Self-injurious behavior or self-harm is as it sounds; intentionally doing harm to oneself. Unlike suicide attempts, self-harming behaviors are not driven by a desire to end one’s life. However, some self-injurious behaviors may be life-threatening. Common self-harm includes cutting, burning, hitting, head-banging and hair-pulling. Although self-harm may occur on any part of the body, it is most common on the hands, wrists, stomach and thighs. Self-injury usually develops as an attempt to cope with emotional distress, and some people cut themselves when they feel overwhelming sadness, anxiety or emotional numbness. This behavior is also sometimes used as a form of self-punishment, and a way to outwardly express inner pain.
Girls tend to engage in self-harm more frequently than boys do. While cutting and other self-harm often begins between the ages of 12 and 15, studies suggest that 30-40% of college students who cut began at age 17 or older. The best research available indicates that self-injury occurs in approximately 1% to 4% of adults in the United States, with chronic and severe self-injury occurring among approximately 1% of the population.
There are many reasons why people self-harm, but the causes usually stem from difficult emotions. Self-harming has been described as a “physical expression of emotional distress.” If somebody is feeling overwhelmed with painful emotions, they may find that the physical act of hurting themselves gives them relief from their feelings. Cutting is frequently linked to childhood abuse (especially sexual abuse). It can occur alongside depression, anxiety, eating disorders, post-traumatic stress disorder and substance abuse. It is also commonly associated with borderline personality disorder. An estimated one-half to two-thirds of people who cut also have an eating disorder. And although cutting is rarely meant as a suicide attempt, it is not uncommon for people who cut to think about suicide.
It is important to realize that self-harm is a marker of emotional distress; it develops as a way for some people to cope with their difficult emotions. Because self-harm and cutting in particular tends to become a compulsive behavior, it can be difficult for some people to stop even when they want to. As with other compulsions, professional help is often needed to stop the behavior. Treatment focuses on making people aware of the stressors that trigger self-harm and on helping them develop alternative coping strategies. Treatment can also focus on effectively expressing emotions so that they can be resolved.