Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Reviewed by Laurele Mitchell
Last updated 25th July 2022 | Next update due 24th July 2025

Self-harm is when someone harms themselves on purpose, usually as a way of coping with difficult emotions. Here we will look further into self-harming, including why someone might self-harm, how to find support and how someone struggling can help themselves.

What is self-harm?

Self-harming often begins when a person feels overwhelmed with upsetting thoughts and feelings. Harming themselves physically can feel like a release, almost giving them a sense of relief from the emotional pain they’re feeling.

This relief is only temporary though and is often followed by feelings of guilt and even shame. As the emotional pain is still present, the person may continue to rely on self-harming in an attempt to cope, continuing the cycle.

In this video integrative counsellor Mike Swift explains how counselling can help people struggling with self-harm, including what self-harm can mean for different people. 

Why do people self-harm?

There are no simple answers as to why someone might hurt themselves as every individual is different. Many people who self-harm say it is a way for them to express something they can’t put into words. This may be emotional pain, loneliness or low self-esteem.

For some, there is a particular event or experience that triggers them to start self-harming. This could include: 

  • being bullied
  • feeling overwhelmed with school/work
  • losing a loved one
  • the end of a relationship
  • losing a job
  • having an illness (mental or physical)
  • feeling stressed
  • having a poor sense of self-worth
  • dealing with discrimination
  • experiencing abuse (sexual, physical or emotional)
  • having difficulties at home

For others, there seems to be no direct cause. If you self-harm but don’t know why, you are not alone and you can still reach out for support.

There may be certain situations or times that make self-harm more likely, for example after drinking alcohol or at night time. Every person experiences self-harm differently and one person’s reasons will be different to another person’s.  

Is it just attention seeking?

Some people might talk about self-harming being an ‘attention-seeking’ act. The truth is, many people keep their self-harming private and feel alienated and upset to hear people misunderstanding their behaviour in this way.

For some, there is an element of wanting, or needing attention. They may want people to see how upset they are and offer help. Either way, self-harming should never be brushed off in this way.

Deliberate self-harm is most often carried out in secret, so the stigma of it being ‘attention-seeking’ or that it’s ‘the behaviour of a drama queen’ seldom applies.

- Lukas Dressler, Psychologist (MSc.), Integrative Psychotherapist (MBACP)

What self-harming can involve

The stereotypical image of someone who self-harms tends to involve cutting. While this is a common form of self-harm, it isn’t the only way people hurt themselves.

Self-harm covers any form of hurting yourself. This can include under or over-eating, overdosing/self-poisoning and even getting into fights when you know you’ll get hurt. In some cases, self-harm can be mental/emotional. This means purposefully doing things that you know will make you feel upset.

Who does self-harming affect?

According to one recent study published in the BMJ in 2019, the prevalence of non-suicidal self-harm in England has nearly tripled over the past 10 years. As study author Sally McManus explains, "Non-suicidal self-harm is increasingly being reported as a way of coping. We need to help people, especially young people, learn more appropriate and effective ways of dealing with emotional stress." 

Self-harm doesn’t discriminate and can affect anybody, at any age. Reports show however that the majority are aged between 11 and 25. Social pressures, discrimination and stigma can all lead to high levels of stress, making it more likely for a person to self-harm.

Getting help for self-harming

Once you get into a cycle of self-harming, it can be difficult to stop. Getting professional support can help you make changes. There are different ways to go about getting help and for many, a combination of self-help techniques and professional support is key.

It is OK to feel nervous about asking for help. It takes a lot of bravery to speak up, but remember you are worthy of support and have the right to receive help.

When asking for help, try to be as honest as you can. It may be tempting to downplay the extent of your self-harming, but speaking honestly about the way you’re feeling is the best way to get the right support.

Below we look at some of the different options for getting help:

Speak to your doctor

Visiting your doctor and telling them you want help is a great first step. They can talk through treatment options and, if appropriate, offer medication for related anxiety/depression.

Join a support group

Talking to other people who self-harm in a supportive setting can be comforting. Understanding that you are not alone and sharing your experience with others who ‘get it’ can help you feel lighter.

If you’re worried about going to a support group, you can explore online support forums. Be cautious when searching, as there are some sites that promote self-harm and these can make you feel worse.

Try talking therapies

Counselling and psychotherapy have been shown to be very helpful for people who self-harm. Counselling offers you space and time to talk about your feelings in a safe, non-judgmental and confidential setting.

Cognitive behavioural therapy (CBT) and psychodynamic therapy are two talking therapies that are recommended for those who self-harm. 

Therapists who can help with self-harm

How to help yourself when you want to self-harm

The urge to self-harm can be intense, making it difficult to know what to do instead. If you’re struggling with this, there are a few things you can try to help yourself.

Recognise your triggers

Try to keep a diary of when you self-harm. Note down what you were doing, how you were feeling and/or what you were thinking before you self-harm to see if you can spot any patterns.

Recognising what triggers you and how you feel before you self-harm can help you anticipate the urge and distract yourself.

Distracting yourself

Distracting yourself when you feel the urge to self-harm can help you change your behaviour. Everyone is different so be sure to try different distraction techniques to see what works best for you. Here are some ideas you could try:

  • hitting cushions
  • going for a walk
  • exercising
  • talking to someone
  • tidying your room
  • listening to music
  • writing about how you feel
  • drawing
  • trying relaxation techniques

If you find distraction doesn’t work, you could also try delaying. This means waiting for five minutes before you self-harm and see if the urge is as strong. Try to build up the amount of time you can put it off.

These self-help techniques are useful for the short term, but in order to recover for the long term, you may need professional support. A professional can help you learn to understand and accept your feelings and help you build self-esteem.

Worried about a friend? Here we look at how you can help a friend who's self-harming.

Recovery from self-harm

Recovering from self-harm is totally possible with the right support. This will involve you gaining a better understanding of why you self-harm, recognising your triggers and developing new ways of coping. You may experience relapses when you fall back into old habits, but don’t be discouraged by this if it happens. You are stronger than you know.

The longer you leave getting help, the harder it can be to stop self-harming. You are not alone in this and everyone deserves happiness. Remember that - and when you’re ready to find support, we are here.

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. 

- Counsellor Fiona Austin explains more in Unwrapping self-harm

What should I be looking for in a counsellor or psychotherapist?

Currently, there are no laws that stipulate what level of training or qualifications a counsellor dealing with self-harm needs. However, the National Institute for Health and Care Excellence (NICE) has developed a set of guidelines that provide advice about the recommended treatments, including the following:

  • If you have harmed yourself, you should be offered a full assessment of your needs. This may be by a specialist mental health professional, for example, a psychiatrist or psychiatric nurse.
  • After the first full assessment, you may be offered a further assessment or further treatment.
  • Psychological treatment has the best evidence for helping people who have self-harmed in the longer term.

Read the full NICE guidelines:

The NHS recommends psychological treatments such as cognitive behavioural therapy (CBT).

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