Common myths about self-harm, such as the belief that it is an attention-seeking behavior, can be debunked with facts about the behavior.

According to the National Alliance on Mental Illness (NAMI), self-harm is when someone intentionally hurts themselves, usually by cutting, burning, or picking at their body. Self-harm typically occurs when a person is struggling to cope with unpleasant emotions. There are many misconceptions about the behavior, and not everyone knows the truth about self-harm. To help dispel myths about self-harm, facts and studies are used as resources for understanding self-harm and why it occurs.

Myth 1: Self-harm is a suicide attempt.

Fact: Self-harm can occur without suicidal ideation. 

Individuals who self-harm often do not intend to end their lives. Instead, they are using self-harm to cope with emotions or trauma. According to NAMI, self-harming behaviors can actually release endorphins, which can improve mood and relieve pain. Other people may find that self-harming is a way for them to experience some sort of emotion if they have been feeling devoid of emotions.

Research confirms that self-harm is not always a suicide attempt. One study with adolescents assessed the characteristics associated with self-harm. The results showed that the most common function of self-harming behavior is to escape from thoughts or feelings. Self-harm can be viewed as temporary relief instead of a permanent plan to end one’s life, and non-suicidal self-injury is common.

The difference between self-harm and suicidal ideation is that with suicidal ideation, a person is thinking about suicide and making plans for it. Self-harm, on the other hand, is often an impulsive behavior that doesn’t involve significant planning. In fact, one study found that half of those who were self-cutting had decided to do so less than an hour beforehand.

Despite the fact that suicide and self-harm are separate concerns, people who self-harm are at increased risk for suicide. Research shows that adolescents who self-harm are nearly five times more likely to think about suicide and nine times more likely to attempt it. The risk of suicide ideation and attempts is also higher among those who self-harm more often. An incident of self-harm may not be a suicide attempt, but self-harming behaviors should be taken seriously to prevent future suicide attempts.

Myth 2: Self-harm is an attention-seeking behavior.

Fact: Individuals who self-harm are typically ashamed and want to hide their behavior. 

While some people may believe that self-harming is a method of seeking attention, this is often not the case. There is shame surrounding self-harm, and those who engage in this behavior will often cover their injuries with bandages or by wearing long sleeves so that others do not notice. In this way, self-harm is not attention-seeking.

The Mental Health Foundation reports that people who self-harm typically don’t tell anyone what they are doing, and they have difficulty talking to others and asking them for help. This expert source also states that it is a common misconception that self-harm is an attempt to seek attention.

One study with adolescents found that they do not approve of using self-harm to seek attention. Instead, they reported that self-harm is a private matter that should be kept secret. It appears that self-harming is a behavior that occurs in secrecy to relieve emotional pain, and those who engage in this sort of behavior do not want attention.

Myth 3: Cutting is the only form of self-harm.

Fact: Cutting is a common form of self-harm, but there are other types of self-harming behavior.

People often associate cutting with self-harm. However, some individuals who self-harm may burn themselves, pull their hair, scratch themselves or bang their heads. In adolescents, the most common forms of self-harm are scratching, cutting and hitting.

Self-harm burning may involve using cigarettes to burn the skin. Other forms of self-harm can include kicking, punching, or attempting to self-poison with medications or toxic liquids. Experts also report that in some cases, people may pick at wounds or engage in extreme behaviors that result in broken bones. There is a range of actions that constitute self-harm.

Myth 4: People who self-injure don’t feel pain.

Fact: People who engage in self-harming behavior do feel pain, but they may experience it differently than those who do not self-harm. 

People who self-harm are not immune to pain, but they find it bearable because it provides relief from uncomfortable emotions. The pain serves as an outlet and a coping mechanism. In some cases, those who don’t experience emotions like happiness or excitement use self-injury to feel something, even pain.

How does it feel to self-harm? Self-harm pain may feel exhilarating for some because of the release of endorphins. There is also some evidence that people who self-injure may have a heightened tolerance for pain. In fact, a review of non-suicidal self-injury research shows that people who self-harm are more tolerant of pain. While they experience the pain, it is offset by the emotional relief they gain from it. It is also possible that people who self-harm may be able to tolerate pain because of self-harm and dissociation, which occurs when a person feels separate from his or her body when engaging in self-injury.

