What is self-injury?

The term self-injury refers to acts, which involve inflicting injuries on one’s own body. Self-injury is sometimes called “self-harm” (a broader term), “cutting up,” “self-abuse” or “self-mutilation.”

The most common form of self-injury is probably cutting, often of the arms as well as other areas. Some cuts are superficial, but some people will cut themselves more deeply. Some people also scrape, scratch or pick their skin so badly that chronic sores develop, and scarring occurs.

Sometimes, people will burn or scald themselves, others may punch themselves or hit parts of the bodies against something to cause pain and bruising. Inserting or swallowing objects might cause less visible injuries. Some people also hurt themselves by pulling out their hair or eyelashes or by repeatedly biting and tearing the skin on their hands or fingers.

Self-injury often begins in childhood or adolescence. It may be short lived, but some people will continue to hurt themselves (perhaps on and off) for many years.

Self-injury is often mistakenly seen as a suicide attempt. However, people who harm themselves are usually very clear about the difference between self-injury and a suicide attempt. Whatever the similarities self-injury may bear to suicidal acts, it is not about dying. It is about trying to cope and carry on with life.

Whilst some people harm themselves in ways which are obvious to others, or seek help for their injuries, others are surprisingly successful at hiding what they do. Shame, fear and humiliation may force people to keep their self-injury a secret for years.

Self-injury can be understood within a wider context of self-harm, which can include things like drug and alcohol abuse, overdosing, putting oneself in danger in various ways and eating problems. While some people self-harm particularly severely, in fact almost all of us self-harm in some way, usually less dramatically. Examples of ways we do this include smoking, worrying, taking risks, not getting enough sleep etc.

How to help someone who self-injures

If you have been feeling helpless, frightened or worrying about someone’s self-injury, it may be difficult to imagine that anything you do will make any worthwhile difference to them. It may seem like a problem that only “experts” can cope with, but you can make a difference.

Many people who self-injure can feel alone with feelings of distress and shame about what they do. Your support, caring and friendship can make a real difference to someone’s life right now and perhaps longer-term to their ability to live without needing to harm themselves.


Acceptance doesn’t mean that you have to like what a person does, or that you do not see it as a problem. It can be helpful to acknowledge that it is their right to hurt themselves if they need to and that they have valid reasons for coping in this way. Sometimes people try various means to prevent someone from hurting themselves, they might ask them to promise not to do it, and they may hide anything that might be used to harm or threaten to withdraw their support. Although this is all well-meant, it is not helpful. If someone could stop injuring themself that easily, they would have done so already. Instead, this approach might make them feel more isolated, guilty and self-hating forcing them to become more secretive about their self-injury.

They may have become used to people telling them that they are “just doing it for attention”, or that they are sick, manipulative and a nuisance. Acceptance can be incredibly important when, with you at least, they don’t have to hide or feel guilty or ashamed about what they are doing.

Listening & Communication

The basis of good communication is listening. People are most able to talk when they know that there is plenty of time and that you will listen and accept what they say; that you won’t immediately try to find solutions or give advice, but will just hear them out and try to understand.

Some people who self-injure may not have been listened to in their lives. Their feelings and views may have not been sought or taken seriously. In particular, it is likely that people will have made false assumptions about why they self-injure and told them why they are wrong to do so.

Simple though it seems, it is rare and special to be really heard by someone. You will be doing something very valuable if you just listen, respect and try to understand what they are saying about themselves, their feelings and their needs especially in relation to their self-injury.

It is also very helpful for someone to know that what they say doesn’t have to make perfect sense straight away. They can explore things in a roundabout or confused way until they become clearer.

It may help to talk about what they find difficult about talking honestly and directly to people. Communication is also helped a lot if you know that you can trust each other – be honest about your limitations and the limitations of confidentiality in your role.

Although it is less visible, the emotional pain behind the physical injuries is probably much more distressing for this person. If you are able, perhaps you could encourage them to talk about the feelings that lead them to self-injure, the way it works for them and so on.

Over time, this might help them to recognise when and why they are likely to self-injure and to develop alternative ways of communicating and coping with their distress.

Remember to respect your own needs and limitations, only offer what you are able to cope with, and remember that you aren’t responsible for stopping them from injuring themselves.

Practical Help

If they show you a recent wound, try not to panic – it will probably look worse that is really is. Show your concern for the injury and help them look after it if you feel able and they want you to.

If the injury is severe, you might go with them to hospital or the doctor. It is not uncommon for people who self-injure to be treated unkindly or with condemnation by medical staff. Attempts may also be made to have them admitted to a psychiatric hospital against their will. Your support through this experience can be very helpful, but if they do want to go alone it is important to respect their wishes.

For more information about self-injury visit the following websites: