Self Harm Treatment
What is Self-Harm?
Have you ever experienced the urge to hurt yourself? If you have, you’re not alone. Just like you, many other people see self-harm as a way to cope with distressing thoughts and emotions. With a lifetime prevalence rate between 4 and 5.9 percent in the general population, self-harm is common among young adults. But how can you heal from this condition? And if you have a loved one with a tendency to self-harm, how can you help them? Here’s what you should know about the condition and treatment options.
Self-harm refers to the act of hurting yourself and causing physical pain as a way to cope with overwhelming emotions, painful memories, or stressful experiences. It can occur due to nonsuicidal self injury disorder or as a symptom of certain personality disorders. You may engage in self harming behaviors to stop feeling numb, distract yourself from negative emotions, or punish yourself for your feelings.
Types of Self-Harm
When most people think of self-harm, the image of cutting oneself on the arm or wrist usually comes to mind. However, there are different types of self-harm, some of which are less visible than cuts.
- Burns from cigarettes or other sources
- Picking on scabs to prevent a wound from healing
- Excessive exercise
- Ingesting toxic substances
- Hitting or punching yourself
- Starving yourself
- Abuse of substances or alcohol
- Head banging
It can also include skin-picking, hair-pulling, and other forms of self-mutilation.
Symptoms of Self Harm
Some of the most common symptoms of self-harm include:
- Statements that indicate hopelessness
- Feelings of worthlessness
- Unexplained bruises, burns, or cuts on the wrist, thighs, arms, and chest
- Difficulty maintaining relationships
- Wearing full sleeves and long-legged pants at all times, even when it's hot
- Excessive hair loss unexplained by the rate of hair fall
- Statements that indicate self-loathing
- Socially withdrawn
- Unexplained weight loss or gain
- Frequently reporting 'accidental' injuries
Causes of Self-Harm
In most cases, self-harm is the result of:
- Poor impulse control and coping skills
- Difficulty in regulating emotions
- Acting in response to intrusive thoughts
- Reducing tension
- Trying to punish yourself
Some risk factors can increase the likelihood of self harming behavior, such as having a mental illness, experiencing traumatic or stressful events, or substance abuse.
Can Self-Harm be Prevented?
It’s possible to prevent self-harm by relying on healthy coping techniques instead. This includes the use of distractions, calming techniques, or talking to someone about your feelings. When you begin therapy sessions, your mental health care provider will help build your coping skills so you can manage emotions and express them without engaging in self-harm.
How is Self Harm Diagnosed?
When you have a habit of self-harm, your mental health care provider will need to determine if you have a nonsuicidal self-injury disorder or if it’s a symptom of some other disorder. For instance, mental health disorders like borderline personality disorder or schizophrenia.
To determine a diagnosis, you’ll have to undergo a pre-treatment evaluation. This includes a medical and psychiatric evaluation to get a complete picture of your physical and mental health.
- During a medical assessment, a physician will look at your medical records and history to see if you have any preexisting conditions. They’ll also ask about your substance use habits to rule out the possibility that you self-harm while under the influence of certain substances.
- In a psychiatric evaluation, mental health professionals will ask about your symptoms. They’ll also get additional information regarding your behavior from family members and friends.
- To make a diagnosis, a psychiatrist will compare your symptoms with the diagnostic criteria in the APA’s DSM-5. Published by the American Psychiatric Association, it provides detailed information that can help mental health practitioners make accurate diagnoses and differentiate between presentations of similar-looking conditions.
For a diagnosis of nonsuicidal self injury disorder, you should have engaged in self-inflicted damage to your body on five or more days. Moreover, you should have done so with the expectation of resolving interpersonal difficulties, inducing a positive-feeling state, or relieving negative feelings.
How is Self-Harm Treated?
The most effective method to treat self-harm involves the use of evidence-based techniques such as psychotherapy. But at the same time, most residential treatment programs, such as URP Behavioral Health, take a holistic approach to improving well-being. This means treating the mind, body, and spirit instead of the mental disorder.
A holistic treatment methodology during a residential treatment program will include complementary therapies that enhance relaxation. Some examples include animal-assisted therapy and meditation.
Starting Self-Harm Recovery
The first step to recovering from self-harm is to acknowledge that you want to make a change. Once you commit to recovery, you can start by reaching out to friends and family members who can provide support along the way.
Then, book an appointment with a mental health professional to discuss treatment options like outpatient and inpatient treatment. During the treatment process, it’s possible that you’ll encounter overwhelming emotions again. In these times, build a safe space, such as a cozy corner in your home or a peaceful outdoor area, where you can calm yourself and feel safe.
Inpatient Mental Health Treatment for Self-Harm
If you want to stop self-harming but can’t help yourself when faced with intense emotions, it’s best to seek inpatient treatment. It’s an intensive form of treatment in which you’ll be provided with an individualized plan, this type of care can be accessed almost immediately.
