The Misconceptions Behind Self Harming Behaviors

Self harm is on the rise* in the US and around the globe. Yet many misconceptions around the behavior continue to persist. These misconceptions often lead to missed opportunities to intervene and provide proper treatment. It also leaves those who self-harm feeling stigmatized and ashamed to ask for help.  

What is Self Harm? 

Self-harm is the more commonly used word for Nonsuicidal Self-Injury (NSSI). Mental health professionals use the definition of NSSI from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned, includes behaviors such as cutting, burning, biting and scratching skin. 

While the injuries can occur anywhere on the body, they are usually seen on the wrists, upper thighs, upper arms and stomach. 

Below we debunk several of the commonly held misconceptions surrounding NSSI.  *Asterisks are used to link studies*

Misconception: It’s All For Attention 

Fact: A majority of those who self-harm go through great lengths to hide scabs and scars – which is why they are most likely to be found in places that are covered by clothing. They will wear winter clothes in the summer to cover up the evidence, and buy tattoo coverup makeup to apply. If someone who self-harms does make their cuts or scars visible, it’s often for one of two reasons (neither of which being for attention): 

• As a nonverbal plea for help 
• They are in recovery and have come to accept and appreciate the scars as a part of who they are

Misconception: Those who self harm are suicidal and/or self-harm is a suicide attempt

Fact: The majority* of those who self-injure do not have suicidal thoughts when self-injuring. Which is why mental health practitioners have an entirely different diagnosis for self-injurious behavior. Self-harm is a poor coping skill often used by clients for one (or multiple) of the following reasons: 

• They feel numb inside and want to feel something
• They are overwhelmed by emotions and use it as a way to release or gain control over them
• They use it as a way to punish themselves for past mistakes 

While these reasons may not seem rational to you, we often are not thinking rationally when we are feeling intense emotions, and desperate to feel better.

Misconception: Self-harm is uncommon, unless you suffer from severe pathology or run in a “goth” or “emo” crowd 

Fact:  Almost 50% of adolescent and young adults who engage in NSSI do not meet the full criteria for a psychological disorder.*

• Estimates of self harm in adolescents vary widely, from about 15-33%
• A  2015 study* reported that 1 in 4 girls and 1 in 10 boys will self-harm.
• 30-40% of college students* surveyed reported engaging in self-harm after the age of 17
• Adults also self-injure (about 5%*).
• There is no “face” for self harm – we have seen just about every adolescent stereotype in our offices for NSSI 
• Studies have found that there are certain populations at higher risk of self harm: bi-sexual females, those with childhood trauma, those who report having been bullied and those diagnosed with Borderline Personality Disorder, Major Depressive Disorder, Addiction, and Eating Disorder or a Developmental Delay. 

Misconception: Self-Harming Behaviors are Easy to Stop 

Fact: Unfortunately, both studies* and anecdotal reports have revealed the addiction-like qualities of self-harming, which can make it difficult to stop. Some similar qualities are: increasing tolerance, loss of control over the behavior and increased tension when self-harm is not performed. Like other behavior addictions, it is thought that self-harm may also release endorphins that stimulate the body’s self-injuring is thought to release endorphins and stimulate the body’s natural opioid system.This is not to say that everyone who self-harms develops an addiction-like relationship with the behavior. With any behavior, there are people who try it once and never try it again, or use it for a period of time but are able to stop pretty quickly with proper treatment. 

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While self harm is not an attempt to commit suicide or gain the attention of others, it is a symptom of an underlying problem. If you or someone you know is self-harming, please seek help right away. And know, you are not alone.

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