Myth 5: Only adolescents engage in self-harm.

Fact: Self-harm is more common in adolescents but can occur in any age group. 

Experts share that self-harm occurs most often in teenagers and young adults, but older adults can also fall victim to self-injury. Self-harm statistics do show lower rates of the behavior in adults compared to teenagers, but that does not mean that adults do not engage in self-injury. It is also noted that some younger children may self-harm, especially if they experience anxiety or significant distress. 

Self-harm in adults may be linked to drug and alcohol use, according to one study. The same study found that self-harm among adults often does not require medical treatment, and it commonly involves the following types of behaviors:

  • Cutting
  • Burning
  • Biting
  • Scratching
  • Scraping
  • Hitting
  • Picking at skin and wounds

Myth 6: Self-harm is extremely rare.

Fact: Rates of self-harm are higher than most people realize. 

There is a sense of shame and secrecy surrounding self-harm, so it may appear that it is extremely rare. However, self-harm statistics show that the condition is not uncommon. According to the data, the prevalence of self-harm is 17.2% during adolescence, 13.4% during early adulthood and 5.5% among adults.

Other self-harm statistics show that among children aged 7 to 16, 9% of females and 6.7% of males report self-harming behaviors. The prevalence of self-harm is different between males and females in the ninth grade, with 19% of girls and 5% of boys this age reporting self-harm.

It may seem that females are most affected by self-harm, but self-harm statistics also show that about 35% to 50% of those who self-harm are male. This shows the rates of self-harm may be relatively equal between genders. It is also noted that non-heterosexual individuals are at a greater risk of self-harm, with nearly half of bisexual females engaging in self-harming behaviors. Self-harm clearly is not rare, and it is even common among certain populations.

Myth 7: Young people self-harm to fit in.

Fact: Fitting in is often not the goal of self-harm. 

As previously noted, young people self-harm to help them cope with distress and manage unpleasant emotions, so fitting in with others is not the goal. According to experts, reasons for self-harm include trying to cope with depression, bullying and rejection. Self-harm occurs not as a way to fit in but instead as a reaction to not fitting in with peers.

Young people may also self-harm due to low self-esteem or body image issues. Others may self-harm because they have difficulty regulating emotions and managing unpleasant feelings.

Myth 8: People self-injure as a way to manipulate others.

Fact: Self-harm is not intended to be an act of manipulation. 

According to the Cornell Research Program on Self-Injury and Recovery, it is a common misconception that people self-injure as a form of manipulation. However, manipulation is typically not the primary intent of self-harming behavior. Self-harm is for stress relief, according to experts from Cornell.

While self-harm is not intended to be a manipulative act, it may be a cry for help. One study found that many adolescents who self-harm may be seeking help, as they report self-harming motives such as showing others their desperation. In this case, self-harming is not manipulation but rather an attempt to ask for help, which can be difficult for someone who is using self-injury to cope with distress.

Myth 9: All individuals who self-harm have been abused.

Fact: Having a history of abuse can increase the risk of self-harm, but not everyone who self-injures has been abused. 

Self-harm and abuse may be related, but there are other risk factors for self-harm aside from abuse. NAMI reports that drug and alcohol use can also be risk factors. Individuals who struggle with body image and eating disorders are also at an increased risk of self-harm, according to research.

One study found that being sexually abused as a child is linked to self-harm. This study also found that people who self-harm tend to experience negative mood states, such as depression and anxiety. While abuse can be a cause of self-harm, that doesn’t mean that everyone who self-injures was abused. It simply indicates that the risk of self-harm is elevated among those with a history of abuse.

Myth 10: Self-harm is just a phase that teens will outgrow.

Fact: Self-harm is a serious concern that requires intervention

While self-harm is relatively common among adolescents and is often a coping mechanism, it is not a healthy or adaptive way to manage stress.  Even if self-harm is not intended to be a suicide attempt, those who continue to engage in self-harming behaviors are at increased risk of suicide. Research shows that among people who self-harm and are not initially suicidal, those who continue to self-harm are significantly more likely to attempt suicide at a later point.

