by Hannah Shewan Stevens
Medically Reviewed by:
Francis Kuehnle, MSN, RN-BC
by Hannah Shewan Stevens
Medically Reviewed by:
Francis Kuehnle, MSN, RN-BC
Misguided beliefs around the decision to self-harm might be preventing people from seeking help. This is my journey moving from dangerous isolation to a place of recovery.
Content note: This piece contains depictions of self-harm and references to sexual abuse.
To cope with childhood sexual abuse, I started self-harming at age 7.
Scratching myself with scissors, pulling out my hair, and pinching my skin became my coping mechanisms.
By the time my teenage years rolled around, self-harm had spiraled into an uncontrollable habit that felt like an overwhelming addiction.
Although approximately 5% of adults and 17% of teens will self-harm in their lives, the behavior is often dismissed as attention-seeking. This leaves many people in shameful isolation, struggling to break the cycle of self-harm.
“Self-harm is any act that someone does to themselves that deliberately causes them some sort of bodily harm,” says licensed professional counselor Jennifer Toof, LPC, NCC. “It may also be thought of as a behavioral expression of psychological distress to seek relief from a terrible state of mind.”
Presentations of self-harming behaviors include cutting, slapping, punching, and burning. Self-harm is not limited to inflicting physical harm, though.
“A wider definition might include bad habits whose rewards are partly material and partly internal, such as overwork, substance abuse, or anorexia,” says Lincoln Stoller, PhD, CHt, CCPCPr, a psychotherapist and coach.
The reasons for self-harm are as varied as the forms the behavior takes.
I used it to punish myself for the trauma my abuser inflicted. It eventually became standard practice for coping with any emotional stressor.
What people fail to understand is that self-injury is not an attempt to injure oneself. It’s an attempt to heal oneself.
— Lincoln Stoller, PhD, psychotherapist
Beginning with scratching and pulling out my hair, my self-harm quickly evolved into using blades to cut my skin at age 11.
The habit escalated into an obsession. Under its spell, I followed my ritual every single day or I couldn’t sleep at night.
The pain alleviated the mental anguish I could not face. Just for a moment, the physical burn eclipsed the darkness that consumed my daily thoughts.
I thought that I deserved the pain because the abuse had made me “dirty.” I now know I had undiagnosed complex PTSD and severe depression characterized by bouts of extreme low moods, dissociation, and suicidal ideation.
Without any guidance on processing the trauma, self-harm became my go-to coping mechanism.
I found serenity in agony and in the irritation of my clothes rubbing against the wounds during the day, which kept the worst of the suicidal thoughts at bay.
Aside from the physical self-harm, I also misused drugs and alcohol starting at the age of 13.
Shouldering the burden of the abuse and the resulting self-harm behaviors alone felt like the best way to protect the world from the horrors of my actions, which I thought I, alone, was responsible for managing — even as a child.
In time, my family realized what was happening, but by that point, the self-harm was ritualistic. The help offered to me felt like it would interfere with my “process.”
“The self-harming person may be quite aware of the trade-off they’re making, but the public mind cannot understand, and it cannot be explained to them,” says Stoller. “What people fail to understand is that self-injury is not an attempt to injure oneself. It’s an attempt to heal oneself.”
Somewhere in the malformed corridors of my mind, I knew that self-harm would never resolve my problems. Yet, the part of me that thought it was my salvation drowned out all semblance of reason, imprisoning me in a torturous cycle of self-harm and self-blame.
Alongside developing a reliance on substances to numb my brain, self-harm joined the crew as a habitual addiction.
“Almost everything humans do becomes habitual, but we distinguish some habits as addictions when the rewards are indirect and the behavior is poorly rationalized,” says Stoller. “There is little internal difference between self-harm and addiction. Both can lead to greater calm and less anxiety.”
While there was no physiological trigger demanding a hit, I had built a pattern of self-harming every single day, which morphed into what felt like an addiction.
Every morning I would think that this time I would go the whole 24 hours without hurting myself. Sadly, this small victory took years to materialize.
