (CBT): Helps to identify the thoughts and situations that trigger self-harm and to develop alternative responses.
- Dialectical behavior therapy (DBT): Specifically designed for people with emotional regulation difficulties, it teaches skills in distress tolerance, emotional regulation, and interpersonal relationships.
- Trauma work: In many cases, self-harm is linked to unprocessed traumatic experiences. Trauma treatment through EMDR can be very beneficial for processing these experiences and reducing the need for self-harm as a coping mechanism.
A message of hope
If you self-harm, I want you to know that what you're going through is important and that you deserve help. You are not "crazy" or "bad": you are suffering and you have found the only way you know to manage that pain. Therapy can help you find other ways to regulate your emotions without hurting yourself.
If you are a parent or family member, you are not alone in this. Your concern shows that you care, and asking for professional help is the most important step you can take. Don't hesitate to contact me to begin a therapeutic process that supports your son or daughter.