In addition to suicide attempts, people who self-harm are at increased risk for mental health conditions such as depression. Self-harm, therefore, represents more than just a phase. It is an unhealthy coping mechanism that can have disastrous consequences if left unaddressed. Overcoming self-harm requires outside help and support.

Myth 11: Self-injury isn’t treatable.

Fact: Psychological treatment is available for those who self-harm, and it can be effective. 

Self-harm treatment can help individuals who self-injure learn healthier ways to cope with stress and difficult emotions. It also helps them to resolve any underlying issues that have contributed to the self-harm, such as eating disorders or trauma. According to NAMI, therapy is an integral part of the treatment for self-harm. Medication may also be necessary to treat associated conditions like depression.

Psychological interventions have been found to be an effective form of self-harm treatment. Specifically, dialectical behavior therapycognitive behavioral therapy and mentalization-based therapy are effective for reducing the occurrence of self-harm.

If you or a loved one is suffering from self-harming behaviors and co-occurring addiction, The Recovery Village can help. We offer locations around the country and can provide comprehensive services to treat both the self-harming and the addiction. Reach out to an admissions specialist today to discuss treatment options.

Jonathan Strum
Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
Jenni Jacobsen
Medically Reviewed By – Jenni Jacobsen, LSW
Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has seven years of experience working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more
Sources

National Alliance on Mental Illness (NAMI). “Self-harm.” 2019. Accessed June 9, 2019.

Gillies, D., et al. “Prevalence and characteristics of self-harm in adolescents: Meta-analysis of community-based studies 1990-2015.” Journal of the American Academy of Child and Adolescent Psychiatry, October 2018. Accessed June 9, 2019.

National Institute of Mental Health. “Suicide.” April 2019. Accessed June 10, 2019.

Rodham, Karen; et al. “Reasons for deliberate self-Harm: Comparison of self-poisoners and self-cutters in a community sample of adolescents.” Journal of the American Academy of Child & Adolescent Psychiatry, January 2004. Accessed June 10, 2019.

The Mental Health Foundation. “The truth about self-harm.” (n.d.). Accessed June 10, 2019.

Chandler, Amy. “Seeking secrecy: A qualitative study of younger adolescents’ accounts of self-harm.” Young, May 15, 2018. Accessed June 10, 2019.

Nixon, Mary; et al. “Nonsuicidal self-harm in youth: A population-based survey.” Canadian Medical Association Journal, January 29, 2008. Accessed June 11, 2019.

National Health Service. “Overview: Self-harm.” May, 25 2018. Accessed June 11, 2019.

Kirtley, Olivia; et al. “Pain and self-harm: A systematic review.” Journal of Affective Disorders, October 2016. Accessed June 11, 2019.

DeAngelis, Tori. “Who self-injures? “American Psychological Association, July/August 2015. Accessed June 11, 2019.

Klonsky, E. “Non-suicidal self-injury in United States adults: Prevalence, sociodemographics, topography and functions.” Psychological Medicine, September 2011. Accessed June 11, 2019.

Swannell, Sarah; et al. “Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis, and meta-regression.” Suicide and Life-Threatening Behavior, June 2014. Accessed June 11, 2019.

Barrocas, Andrea; et al. “Rates of nonsuicidal self-injury in youth: Age, sex, and behavioral methods in a community sample.” Pediatrics, July 2012. Accessed June 11, 2019.

Cornell Research Program on Self-Injury and Recovery. “Top 15 misconceptions of self-injury.”  2009. Accessed June 11, 2019.

Scoliers, Gerrit; et al. “Reasons for adolescent deliberate self-harm: A cry of pain and/or a cry for help?” Social Psychiatry and Psychiatric Epidemiology, August 2009. Accessed June 11, 2019.

Fliege, Herbert; et al. “Risk factors and correlates of deliberate self-harm behavior: A systematic review.” Journal of Psychosomatic Research, June 2009. Accessed June 12, 2019.

Ougrin, Dennis; et al. “Therapeutic interventions for suicide attempts and self-harm in adolescents: Systematic review and meta-analysis.” Journal of the American Academy of Child & Adolescent Psychiatry, February 2015. Accessed June 12, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.