Personality Disorder Support Community

Personality Disorder Support Community

Self Harm

Self harm refers to deliberate and intentional harming of one self and includes:

  • Skin cutting

  • Scratching

  • Punching/hitting one self

  • Burning

  • Bruising

  • Breaking bones

  • Hair pulling (trichotillomania)

  • Preventing wounds from healing by picking at scabs etc

  • Taking toxic substances

There is also a broader use of the term self harm to include disordered eating habits.

Self Harm is usually done without any suicidal intent (non suicidal self injury or NSSI). It is estimated that sufferers make up 1% of the population, with a higher number of females to males. The onset of self harm is usually around puberty.

There has been research that shows that the incidence of self harm is higher in adolescents around the age of 15-19, and those who suffer from depression and/or anxiety.

Most people who self harm report a history of trauma and/or abuse, although most appear to be high functioning. However, those who seek treatment are usually from a middle to higher income background.

There is no actual diagnostic criteria in either the DSM-IV or the ICD-10 for Self Harm as a diagnosis on its own but it is seen as an underlying disorder and occurs most often in people who suffer from personality disorders such as Borderline Personality Disorder. Sufferers of other mental health diagnoses including eating disorders, substance abuse, schizophrenia, depression, anxiety disorders, post traumatic stress disorder, phobias and other personality disorders may also self harm.

Signs and symptoms

Most self harm involves cutting, but there really is no limit to the range and severity of self harm, depending on the availability of whatever is to hand at that moment, and how resolved the sufferer is about harming themselves.
The sufferer also tends to harm themselves on hidden areas of their body.

A person who self harms may:

  • Exhibit scars from previous self harm

  • Exhibit fresh wounds, cuts or bruises, usually on their limbs

  • Seem depressed or unmotivated

  • Show signs of negative thought patterns

  • Exhibit signs where hair has been systematically and frequently pulled out

  • Unexpectedly change their dress sense and be fully covered even in the summer or hot weather

  • Show signs of alcohol or substance abuse


Many people who self harm report that they do so because it often is the only way to express negative feelings. Some also self harm because they feel disconnected from the real world, and self harming is the only way they know to stop feeling numb or dissociated. Others do it because they find that the only way to regain control is through self harming. There are wide ranging reasons and they are often personal to the individual.


Treatment usually involves different approaches. If the person who self harms also suffers from depression or anxiety, the usual treatment involves prescribing anti-depressants or anti-anxiety medication to help with those feelings.

Sometimes, Cognitive Behavioural Therapy is offered. This therapy helps the sufferer recognise the thought patterns and to change the corresponding behaviour.

Dialectical Behaviour Therapy is also offered to those on Axis 2 Disorders, such as Personality Disorders, who also have self harming behaviours.

Another method of treatment also include avoidance or distraction techniques, whereby other interests and activities seek to preoccupy the sufferer, as well as avoiding sharp or potentially destructive objects.

Together, these may help the person who self-harms to cope without resorting to self harming methods.

References: ... ction.aspx
Muehlenkamp, J. J. (2006), "Empirically supported treatments and general therapy guidelines for non-suicidal self-injury", Journal of Mental Health Counseling 28 (2)
Truth Hurts Report, Mental Health Foundation, 2006, ISBN 978-1-903645-81-9 ... yId5=38712
Greydanus DE, Shek D (September 2009), "Deliberate self-harm and suicide in adolescents", Keio J Med 58 (3): 144–51