Let's talk about self-harm: it's not just a wound, but an emotional struggle no one has seen
When you hear the word "self-harm", what's the first image that surfaces in your mind?
Perhaps it's the scars on a wrist, the cuts that can't be hidden, or a kind of unspeakable, hidden pain.
But psychology wants to tell you that what lies behind self-harm isn't simply physical pain — it's an emotional struggle, played out again and again, that has never been put into words.
Today, let's use the lens of psychology to sit down and talk this through together: why do people self-harm? And what are the ways to slowly walk out of this cycle?
1) What is self-harm? Understanding NSSI through psychology
The formal name for "self-harm" is Non-Suicidal Self-Injury (NSSI).
Put simply, it is "the deliberate, self-inflicted harm of one's own body without any intent to die" (Klonsky & Muehlenkamp, 2007).
These behaviours might include:
- Cutting oneself with a blade
- Hitting one's head against a wall
- Burning the skin with a cigarette
- Scratching or biting one's own skin
Many people assume self-harm means seeking death, but in fact, the psychological motivations behind self-harm and suicide are entirely different.
Behind self-harm is, in truth, a survival response — a sense of "wanting to keep living but not knowing how" (Nock, 2010).
Psychology reminds us: self-harm is not the same as suicide, but over the long term, the two are indeed strongly connected.
Why do we self-harm? Psychology explains the 7 most common reasons
1) Emotion regulation: using physical pain to push down the pain inside
When emotions surge in like a flood — anxiety, anger, loneliness and numbness all rising up at once —
some people choose to use "physical pain" to distract themselves and shift the emotional storm elsewhere (Chapman et al., 2006).
Many describe it this way: "Physical pain is, at the very least, more controllable than heartache."
2) Self-punishment: being so angry at yourself that you want to be punished
Sometimes, self-harm is like an "emotional retaliation" against oneself.
Disappointment in yourself, self-loathing, the feeling that "it's all my fault" — this intense shame and self-blame can ultimately turn into one cut after another, a punishment aimed at oneself (Taylor et al., 2018).
3) Ending dissociation: wanting to confirm you're still alive
Have you ever had a feeling of being "outside your own body"?
When stress reaches an extreme, the body can enter a state called dissociation, as if your whole self isn't quite real — empty, drifting.
In that moment, letting oneself "feel a flash of pain" through self-harm becomes a way of pulling consciousness back to reality (Klonsky, 2007).
4) Difficulty expressing emotion: when pain can't be spoken, it can only become a wound
Many people don't refuse to ask for help — they simply have no idea how to begin.
When the words inside are stuck and impossible to express, the wound becomes a "silent cry for help" (Nock, 2010).
5) A craving for control: at least this is something I can command
When life is in chaos and emotions are tangled into a knot, many people turn to self-harm to recover a little sense of "control".
"At least this is a pain that I get to decide on."
This is what psychology calls the "illusion of control effect" (Glenn & Klonsky, 2010).
6) Social function: wanting to be seen doesn't mean wanting to be judged
Some adolescents who self-harm are, in fact, trying to let those around them know: "I'm really in pain, and I really need to be understood."
But because the way they express it is so extreme, they end up being misunderstood all the more easily (Heath et al., 2008).
Psychology reminds us: wanting to be seen does not mean wanting to be blamed.
7) Peer and online influence: don't let the "romanticising of wounds" harm you
On social media platforms and online forums, some content unwittingly romanticises self-harm, even glorifying it into an "artistic act".
This kind of "social contagion effect" is especially likely to affect those who are emotionally vulnerable and already struggling (Lewis et al., 2011).
Psychology reminds us: when you come across this kind of content online, please remember to protect yourself, and don't let yourself be unconsciously drawn into that atmosphere.
Who is more prone to falling into the self-harm cycle? The 4 high-risk groups in psychology
1) Those with mental health conditions
Depression, anxiety disorders, PTSD, borderline personality disorder (BPD) and the like —
all of these psychological states substantially raise the risk of self-harm (American Psychiatric Association, 2013).
