Self-Harm

Self-harm is a complex issue that affects many people, often hidden beneath layers of secrecy and shame. It’s essential to understand what self-harm is, why people do it and what help is available. Self-harm, also known as nonsuicidal self-injury (NSSI), is the act of deliberately harming one’s own body without the conscious intent to die. It’s a coping mechanism, not a suicide attempt. However, it can increase the risk of future suicide attempts. Self-harm is often a response to intense emotional pain, overwhelming thoughts or difficult life circumstances. Self-harming is a way to express feelings that are hard to put into words, gain a sense of control or find temporary relief from distress. 

People self-harm for a variety of reasons, and it’s rarely about seeking attention. The underlying causes are often deeply personal and complex. Here are some common reasons people self-harm:

• • Intense emotional pain
  • Intrusive or intense thoughts
  • Numbness or an empty feeling
  • A sense of control
  • Self-punishment
  • Difficulty expressing emotions
  • Coping with trauma

Self-harm can take many forms, and it’s not always easily visible. Some common types of self-harm include:

Cutting — Using sharp objects to make cuts on the skin

Burning — Using heat sources such as lighters or cigarettes to burn the skin

Scratching — Using fingernails or other objects to scratch the skin deeply

Hitting or punching — Hitting oneself or objects, often leading to bruises or other injuries

Picking or pulling skin — Repetitively picking at the skin or pulling hair out

Head-banging — Repeatedly hitting one’s head against a hard surface

Poisoning or overdosing (without suicidal intent) — Ingesting harmful substances or excessive amounts of medication, not with the intent to die

Interfering with wound healing — Picking at wounds to prevent them from healing properly

While types of self-harm vary, self-harm is not a monolithic experience. People may use different types of self-harm at different times, or they may have a preferred method. The underlying function of the self-harm behavior, however, usually stays consistent: to cope with overwhelming distress.

Triggers are specific situations, feelings or events that can increase the urge to self-harm. These triggers can be generally sorted into emotional and environmental factors. Recognizing these triggers is a vital step in preventing self-harm. 

Emotional triggers are internal feelings or states that can cause self-harming behaviors. Emotional triggers may include:

• Depression
• Anxiety
• Anger
• Shame
• Guilt
• Loneliness
• Emptiness or numbness
• Overwhelm

Environmental triggers are external situations or events that can contribute to the urges to self-harm. For example:

• Specific locations
• Exposure to self-harming
• Anniversaries of traumatic events
• Stressful situations
• Social isolation
• Interpersonal conflicts

Self-harming behaviors have significant consequences, both physically and emotionally. These behaviors can have a profound impact on a person’s well-being and overall quality of life. 

The immediate physical consequences of self-harming behaviors can range from minor injuries to severe and potentially life-threatening conditions. These consequences may include:

Scars — Permanent marks on the skin that can lead to feelings of shame and self-consciousness

Infections — Increased risk of infection from open wounds

Nerve damage — Potential damage to nerves, leading to the loss of sensation or chronic pain

Blood loss — Significant blood loss, requiring medical attention

Permanent disfigurement — Severe self-harm can result in permanent changes to the body

Increased risk of accidental death — Self-harm can sometimes lead to death, even if that was not the intent

The emotional consequences of self-harming behaviors can be just as damaging as the physical consequences. Emotional consequences may include:

Increased feelings of shame and guilt — Self-harm often leads to a cycle of negative emotions, making it harder to ask for help.

Difficulty in relationships — Self-harming behavior can strain relationships with friends and family, who may not understand the behavior. 

Social isolation — People may withdraw from social situations due to experiencing feelings of shame or the fear of judgment. 

Decreased self-esteem — Self-harm can reinforce negative self-perceptions and feelings of worthlessness. 

Worsening of underlying mental health conditions — Self-harming behavior can make depression, anxiety and other mental health issues worse. 

Increased risk of suicide — While not a suicide attempt, self-harm increases the risk of future suicidal behavior.

