Self-harm is often a silent cry for help, a way to cope with overwhelming emotions. Learn about the underlying causes, how to support loved ones, and pathways to healing.  I first learned about self-harm when I found a loved one’s hidden journal filled with sketches and poems that hinted at a pain I couldn’t see. When I finally worked up the courage to ask, they showed me faint scars on their forearm, each one a testament to moments when emotional pain became so overwhelming that physical pain felt like the only escape. That conversation changed my understanding of self-harm forever. It wasn’t a bid for attention or a dramatic gesture. It was a survival strategy, a way to stay alive when everything inside felt like it was dying. 

Self-harm is one of the most misunderstood and stigmatized struggles a person can face. It manifests in many forms—cutting, burning, hitting, or other methods of inflicting physical pain—but the common thread is never the action itself. It’s the desperate attempt to externalize emotional agony, to make invisible pain visible, to feel something, anything, other than the numbness or overwhelming anguish that consumes them from within. 

The reasons people turn to self-harm are as complex as the individuals themselves. For some, it’s a way to punish themselves for perceived failures or shortcomings. For others, it’s a release valve for intense emotions that feel too big to contain. I’ve sat with teens who described the rhythmic focus of cutting as a form of meditation—the only thing that could quiet the chaotic thoughts in their heads. I’ve listened to adults who said the physical pain grounded them when dissociation made them feel disconnected from their own bodies. None of them wanted to continue harming themselves. They simply didn’t have other tools to cope with the depth of their suffering. 

One of the most painful aspects of self-harm is the shame that accompanies it. Society often dismisses it as “attention-seeking,” when in reality, most people who self-harm go to great lengths to hide their wounds and scars. They wear long sleeves in summer, make excuses for accidental injuries, and withdraw from relationships to avoid detection. This isolation only deepens the emotional pain that drives the behavior in the first place. The person becomes trapped in a cycle of hurting, hiding, and feeling ashamed—which leads to more hurting. 

Supporting someone who self-harms requires replacing judgment with curiosity. Instead of asking “Why would you do that to yourself?” we might ask, “What does this help you cope with?” This shift in questioning opens the door to understanding rather than condemnation. It acknowledges that self-harm, however concerning, is serving a function—and that function must be addressed before the behavior can change. 

Recovery is rarely a straight line. There will be relapses and setbacks, and each one can feel like a catastrophic failure to the person struggling. I’ve learned to reframe these not as failures but as data points—opportunities to understand what triggered the return to old coping mechanisms and how to strengthen new ones. The goal isn’t perfection. It’s progress. It’s building a toolkit of healthier strategies that can eventually outweigh the urge to self-harm. 

Professional help is often essential, but finding the right fit matters. Traditional talk therapy might work for some, while others respond better to dialectical behavior therapy (DBT), which specifically addresses self-harm behaviors. Art therapy, movement therapy, and trauma-informed care can also provide pathways to healing that words alone cannot. Medication may help manage underlying depression or anxiety, but it’s most effective when combined with therapeutic support. 

For loved ones, the impulse to “fix” the situation can be overwhelming. We want to remove every sharp object, monitor every moment, and somehow love the person enough to make them stop hurting themselves. But true support looks different. It’s about creating a space where the person feels safe enough to share their struggles without fear of judgment. It’s helping them identify triggers and develop safety plans for when urges arise. It’s learning to sit with their pain instead of trying to immediately solve it. 

The journey toward healing often involves rediscovering the body as something beyond a source of pain. For some, this means tactile activities like gardening, pottery, or playing a musical instrument. For others, it might involve martial arts, rock climbing, or dance, activities that require being present in the body in a empowering way. The goal is to rebuild a positive relationship with the physical self, gradually replacing associations of harm with experiences of strength and capability. 

Perhaps the most important thing I’ve learned is that self-harm doesn’t define a person. It’s a behavior, a symptom of deeper pain, not an identity. With time, support, and appropriate resources, people can and do find healthier ways to cope. The scars may remain, but they can become reminders of survival rather than shame. They can tell a story of pain, yes, but also of resilience, courage, and the slow, steady work of healing. 

If you’re struggling with self-harm, please know this: your pain matters. Your life matters. There are people who want to sit with you in this darkness until you can find your way toward the light. And if you love someone who self-harms, your steady, nonjudgmental presence might be the anchor they need to begin believing that healing is possible. 

References

National Health Service (NHS). (2023, August 22). Why people self-harm. https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/self-harm/why-people-self-harm/

Mayo Clinic Staff. (2024, November 20). Self-injury/cutting: Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950

Healthdirect Australia. (2025, July 13). Self-harm. https://www.healthdirect.gov.au/self-harm

Oxford Academic. (2012). Risk of self-harm and suicide in people with specific psychiatric and physical disorders: Systematic review and meta-analysis. *The Lancet Psychiatry*, 2(5), 408-415. https://pmc.ncbi.nlm.nih.gov/articles/PMC4023515/

Cleveland Clinic. (2025, July 17). Self-harm (nonsuicidal self-injury disorder). https://my.clevelandclinic.org/health/diseases/12201-self-harm