Webb Therapy Uncategorized Understanding self-harm, self-injury, and self-destruction

Understanding self-harm, self-injury, and self-destruction

What is meant by self-harm?

Self-harm is any behaviour that involves the deliberate causing of pain or injury to oneself without the intention to end your life. Self-harm can include behaviours such as cutting, burning or hitting oneself, binge-eating or starvation, or repeatedly putting oneself in dangerous situations. It can also involve abuse of drugs or alcohol, including overdosing on prescription medications. Self-harm is usually a response to distress, whether it be from mental illness, trauma, or psychological pain. Some people find that the physical pain of self-harm helps provide temporary relief from emotional pain (extract from Self harm (lifeline.org.au)).

People who engage in self-harm will profess that they have no intention of dying and that their self-harming behaviour is a coping strategy, however, there are incidents of accidental suicide. The act of self-harm can develop into an obsessive-compulsion experience which can be very difficult to stop, like addiction, without outside intervention. This can result in feelings of hopelessness and possible suicidal thinking. Like building a tolerance to a drug, when self-injury does not relieve the tension or help control negative thoughts and feelings, the person may injure themselves more severely or may start to believe they can no longer control their pain and may consider suicide.

The following extract by Tracy Alderman Ph.D explains the physiological response to physical pain:

“Physiologically, endorphins are released when we are injured or stressed. Endorphins are neurotransmitters that act similarly to morphine and reduce the amount of pain we experience when we are hurt. Joggers often report experiencing a “runners high” when reaching a physically stressful period. This “high” is the physiological reaction to the release of endorphins – the masking of pain by a substance that mimics morphine. When people self-injure, the same process takes place. Endorphins are released which limit or block the amount of physical pain that’s experienced. Sometimes people who intentionally hurt themselves will even say that they felt a “rush” or “high” from the act. Given the role of endorphins, this makes perfect sense” (Oct 22, 2009).

Please click on the link for the full article Myths and Misconceptions of Self-Injury: Part II | Psychology Today Australia

The first step is to distinguish between self-harming and suicidal behaviour by paying attention to a person’s underlying motivation. When working with self-harming behaviour it is important to remember that this behaviour serves a purpose. In collaboration with the client, try to identify what problem self-harm solves for the client. For example, from the client’s perspective:

  • To make me feel real (counteracts dissociation)
  • To punish me (temporarily lessens guilt or shame)
  • To stop me from feeling (when strong feelings are too dangerous)
  • To mark the body (to show externally the internal scars)
  • To let something bad out (symbolic way to try to get rid of shame, pain, etc.)
  • To remember
  • To keep from hurting someone else (to control my behaviour and my anger)
  • To communicate (to let someone know how bad the pain is)
  • To express anger indirectly (to punish someone without getting them angry at me)
  • To reclaim control of the body (this time I’m in charge)
  • To feel better

Tips for helping yourself in the moment
It can be hard for people who self-harm to stop it by themselves. That’s why it’s important to get further help if needed; however, the ideas below may be helpful to start relieving some distress:

  • Intense exercise for 30 seconds, 30 second break, repeat, up to 15 minutes – Exercising intensely will help your body mitigate unpleasant energy that can sometimes be stored from strong emotions. Transfer this energy by running, walking at a fast pace, doing jumping jacks, etc. Exercise naturally releases endorphins which will help combat any negative emotions like anger, anxiety, or sadness.
  • Delay — put off self-harming behaviours until you have spoken to someone.
  • Distract — do some exercise, go for a walk, play a game, do something kind for yourself, play loud music or use positive coping strategies.
  • Deep breathing — or other relaxation methods.
  • Cool your body temperature – Cooler temperatures decrease your heart rate (which is usually faster when we are emotionally overwhelmed). You can either splash your face with cold water, take a cold (but not too cold) shower, or if the weather outside is chilly you can go outside for a walk. Another idea is to take an ice cube and hold it in your hand or rub your face with it.
  • Listen to loud music
  • Call someone you trust or one of the services available like LifeLine 13 11 14, MensLine Australia 1300 78 99 78 and BeyondBlue 1300 22 4636 [see below].
  • You could write an email to yourself to express your emotions, or journal your feelings, if that’s something that might be effective for you.
  • Watch humorous Youtube clips

New, healthier coping strategies may not be as effective as the one you’re trying to replace so it may take practice. Bring lots of compassion to yourself, okay.

You may find that some of these strategies work in some situations but not others, or you may find that you need to use a combination of these. It’s important to find what works for you. Also, remember that these are not long-term solutions to self-harm but rather, useful short-term alternatives for relieving distress.

Mental health services infographic

Related Post

The Four Options for any Problem (Linehan, 1993)The Four Options for any Problem (Linehan, 1993)

Marsha Linehan, the creator of Dialectical Behavior Therapy, gives four options for any problem that you face: Solve the problem, change your perception of the problem, radically accept the situation, or stay miserable.

