By: Naiara Perin Darim, M.Psy
Self-harm is observed in people of all ages and backgrounds and may have diverse types. It serves many functions and frequently develops into a pattern of behaviour that prevents individuals from achieving their life goals. There are some key elements to self-harm that are considered when we are facing this problem:
- Self-harm differs from suicidality AND can increase it. Most of the time, people can notice the difference between feeling suicidal and self-harming to act on that urge or when self-harm serves a different function. In any case, a person that self-harms has a higher chance of dying by suicide at some point in life. That data can be explained by the desensitization that happens when they frequently cross the line between prioritizing their safety and well-being and harming themselves.
- Self-harm has a function AND is never the best choice to address a need. Usually, the individual sees this practice as a solution or escape, while individuals around them see it as a problem. Self-harm may be a (very unhelpful) coping strategy for suicidal thoughts because people want to stay alive. Figuring out what need is being met with self-harm and coming up with helpful ways to meet that need is a very important step to stop.
- Self-harm is not a cry for attention AND may be reinforced by others. Unknowingly to the individual, this behaviour might be serving the function to communicate distress or receive affection/support. Even if it is serving a communicative function, the desensitization to harm is happening and the increased risk is present.
- Self-harm is not solved through:
- Hospitalization. People may need hospitalization to be safe temporarily, and nothing in the hospital will treat the practice of self-injury, that is addressed in therapy.
- Sterilizing the environment. It is helpful to remove items that are more used for self-harm, and that is not a long-term sustainable solution.
Dialectical Behaviour Therapy addresses self-harm as a behaviour that serves a function, it is most likely reinforced by the environment, and it is in the way of the person getting to live a fulfilling life. The way to address behaviour is by talking to a therapist.
There are many resources that clinicians use to support people to address self-harm, some are:
- Identify the function and the pattern with a Behaviour Chain Analysis: https://youtu.be/6i_vDsXj2VA
- Tolerate Distress with TIPP: https://youtu.be/UuvH_j9O0f4
- Regulate Emotions with Mindfulness of Current Emotions: https://youtu.be/NECs97k_8Z4
Free app for support: https://calmharm.co.uk