Instead, I reveled in the climax of the pain inflicted on my body every evening. I leaned into the residual pain that followed me around during the day, sometimes triggering it deliberately by picking off scabs or using my nails to imprint crescent-shaped cuts into my hands.
Between the ages of 13 and 16, I self-harmed every day in some form or another. At first, it was primarily through cutting, but the behavior later manifested as burning and heavily using drugs and alcohol.
As I entered my late teens, my physical self-harm decreased. It would still rear its head occasionally until one incident shocked me out of the habit for life.
At age 19, a traumatic event sent me running straight for the blade, brutalizing the skin on my thigh like never before.
I blacked out during the process. Coming to, I fixated on the blood pooling on the floor. Numbly looking between the cuts and the evidence, I put the blade down for the last time.
I struggled with self-harm through heavy substance use for several years after the incident. However, I never cut myself again.
The difference between this incident and the countless others that came before it is that I told someone about it. After wrapping my leg in bandages, I returned to my family home — a sanctuary where I could trust my mom to help without judgment.
Stopping the urge to self-harm is not an overnight process. The first step is letting someone know what’s happening.
“Working in isolation to manage the temptation of self-harm is unproductive, and it is essential to seek help initially from a trusted loved one and eventually from professionals such as educational psychologists,” says educational psychologist Dr. Patricia Britto.
In the opening acts of my healing, I focused on self-compassion, refusing to punish myself further for relapses.
I endeavored to look at the bigger picture and appreciate the tiny milestones, like going a whole 24 hours without engaging in any self-harm behaviors for the first time.
I treated myself to small gifts of self-care, such as hot baths and delicious treats, like my favorite ice cream, when I hit milestones.
I failed to stop self-harming as a young teenager because I focused on the short-term, trying to get through a day instead of a month or getting lost in the frustration of relapse.
My refusal to acknowledge the root cause of the self-harm — the childhood abuse I experienced — also delayed progress. Neglecting the past fed poison to my future.
“It is vital to focus more on the root causes that led to self-harm and to explore with a mental health professional how to address the associated feelings and underlying problems,” says Britto. “Attempting to resolve the issue of self-harm in isolation is unlikely to be effective and may result in further regression rather than progression.”
The most important coping mechanism I developed arrived in the form of counseling to start working through the untapped mine of trauma I’d locked away beneath my self-harming obsession.
I also recognized that because the behavior had felt addictive, I needed a replacement instead of going cold turkey.
I drew patterns on my legs and ribs, where I tended to self-harm the most, and wrote affirmations of self-love on my wrists. Later, I invested in tattoos to decorate my skin as a reminder that it’s too beautiful to fracture for a moment of twisted peace.
“It takes practice to use healthy coping mechanisms when experiencing overwhelming emotions,” says Toof. “Eventually, the healthy mechanisms will become a habit, and you will naturally turn to the healthy mechanisms instead of the unhealthy ones.”
“Short of witnessing the self-harm or the physical scars of self-harm, the best way to know if somebody you know is self-harming is to ask them directly,” says Faisal Tai, MD, a board certified psychiatrist and the founder and CEO of PsychPlus. “This opens the door for communication and trust so that you can offer the compassion, empathy, and support they need.”
Approaching the person with empathy is crucial because the shame associated with self-harm means that a negative or angry reaction is likely to convince them that keeping the behavior a secret is the better option.
“Try not to panic and overreact,” says Britto. “Remember that how you respond to the person who has shared their feelings with you will have an impact on whether they continue to open up to you and other people about their self-harm behaviors in the future.”
If self-harm had not become a running gag among my high school peers, it might have been easier to get help sooner.
But the trope of the “attention-seeking cutter” loomed over me, and I let the stigma silence me.
Shedding the shame associated with this oft-ignored or shushed behavior can save lives, as it did mine. Only when the secret is acknowledged and treated seriously can people start to heal.
Medically reviewed on January 18, 2024
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About the author
Hannah Shewan Stevens
Hannah Shewan Stevens is a freelance journalist, speaker, press officer, and newly qualified sex educator. She typically writes about health, disability, sex, and relationships. After working for press agencies and producing digital video content, she’s now focused on feature writing and on best practices for reporting on disability. Follow her on Twitter.