BPD in particular: "repeated self-harm" is even listed as one of its diagnostic criteria (Glenn & Klonsky, 2010).
2) Those with a background of developmental trauma
People who experienced neglect, abuse or emotional disconnection in childhood
often grow up with more fragile emotion-regulation abilities, and a higher risk of self-harm (Laye-Gindhu & Schonert-Reichl, 2005).
3) Those with lower emotional expression abilities
When "expressing emotion" is in itself so difficult,
then, at moments when stress explodes, self-harm can easily become the "last way out" (Adrian et al., 2011).
4) Adolescents
Among adolescents aged 12 to 18 in particular, peer influence and online imitation effects are especially pronounced (Heath et al., 2008).
Children at this stage have fewer emotion-regulation resources, and their judgement about risky behaviour is still developing.
Does self-harm really lead to suicide? Here's what the psychological data says
When self-harm comes up, the first thing many people ask is: "Could there come a day when it turns into suicide?"
Honestly, that worry isn't unfounded.
Although self-harm (NSSI) and suicide are essentially different — self-harm usually carries no intent to die, and is only meant to relieve the pain or emotion of the moment — psychological research has found that:
people who have a history of self-harm carry a future suicide risk several times higher than the general population (Whitlock et al., 2013).
Why is this so? The reasons usually come down to a few:
- A rising tolerance for pain: the body gradually adapts to physical pain, lowering the psychological barrier to more intense behaviour in future.
- Emotion-regulation capacity gradually running dry: when the "self-harming behaviour" once used to cope with suffering no longer works, the emotional black hole may grow larger and deeper.
- The line between life and death becoming blurred: after testing the limits with one's body time and again, the boundary between "alive" and "not alive" slowly begins to blur.
Psychology reminds us: every act of self-harm is a cry for help from inner suffering, and it absolutely deserves to be taken seriously, to be properly seen.
How do you walk out of the self-harm cycle? 4 effective methods recommended by psychology
Walking out of self-harm isn't something you can achieve in a single day. But the good news is — you don't have to carry it all on your own. Here are several methods recognised as effective in the field of psychology:
1) Have the courage to seek professional psychological help
Whether it's counselling, psychotherapy, or support from a social worker, finding someone professional who is willing to listen to you is the first step towards change.
Here are three therapies commonly used specifically for self-harm:
- Dialectical Behaviour Therapy (DBT): helps you learn healthier ways to regulate emotion, and is especially suited to people who experience big emotional swings and difficulty controlling impulses (Linehan et al., 2006).
- Cognitive Behavioural Therapy (CBT): helps you change negative thinking and cognitive distortions, reducing emotional outbursts and self-harm impulses (Bentley et al., 2014).
- Family intervention therapy: especially suited to adolescents, helping parents and family members learn the right ways to offer support and walk out of the shadow together (Asarnow et al., 2017).
2) Learn to use "safe alternative behaviours"
When the urge to self-harm comes crashing in, why not first try these safer ways:
- Hold an ice cube in your hand to redirect your attention
- Flick your wrist gently with a rubber band to mimic the sensation
- Write down what you're feeling in the moment, giving the emotion an outlet
- Practise deep breathing or brief mindfulness meditation, letting body and mind slowly settle (Taylor et al., 2018)
These methods won't necessarily work right away, but every time you're willing to try, that itself is a kind of progress.
3) Begin small exercises in emotional expression
Speaking it out loud may be very hard. So start by writing it down.
- Write a few lines each day about how you feel in the moment
- Draw, make music, dance — release your emotions in your own way
- In a safe space, try slowly expressing your needs to someone you trust
This isn't just venting — it's also a way of letting yourself slowly practise "not harming yourself to express your pain".
4) Build your own "support network": make care a habit
You don't need a big crowd — you only need that one or two people who "genuinely want to listen to you and won't judge you".
It could be:
- A good friend
- A psychologist
- A supportive online community
- A helpline counsellor
Make reaching out a part of your life, rather than crying for help only once you can no longer hold on.
