Unwrapping self-harm

Self-harm isn’t just for girls, it comes in all forms at all ages including boys and men. It’s a coping strategy for when we feel emotionally too much so distract ourselves with a seemingly more real pain, a physical one that we can see, but most importantly can control. 

Self-harm is a mental distress. It can come in the form of punching a wall until you injure yourself, cutting parts of your body, burning, scalding or scratching yourself. It can also come in the form of eating or drinking things that are poisonous. 

It's not a simple issue, neither for the person who is doing it nor for the person on the outside - like a parent, relative or friend. It can seem almost impossible to understand because for those on the outside it runs contrary to our instinct to keep ourselves safe. Or to put it into a biological context - our autonomic system, which manages our breathing, steadies our heart or helps us stay healthy, the part of us that aims in every way to help us stay safe, healthy and strong - is overridden. 

Self-harm can be associated with anxiety, which is my area of expertise. I’ve noticed that people say when I first meet them that they ‘have suffered or do suffer from anxiety’. With that said, we then go on to explore the circumstances. But if this anxiety release is tangled in with self-harm, managing and understanding it takes a different route to support and help.


My take on anxiety is that it's a messenger system that needs to be heard. But the more we push it away, the more it will just knock on the door. Now, with self-harm, the problem isn't pushed away, instead, it's like the message has been delivered - temporarily - to another house. Unfortunately, 'temporarily' is an important thing to note. It keeps coming back, wanting to be unwrapped - to be heard and understood. It just doesn't go away until you deal with it properly.

The biggest obstacle to dealing with self-harm, ironically, is the fear that talking about it will hurt. The good news is, it actually can come as a relief, like you've let that delivery in the door and signed for it. The difference being is now you’re no longer alone. You are at last with someone to help you with that unwrapping process. It's at last truly in your control.

Woman in counselling session

What happens in therapy?

This can be done a few ways - it can be online, in person or even walking and talking around the park. 

Your sessions

The first thing is - we establish that you feel OK about what we're doing. You ask as many questions as you need to. This is your session and you're in control. Also, you are the expert of you, so I need to understand how you manage yourself! In a way you've to teach me how to feel like you and how you cope, so we're talking with a complete understanding of each other. 

With your confidence in the process secure, we then move on to examine why you self-harm, gently. Obviously, this is not necessarily easy, as one of the beginning challenges is not just untangling but putting emotions into words, especially as self-harm is often a feeling of overwhelm, wordlessness. Added into the mix is discovering if the feelings are being triggered from the inside or the outside - like social pressures - or both.

Good news

After you've found a way to explain your 'why' - you're halfway there - because at last, you've externalised your feelings and the story surrounding it all. It's like suddenly there's a handle on the door. But a door you can open as far as you feel comfortable enough to. Your pace is important. With the handle in place, we explore if you harm for punishment, to feel normal, get control, to disassociate or something else?

All this unpacking ultimately leads to an alternative way to cope. To a stronger and more resilient you. It’s a journey that you’ve been in control of and the final reveal is your freedom to be you.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London, W10
Written by Fiona Austin
London, W10

I specialise in Anxiety related issues. This can be anything from relationships to work, something from your past or something happening now like social, stress, burnout or health concerns or a fear. It can be a one-off anxiety, like starting a new job, getting married or divorced or just something new going on in your life.

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