Self-harm describes a wide range of behaviours that people sometimes use to cope with difficult feelings and distressing life experiences. These behaviours may include cutting, burning, scalding, banging, scratching, pulling hair or swallowing objects or poisonous substances. The majority of people who self-harm have no intention of ending their life. Most people who self-harm do it to cope with, and manage, their difficult feelings.
To help us understand why people self-harm, it may be useful to think about other ways people cope. While some people cope with feelings of stress, anger and frustration by having a glass of wine or smoking cigarettes, others manage similar feelings by self-harming.
Self-harm is an issue for a lot of children and young people, and many adults find it challenging to deal with. It is very difficult to say exactly how many children and young people self-harm, as they often hide this behaviour and don’t tell anyone about it. The average age self-harming starts is 12 years old, and girls are more likely to self-harm than boys. There are many other groups at increased risk of self-harming including children and young people who have learning disabilities, are in care, or have friends who are self-harming.
However negative and self-destructive it may seem to hurt your own body, for some children and young people self-harm can serve many important functions. Self-harm is primarily a way to cope, and in some cases it may feel like the only way to deal with their extremely distressing feelings.
It is likely that most of the reasons for self-harm are underpinned by a desire for control. Self-harm is a way of regaining control, by controlling the injuries to their own body. Determining the nature, where on the body, timing and severity of self-harm is a way of staking claim to their own body.
Relief of feelings
Through hurting themselves, they may be able to release feelings that feel unbearable when held inside.
Self-harm can help them cope by providing a distraction. The physical pain and injury take the focus away from an emotional pain that feels much worse.
They may have feelings of self-hatred or self-blame. When these feelings are very powerful, they may use self-harm to punish themselves. This may help reduce their guilt.
They may see themselves as dirty, often as a result of abuse. Self-harm may be a way of symbolically ridding themselves of the contamination they feel.
Self-harm is primarily carried out to regulate feelings rather than to gain a response from others - they may never show or tell anyone else about their injuries. However, self-harm may also be a way of trying to communicate feelings without using words.
Comfort and nurturing
Self-harm can provide a release of tension which can be experienced as calming or comforting. It can also provide an opportunity to self-soothe or seek care and nurture from others.
Making your body unattractive
Sometimes they harm themselves to make their bodies unattractive in the hope this will keep others away, particularly when they fear someone who abuses them sexually.
Feeling real or alive
Sometimes their life experiences leave them feeling numb, dead or unreal. Hurting their own body is one way of breaking through these feelings and actually experiencing something that makes them feel alive again.
Children and young people who self-harm often carry feelings of shame, guilt, self-hatred, anger, frustration and isolation. However, there is a common misconception that children and young people who self-harm are attention-seeking. In reality, most children and young people who self-harm do it in secret. Labelling someone as attention-seeking only serves to further their feelings of shame and guilt, this may make the self-harming behaviour worse.
There are many different reasons why a child or young person self-harms. In trying to understand why, ask yourself the following:
Self-harm in children and young people can lead to strong feelings of anxiety, fear and frustration in the people who are trying to support them. It is really important that you manage your feelings when supporting a child or young person who is self-harming. To help you do this, don’t focus too much on the self-harming behaviour and ensure that you respond to the child or young person and the issues underlying the self-harm.
Listening and caring is the most important thing you can do to help. It might not seem much, but showing that you want to know and understand can make a big difference.
Show concern for the child or young person's injuries. By offering the same concern you would show for any other injury, you are showing them that their body is worth caring about. There is no need to overreact just because it is self-inflicted.
If you accept that the self-harm helps them cope, this shows you understand that, at the moment, self-harm works for them when nothing else can.
"You shouldn't be ashamed of who you are. That was something the workers told me"
The issue of confidentiality should be openly discussed with the child or young person and jointly understood. For more information on confidentiality and sharing information please see page 39 of Fife's Self-harm Guidance at:
Please contact your GP or other health professional involved with your family.
You may continue working with a child or young person, or you may decide to refer them on to another service or professional. This decision will depend on the identified needs of the child or young person, including the level of risk they present. For more information, please see page 26 of Fife's Self-harm Guidance at:
Resources packs from YoungMinds:
Calm Harm App:
Here are some quotes from young people about why they self-harm:
I’m in control
"I’ve always had to do what suited other people - different foster parents, children’s homes, schools. Nobody ever asked me what I wanted."
"It’s like a control thing. How deep, how often, where I cut - it’s all down to me. It’s my body and I’ll decide what to do with it."
Time-bomb ticking inside me
"I get mad about things, it all knots up inside me and I just want to scratch myself and slash at myself."
"I hit myself because I’m so angry with myself - for being so stupid and pathetic, for being the sort of person bad things happen to."
"After I cut myself I feel good, like I’ve punished them, secretly. I can be talking to them and I can feel my arm and it’s like ‘stuff you’, like I’ve got one over on them."
"The badness I feel becomes unbearable. I can’t take it any more so I cut. The relief is instant. It’s like I’ve got what I deserve. The badness just drains away."
"Washing doesn’t work, however much I do it. I cut myself where I was touched. It gets rid of the dirt."
An excuse for some comfort
"When I feel empty it’s like there is nothing inside me. I’d do anything to fill that gaping hole. I used to stuff myself with food but it was never enough. But when I cut it just goes."
"It gave me an excuse to go to the nurse and be bandaged up and taken care of."
"I like looking after my cuts. It’s the one time I can be really nice to myself. Then I curl up in bed and just snuggle down and go to sleep."
Showing there’s something wrong
"I thought if I had bruises on me, someone would realise that things weren’t all right at home, and would make it stop, somehow."
"I wanted my Dad to feel bad, to realise that it mattered what he’d done to me. That I was screwed up by it. I wanted him to be sorry."
"People always think I’m happy and together. Even if I say that I’m down they think it’s not serious. In the end I took tablets - not to die but to prove I wasn’t OK."
"Self-harm - it’s something special I do for myself, it’s mine, my secret. Like a friend, just for me."
"Cutting is like part of me, my identity. Sometimes when people are having a go at me about ‘looking nice’ or getting a good job or something (and I’m keeping my mouth shut), I think about my arms and my scars and then I don’t care."
"Sometimes my emotional pain is so strong that I don’t feel I can take it and that it’s going to destroy me. I just know I need to stop it. Cutting my arms seems to help me do that. The physical sensation ground me somehow - it brings me back to reality away from the overwhelming feelings. After hurting myself, I can care for and bandage the wounds and therefore feel justified in looking after myself. When feeling the physical hurt that it causes, I am numb to the emotional pain which is a million times worse and so much harder and scarier to deal with."