To you, caught in the self-harm cycle: a few gentle words
If you're walking through the valley of self-harm right now, there's something very important I want to tell you:
"None of this is your fault. It isn't that you aren't strong enough, it isn't that you're too fragile — it's that you're using the only means you have to struggle through the pain in front of you."
Psychology often says: behind every behaviour lies a story that hasn't been properly heard.
What you've been doing is nothing more than trying to make yourself feel a little better. It's just that the way of doing it is, perhaps, a little heartbreaking.
The you of today truly deserves to be understood, to be embraced, to be cared for well.
Please believe this: you don't have to spend a lifetime harming yourself to prove that you're still alive.
One last thing: behind self-harm is a heart waiting to be understood
Whether you're going through this yourself, or someone close to you is walking this road, I hope you'll remember:
"Self-harm is not the end of the story, but the starting point of another turning in life."
Pain won't suddenly disappear, but it can be slowly held.
May everyone who has ever been crushed, ever been drowned by their emotions,
one day learn to use gentler, safer ways
to carry on, and live well.
Explore the MindForest App: walking with you out of the self-harm cycle, learning to treat yourself more gently
Self-harm doesn't mean you're weak — it means you're fighting with your emotions using the only means you have. Recognising the reasons behind these emotions is the first step towards change. Through the MindForest App, you can better understand the ebb and flow of your emotions, and find safer, gentler ways to care for yourself.
?ForestMind AI: psychological support in your emotional low points
ForestMind offers caring, practical psychological suggestions based on your emotional state. Whether you're facing an intense impulse or a low moment, it can sit with you to untangle your thoughts and find an outlet that doesn't harm yourself.
?Insight Journal: recording your true inner feelings
Through the Insight Journal, you can vent stress at any time, record how you feel in the moment, practise replacing harm with words, and slowly build an emotional release space that's all your own.
?Psychological Assessment: understanding your own emotional triggers
Through a psychological assessment, you can understand your own personality, and find the emotion-regulation and self-care strategies that suit you best.
Download MindForest now, and start by understanding yourself — walking with you out of the emotional black hole of self-harm, and finding safer, gentler ways to carry on living.
References
Adrian, M., Zeman, J., Erdley, C., Lisa, L., & Sim, L. (2011). Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. Journal of Abnormal Child Psychology, 39(3), 389-400.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Asarnow, J. R., Hughes, J. L., Babeva, K. N., & Sugar, C. A. (2017). Cognitive-behavioral family treatment for suicide attempt prevention: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 506-514.
Bentley, K. H., Nock, M. K., & Barlow, D. H. (2014). The four-function model of nonsuicidal self-injury: Key directions for future research. Clinical Psychological Science, 2(5), 638-656.
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44(3), 371-394.
Fortune, S., Sinclair, J., & Hawton, K. (2008). Help-seeking before and after episodes of self-harm: A descriptive study in school pupils in England. BMC Public Health, 8(1), 369.
Glenn, C. R., & Klonsky, E. D. (2010). A multimethod analysis of impulsivity in nonsuicidal self-injury. Personality Disorders: Theory, Research, and Treatment, 1(1), 67.
Heath, N. L., Toste, J. R., Nedecheva, T., & Charlebois, A. (2008). An examination of nonsuicidal self-injury among college students. Journal of Mental Health Counseling, 30(2), 137-156.
Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27(2), 226-239.
Klonsky, E. D., & Muehlenkamp, J. J. (2007). Self-injury: A research review for the practitioner. Journal of Clinical Psychology, 63(11), 1045-1056.
Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34(5), 447-457.
Lewis, S. P., Heath, N. L., St Denis, J. M., & Noble, R. (2011). The scope of nonsuicidal self-injury on YouTube. Pediatrics, 127(3), e552-e557.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., … & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766.
Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339-363.
Taylor, P. J., Jomar, K., Dhingra, K., Forrester, R., Shahmalak, U., & Dickson, J. M. (2018). A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders, 227, 759-769.
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