The plan will include therapies that can help you manage unpleasant emotions and cope with them in a productive manner. Some of the most common evidence-based treatment options include the following:
Cognitive-Behavioral Therapy (CBT) for Self-Harm Behavior
Research indicates that psychotherapy, such as cognitive behavioral therapy, is effective for people who self harm. It’s a structured form of psychotherapy with fixed goals, and it’s used to identify and change negative thought patterns.
Some examples include overgeneralizing or catastrophizing. In these situations, your therapist will ask questions encouraging you to reach a rational conclusion to the problem.
There’s evidence that CBT leads to greater reductions in self-harm behavior, as well as depressive and anxious symptoms. You’re also more likely to show healthy problem-solving skills, impulse control, and self-esteem.
Psychodynamic Therapy
Individual psychotherapy is a core component of any inpatient treatment plan. One of the perspectives your therapist can apply is the psychodynamic theory. It emphasizes our unconscious conflicts and repressed emotions, which cause us to act in the ways we do.
During psychodynamic therapy, a mental health professional will explore your relationships and experiences in a safe environment. This can help you understand how your past experiences and conflicts cause you to act aggressively toward yourself. Once these thoughts and feelings are in your conscious awareness, your therapist will assist you in managing them.
Dialectical Behavioral Therapy
A variation of CBT, dialectical behavior therapy is also a form of talking therapy, but it’s focused on improving emotional regulation. It’s designed for people who experience intense emotions, which is common when you self-harm.
In DBT sessions, you’ll build important skills like distress tolerance, interpersonal effectiveness, emotional regulation, and mindfulness. Adopting these principles will allow you to understand and manage your difficult emotions.
Relapse Prevention
Even if you stop self-harming after getting treatment, it’s possible to relapse during a stressful situation. To prevent a relapse, it’s important that you understand your triggers and practice alternative strategies. Your therapist may suggest the following:
- distraction techniques like watching something funny or exercising
- calming exercises like meditation or snuggling with your pet
- practicing self-expression, such as painting or journaling
- talking to others about how you feel
- changing your environment by going outdoors or in a public space
References
- https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-1060-x
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037877/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422226/
- https://www.sciencedirect.com/science/article/pii/S0010440X14002351
- https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013668.pub2/full
- https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/cognitivebehavioural-intervention-for-selfharm-randomised-controlled-trial/DFB8B20412C79D544036627D1CB91627
- https://www.cambridge.org/core/journals/bjpsych-advances/article/psychodynamic-approaches-to-suicide-and-selfharm/13754D5307826B56844258FAF82C0305
- https://pubmed.ncbi.nlm.nih.gov/33875025/
Self-Harm Treatment FAQs
Here are some of the most commonly asked questions about self-harm and treatment options.
When you have a tendency to self-harm and feel like you’re having a crisis, it’s important to talk to someone who can help you calm down. Ideally, you should speak to a licensed crisis counselor who can offer support and guidance to get you through the situation. You can call a crisis helpline or send a message on a text line to connect with a counselor and get the help you need. Additionally, you should reach out to a close friend or family member you trust, so they can stay with you and keep dangerous objects or weapons out of reach.
If you suspect that a loved one is engaging in self-harm, look for signs such as:
- Unexplained bruises, burns, or cuts on the wrist, thighs, arms, and chest
- Wearing full sleeves and long-legged pants at all times, even when it’s hot
- Excessive hair loss unexplained by the rate of hair fall
- Statements that indicate self-loathing
- Socially withdrawn
- Unexplained weight loss or gain
- Frequently reporting ‘accidental’ injuries
These signs indicate that someone is using self-harm as a coping mechanism and can potentially hurt themselves. If you spot these signs, talk to them and listen to their struggles before recommending treatment options.
These signs indicate that someone is using self-harm as a coping mechanism and can potentially hurt themselves. If you spot these signs, talk to them and listen to their struggles before recommending treatment options.
In most cases, self-harm refers to nonsuicidal self-injury, but it’s possible to self-harm with suicidal intent. When you engage in suicidal self-harm, you cause physical injury to yourself with the intent of ending your life. This can include things like cutting or using firearms. On the other hand, you may engage in acts of nonsuicidal self-harm as a way to regulate intense emotions. Some examples of nonsuicidal self-harm include punching walls or banging your head against the wall. So although self-harm can be a sign of suicide, it isn’t always the case.
If you’re looking after someone with a tendency to self-harm, you’ll need to provide support and assistance to prevent them from engaging in self-harm behavior. This can include reducing the risk at home by doing the following:
- Remove sharp and dangerous objects such as knives and firearms.
- Remove alcohol and substances that cause them to act on their feelings.
- Understand their triggers (objects, people, events)
- Communicate with them and practice active listening to understand their condition.
- If they experience the urge to self-harm, engage them in alternative coping strategies
- Enroll them in a treatment program and offer support to ensure treatment completion.
Enroll them in a treatment program and offer support to ensure treatment completion.
Let us guide you towards healing
We know that seeking treatment can be overwhelming, but our staff is here to make the process as smooth as possible. We’re available 24/7 to address any questions or concerns you may have.
