What is self harm?
Self harm or NNSI (Non-Suicidal Self Injury) is basically when someone hurts themselves on purpose. Self harm is different from suicidal attempts or thoughts in that, when someone is engaging in self harm (i.e. cutting or burning themselves), they are not typically trying to kill themselves. Instead, self-injury is a way to escape or avoid intense feelings and emotional pain or distress.
The most typical types of self harm are:
- Skin cutting (70-90%),
- Head banging or hitting (21%-44%), and
How is Self Harm Diagnosed?
According to DSM-5, NSSI diagnostic criteria are as follows (American Psychiatric Association, 2013):
Over the past year, the person has for at least 5 days engaged in self-injury, with the anticipation that the injury will result in some bodily harm. No suicidal intent.
- The act is not socially acceptable.
- The act or its consequence can cause significant distress to the individual’s daily life.
- The act is not taking place during psychotic episodes, delirium, substance intoxication, or substance withdrawal. It also cannot be explained by another medical condition.
- The individual engages in self-injury expecting to
- Get relief from a negative emotion
- To deal with a personal issue
- To create a positive feeling
The self-injury is associated with one of the following:
- The individual experienced negative feelings right before committing the act.
- Right before self-injury, the individual was preoccupied with the planned act
The individual thinks a lot about self-injury even if act does not take place.
What is the cause of self harm?
There are many possible causes of self harm.
Risk factors include but are not limited to:
- Low self esteem
- Relational difficulties
- Lack of secure attachment
- A diagnosis of Borderline Personality Disorder
At MCFT, we will do a thorough assessment of the history of self-harm, as well as personal developmental and psychological history to screen for any underlying issues that can be a root cause for the felt need to self-harm. We also do a risk assessment during every session with clients of self harm to ensure safety and stability in order to provide the most effective treatment.
Then, we will decide on the best course of treatment that might include:
- Referral to a psychiatrist for medication management
- Mindfulness strategies and relaxation skill for managing overwhelming thoughts and emotions
- Cognitive behavioral therapy to work through maladaptive thoughts and feelings associated with self harm
- Parent-child interaction therapy to help create a strong support system for coping with self harm as a family
- EMDR (eye movement desensitization reprocessing) to work through traumas that are triggering emotional reactivity
If you are needing immediate assistance, here are some numbers you can call:
- 1-800-273-TALK (8255): National Suicide Prevention Hotline, a 24-hour crisis line for if you're about to self-harm.
- 1-800-334-HELP (4357): The Self-Injury Foundation's 24-hour crisis line.
- 1-800-366-8288: S.A.F.E. Alternatives information line for immediate support and/or referrals to a local physician .