Self-injury (self-harm): causes, forms, and responses

Common characteristics and methods

Methods vary in severity and visibility. Common forms include cutting, scratching, burning, hitting, and interfering with wound healing. Some behaviors are indirect, such as excessive substance use or deliberately avoiding medical treatment. The appearance, frequency, and severity can differ greatly between individuals and over time. For general descriptions of symptoms and presentations see clinical guidance and patient information.

Reasons and psychological functions

People harm themselves for many reasons; a single cause is rarely identifiable. Frequently reported functions include:

• Emotion regulation: reducing or transforming intense feelings like anger, despair, shame, or numbness.
• Relief from dissociation or a sense of unreality.
• Self-punishment or coping with guilt and low self-worth.
• Communicating distress, establishing interpersonal boundaries, or resisting suicidal impulses.

Because motives are varied, assessment explores both what the behavior accomplishes for the person and the context in which it occurs. Additional discussion of psychological functions is available at function-based frameworks.

Associated conditions and risk factors

Self-injury is often associated with other problems rather than existing in isolation. Commonly linked issues include histories of physical or sexual abuse, mood disorders, anxiety disorders, eating disorders, post-traumatic stress disorder, and personality disorders. Social factors such as bullying, relationship conflict, and social isolation also contribute. For information on associated conditions see trauma and self-harm, sexual abuse and self-injury, and eating disorders and harm.

Assessment, safety, and treatment

Assessment should determine the intent (suicidal or non-suicidal), immediate danger, medical needs, and underlying problems. If there is any active intent to die or imminent danger, urgent professional help is necessary. Treatments that reduce self-injury focus on skills and underlying distress: dialectical behavior therapy (DBT) and cognitive-behavioral approaches are among the evidence-based options. Medication may treat co-occurring psychiatric disorders. Practical strategies include safety planning, identifying triggers, and developing alternative coping skills. Trusted resources on interventions and support include treatment guidance.

Distinctions and important notes

Language matters: "self-harm" is sometimes used broadly to include suicidal acts, whereas "nonsuicidal self-injury" is narrower. Stigma and secrecy are common barriers to seeking help; many who self-injure hide their behavior due to shame or fear. Research and clinical practice emphasize compassionate, nonjudgmental care, attention to coexisting mental health needs, and involvement of family or peers when appropriate. For further reading and support options see definitions, assessment tools, and other summaries at professional pages.

If you or someone you know is engaging in self-injury, consider contacting a health professional, a trusted person, or emergency services in a crisis. Early, respectful help can reduce harm and improve coping over time.