How To Cope With the Urge to Self-Harm

Have you ever wanted to bang your head on a wall and actually done it? Or secretly tried to cut away the pain of your existence? You're not alone. Acts like this are considered Nonsuicidal Self-Injury.

What is Nonsuicidal Self-Injury?

Nonsuicidal Self-Injury, or NSSI, is intentional, self-inflicted, low-lethality bodily harm of a socially unacceptable nature, performed to reduce and/or communicate psychological distress.

You might be thinking—“What the heck is socially acceptable self-injury?” As an example, some cultures engage in practices like scarification, which is considered to be socially acceptable.

It’s also important to note that self-harm and suicidal behaviors are different. In suicide, the intent is to permanently end life and escape pain. In NSSI, the intent is typically relief from an unpleasant feeling (e.g. anger, emptiness, shame). NSSI is typically low-lethality, meaning that you would be unlikely to die from the injury; for example, shallow cuts on an inner thigh. However, there have been individuals who have hurt themselves more severely than intended.

NSSI is most common among adolescents and young adults, usually starting around age 13 or 14. Lifetime rates in these populations are about 15% to 20%. In both adolescents and adults, rates of NSSI are highest among those with a history of mental health disorders such as depression, anxiety, problems with emotion dysregulation, and distressing negative emotionality, particularly those with self-directed negative emotions and self-criticism.

A common myth is that women engage in this behavior more than men; the research shows that the rates of NSSI are actually equal. What appears to be different between men and women is the method used. Women are more likely to engage in cutting while men are more likely to engage in hitting or burning. NSSI is more common among LGBTQIA+ folks and White people are more likely than BIPOC to self injure.

Why and how do people self-injure?

Let’s get deeper into the intention behind NSSI.

In contrast to suicidal behavior, the intent of the self-injuring person is not to terminate consciousness, but to modify it. The overwhelming majority of self-injuring individuals report that they harm themselves in order to relieve painful feelings like anger, shame or guilt, frustration, contempt, anxiety, tension, and panic. A smaller proportion of self-injurers report feeling too little emotion. They may state that they feel “empty,” “like a zombie,” “dead inside,” or “like a robot.” These individuals self-injure to provide relief for this absence of feeling.

The key point regarding intent is that a suicidal person wants to end their experience; a...

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