What is non-suicidal self-harm?
Photo by Tim Mossholder
Non-suicidal self-harm means inflicting damage to your own body without the intention of suicide (and not consistent with cultural norms). Here are some facts about these behaviors, mental health first aid, and strategies which can help).
The most common methods of non-suicidal self-harm are cutting (70%) or scratching, deliberately hitting the body on a hard surface, punching, hitting or slapping one’s self, and biting or burning. Burning or self-battery are more common in men than women.
Non-suicidal self-harm is common in adolescents and young adults. The lifetime rates in these groups are 15 to 20 %, with the onset typically at 13 to 14 years of age. Occurrence is highest in individuals with mental health issues, such as depression and anxiety, or those who struggle to regulate their emotions or those who are highly self-critical. About 6 per cent of adults report non-suicidal self-harm.
Some of the reasons behind self-harm
The reasons for these self-harm behaviors are reported to be to:
manage painful or overwhelming feelings
punish oneself
communicate with others, or
for other reasons (e.g. feeling emotionally numb).
Remember that most men feel ashamed of the behaviours and are not seeking attention. They are at a higher risk of suicide. In fact, it has been found that 10 per cent of people who had injured themselves in the past four weeks had made a suicide attempt in the last year, and 60 per cent had thoughts of suicide.10
Mental health first aid
Don’t assume that those who self-harm are suicidal, and don’t presume they are not. The only way to know is to ask them.
If you suspect someone is self-harming, then discuss it with them if you feel able to, in a private place. You might say something like, ‘Sometimes when people are in a lot of emotional pain, they injure themselves on purpose. Is that how your injury happened?’
Reaching out for help
If you interrupt someone who is injuring themselves, be calm and intervene in a supportive and non-judgmental way. Tell them you are concerned and ask if you can provide support. Organize medical help if needed. When talking with them express empathy, listen to them, validate their feelings or concerns, give support and reassurance that there is help available, don’t promise to keep the behavior a secret, and encourage them to seek professional help (from a doctor or mental health professional), and assist them to do so if they ask you.
KEY POINT: If the self-harm is severe, interfering with functioning, or if the person has injured their eyes, genitals, or expressed a desire to die, contact the emergency services immediately.
Instead of self-harm, consider these ideas
Talk to someone (e.g. family, friend, helpline).
Delay (the urge to self-harm will pass).
Wait 5 minutes, then wait another 5 minutes more.
Count from 1 to 100 or do some breathing exercises (see Chapter 3).
Make the environment safe (e.g. make sure sharp objects are removed).
Go to a different spot in the house or change your environment (e.g. go for a walk).
Use a distraction (e.g. watch a film, play video games, do some exercise, or make a self-harm distraction box with things to concentrate on).
Do something like holding a piece of ice or touch different textures around you.
Have a cry.
Write in a journal.
If you need to see blood, then draw on the skin with a red pen.
If you feel the need to punish yourself, then instead look for a way to forgive or be kind to yourself.
If you feel overwhelmed and need to express anger, then punch a pillow or a punching bag.
Avoid any activities that harm you or cause pain. In this way the brain will stop associating physical pain with relief or feeling good.11, 12
Dr Cate Howell is a GP, therapist, educator and author in Australia. She had a year 2000 Churchill Fellowship and completed a PhD on depression. In 2012 Cate was awarded the Order of Australia Medal for services to mental health. Cate currently works as a General Practitioner with Defence, and also has a private practice focusing on mental health and various teaching activities. Cate has a passion for sharing practical information about mental health through writing, and she has authored five books on mental health and counseling. She loves spending time with her family and friends, walking her dog, reading and swimming.