When we are overwhelmed by a life challenge, one way we might naturally respond is by defending our position. Perhaps, we’ll resort to an effective yet temporary coping strategy like denial, projection, victimhood, or blaming. We attempt to cope in ways that lessen the stress – the internal discomfort and unpleasantness. Coping strategies that offer temporary relief generally make the situation worse in the long run, especially when fostering relationships at work and in our personal lives. For example, crawling back into bed when you need to work or have commitments with friends. Maybe you over-eat, use chemicals or resent the world, which alleviates the immediate emotional pain, then feel guilty or ashamed afterward. 

Sometimes, in an effort to take action, people attempt to solve problems cognitively – problems that cannot be solved, becoming more and more frustrated when their efforts don’t work. Others become paralyzed or dissociate, unable to decide what to do. Intense emotions can be overwhelming, fatiguing, and compromise our ability to think with an open heart and a clear mind. Searching endlessly for the right solution adds to anxiety and distress.

Marsha Linehan, the creator of Dialectical Behavior Therapy, gives four options for any problem that you face: Solve the problem, change your perception of the problem, radically accept the situation, or stay miserable.

Choice 1: Solve the Problem.

There are many problem-solving strategies, but most use the same steps. First, define the problem. Be as specific as possible. Use numbers whenever possible. For example, “I’ve been late for work four days this week.”

Next, analyze the problem. Is it in your power to solve the problem? If not, then consider one of the other three options. If yes, then continue to analyze the problem.

What are the reasons you’ve been late? Is the reason always the same?  Does it depend on your mood or what time you went to bed? Does it depend on what tasks you have to do at work? Who you work with? Where you went the night before?  Consider the who, what, when, and where of the behavior you want to change.

The third step is to consider possible solutions. Think of various solutions that could solve the problem. Evaluate the solutions carefully to determine which might work best for you. What are the pros and cons of different actions? What could go wrong? What can you do to make the solution more likely to work?

For example, if you decide to give yourself a weekly budget and to freeze your credit cards in a block of ice, what would you do in case of an emergency? Would giving yourself a certain amount of spending money for the day work better than an amount for the week?

A key variable to remember is how difficult it is to make changes in behavior. A strong commitment to change is important. Be specific in stating the change you want to make. Be willing to make small changes at first. Implement the solution: Take action. Trouble-shoot as you go along, tweaking it to resolve any issues you didn’t anticipate.

Choice 2: Change Your Perception.

Changing your perception of the problem can be a challenge. An example of changing your perception of a problem might be to see a difficult boss as an opportunity to work on coping with someone who is disorganized and demanding. If you feel irritated because your house is cluttered with toys, maybe change your perception to one that the clutter is a signal to be grateful for young children in the home. Changing your perception could also mean changing your view of emotion. Instead of trying never to feel anger, look at your frustration as a source of information, perhaps a signal that you need to speak up for yourself.

Choice 3: Radically Accept the Situation.

Radical Acceptance means wholeheartedly accepting what is real. Radical acceptance is like saying, “It is what it is,” and giving up your resistance to the situation. Radical acceptance could be about issues we can’t control or concerns that we decide not to change, at least for the time being. It doesn’t mean you agree with what has happened or that you think it is reasonable.

Choice 4: Stay Miserable.

Of course, staying miserable is not a choice anyone wants to make, and no one would want to consider it as an option. But if you can’t solve the problem, can’t change your perception, and you aren’t ready to radically accept the situation, then staying miserable is the only option left.

Staying miserable may be all you can do in certain situations. Sometimes staying miserable may be what you have to do until you are ready to do something else. There are ways to cope that can help until another option can be used.

In future posts, we’ll look at specific skills that enhance your ability to problem-solve, change your perception, or radically accept situations. We’ll also consider ways to get through the times when you can’t make any of those choices.

Problematic Thinking Styles (continued)Problematic Thinking Styles (continued)

Hello readers! A few of the cognitive styles below were mentioned in my last post. As humans, we have a tendency to forget things so a bit of revision can be useful.

Many people have cognitive processes that result in overall unhelpful thinking styles that they tend to apply globally across situations and which may result in emotional distress (such as depression or anxiety) or unhelpful behaviours (such as anger or avoidance). Some of the most problematic thinking styles are listed in the extract below.


Mental Filter: This thinking styles involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.


Jumping to Conclusions: I’m sure you’ve heard people say on television, “Don’t jump to conclusions” or “The truth is we just don’t know yet”. We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).


Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events.


Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small. A helpful restructuring of this cognition is to ask yourself if the situation will still be awful, terrible, or dreadful in a month. There may be ongoing consequences or stress involved if you lose a job or a relationship ends, so validate the experience you are having but also take a look at the big picture. What’s the worst that could happen? Why is the worst so “bad”? And if you are being realistic about the issue, reach out for some help if you can.


Black & White Thinking: This thinking style involves seeing only one extreme or the other. You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.


Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g. “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.


Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.


Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that aren’t consistent with that label.


Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. I live with anxiety and it can be debilitating at times. I use my “wiser thinking” or “rational thinking” to evaluate whether I am operating from an emotional mindset. You might ask yourself: “What’s the evidence?”, “Does the past necessarily predict the future?”, “Am I angry or fearful right now because that might be clouding my judgement?”. It can be helpful to talk to someone who isn’t caught in your emotional headspace, or perhaps wait for the emotion to subside to think about the situation again.


Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. It’s as though you’re explaining away your own positive characteristics.

(CCI, 2008)