Self injury, also called self harm, self abuse or self mutilation, is when a person intentionally hurts him/herself.  It is often a way of coping with intense emotions, but can also be a call for help.  Contrary to what many assume, it usually is not a suicide attempt though people who self harm are more likely to be suicidal than those who do not.  It is most common among teens, but also seen in adults.  It cuts across race, gender, and social class.

Self injury can take many forms: cutting, burning, scratching, biting, interfering with wound healing, hitting oneself or objects, sticking objects into one’s skin, hair pulling and purposely bruising one’s self or breaking one’s bones, to name just some of them.

Typically self-harm is a response to stress.  It may be present day social, occupational, educational or familial stress.  It may also be stress associated with a trauma from the past.  Sometimes it is a response to feeling emotional numbness; other times it is a way to achieve it.  Self harming can serve as a distraction from unbearable thoughts or feelings.  It can be a form of self punishment to feeling bad, selfish, unworthy, undeserving or disgusting. Sometimes people harm themselves because the pain associated with doing so is preferable to the psychic pain they would otherwise be experiencing.

Clinically speaking, the key to assisting people who self harm is twofold. It involves helping people learn to tolerate intense emotions on the one hand and giving them skills to modulate their emotions on the other hand. The so-called emotion regulation and distress tolerance skills associated with dialectial behavioural therapy are useful for both the self-harming clients and the counsellors who assist them.