Self-harm is a serious issue with significant physical and emotional consequences. Early intervention is key in addressing self-harm. The sooner a person receives help, the better their chances of recovery and long-term well-being. At Guidelight, we offer comprehensive and compassionate support for those struggling with self-harm. Our approach focuses on understanding the root causes of the behavior, developing healthier coping skills and promoting long-term healing. We use a range of evidence-based therapeutic techniques tailored to meet the unique needs of each individual. These techniques include:

Cognitive behavioral therapy (CBT) — CBT is a structured, goal-oriented therapy that focuses on identifying and changing distorted or unhelpful thought patterns and emotional responses that contribute to self-harm. CBT consists of the following:

• Identifying negative thought patterns
• Challenging and reframing thoughts
• Developing healthy coping skills
• Behavioral experiments

Dialectical behavior therapy (DBT) — DBT is a comprehensive therapy that combines cognitive behavioral techniques with mindfulness and acceptance. It was originally developed for people with borderline personality disorder (BPD) and chronic suicidality. DBT has also been found to be effective for a wide range of issues, including self-harm. DBT focuses on four key areas:

• Mindfulness
• Distress tolerance
• Emotional regulation
• Interpersonal effectiveness

Acceptance and commitment therapy (ACT) — ACT is a values-based therapy that encourages individuals to accept difficult thoughts and feelings rather than trying to suppress them. ACT focuses on:

• Acceptance
• Defusion
• Values clarification
• Committed action
• Present moment awareness

Mindfulness — Mindfulness practices, derived from Buddhist meditation, involve training the mind to focus on the present moment without concern for judgment. In the context of self-harm treatment, mindfulness can help people to:

• Observe urges without acting on them
• Increase emotional awareness
• Develop self-compassion
• Improve distress tolerance

Guidelight provides different levels of care to address the varying needs of those struggling with self-harm:

Intensive Outpatient Program (IOP) — Our IOP offers structured therapy sessions three hours per day for three days each week. The average treatment duration is six weeks. Our IOP is designed for individuals who need more support than traditional weekly therapy. Our IOP allows individuals to receive compassionate and comprehensive care while still keeping aspects of their daily life, offering a flexible path toward stabilization and recovery. This program usually involves individual and group therapy and may include medication management when needed. IOPs also include specific training modules for managing emotions, tolerating stress and improving personal relationships. 

Partial Hospitalization Program (PHP) — Our PHP provides a more intensive level of care than an IOP. During a PHP, individuals attend structured programming for approximately five hours a day, starting in the morning and lasting through the afternoon. The average treatment duration for a PHP is approximately two weeks, excluding weekends. PHPs are appropriate for individuals who are experiencing significant emotional distress or functional impairment but do not require inpatient hospitalization. This programming allows for compassionate and comprehensive care during the day and allows people to return home to their stable living conditions in the evenings. PHPs typically include individual, group and family therapy, medication management, therapeutic activities, psychoeducation, and case management. 

If you or someone you know is struggling with self-harm, it’s crucial to seek professional help. At Guidelight, we offer a range of evidence-based therapies and programs designed to support people in overcoming self-harm and developing healthier ways to cope with distress. Guidelight helps people break free from the cycle of self-harm and build a healthier, more fulfilling life.

If you’re struggling with self-harm, such as cutting or any other form of self-injury, know that you are not alone. 

We recognize that self-harm can be a coping mechanism for managing overwhelming emotions or distressing situations and is often indicative of underlying mental health challenges. Our dedicated team will work with you to explore healthier alternatives, helping you develop constructive ways to cope with emotional pain and build resilience.

At Guidelight, we believe in the power of a strong support system. We will encourage and assist you in building a network of understanding individuals who can help you through tough times.

Together, we will navigate the complexities of self-harm, empowering you to break free from its grip and embrace healthier ways of managing emotions and finding peace. 

Everyone has a seat at Guidelight. Contact our team today for more information or to schedule an initial evaluation.