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Psychology Behind Self-Harm: Looking at the Underlying Causes

Self-harm is the act of hurting oneself, whether it is physical or emotional, intentional, or non-intentional. When many individuals hear the term “self-harm,” they often associate it with intentional physical self-harm behaviors such as cutting, burning, or skin picking, but self-harm can present in other ways as well. Unhealthy and self-destructive behaviors that are either intentional or unintentional are often highly linked to emotional self-harm. Emotional self-harm comes in all forms and can be just as dangerous as physical self-harm. Self-harm behavior can lead to mental health disorders, eating disorders, and substance abuse disorders, but what is it specifically that causes an individual to engage in self-harm? The psychology behind self-harm is multifactorial meaning that there is no one single trigger or cause. Research shows that self-harm frequently starts in adolescence and is particularly prevalent in homes where there is a repressive environment, where negative emotions are swept under the carpet or where feelings aren’t discussed. One factor common to many people who self-harm is that they were taught at an early age that their feelings were “bad” and “wrong.”

Psychology behind cutting

Cutting is the most common form of physical self-harm, formally known as non-suicidal self-injury. Like other forms of self-injury behavior, cutting is not a form of suicide but rather an unhealthy coping mechanism individuals use to relieve stress. Knives, paper clips, razors, and other sharp objects are commonly used in this behavior. Cutting is part of a vicious cycle associated with anger, sadness neglect followed by a quick mental relief from cutting. Once the act of cutting is completed and the feelings of mental relief dissipate, the individual if often overtaken by feelings of guilt and shame, which then turn to anger and neglect until the cycle continues again. Individuals who have a past or current history of abuse, trauma, low self-esteem, family conflict, bullying, and sexual identity conflicts are often at risk for extreme stress and negative feelings that he/she may not be able to control. As a result, cutting is used as an unhealthy coping mechanism to relieve the stress and these negative feelings. Some individuals may even engage in cutting to numb their pain or actually feel pain because they are numbed from their negative emotions. Many individuals who engage in self-harm view this behavior as a psychological release, a way to unravel their deep underlying negative emotions and thoughts.

The psychology behind emotional self-harm

Emotional self-harm ranges from telling ourselves we are not good enough and becoming our own worst enemy to engaging in a pattern of destructive friendships and relationships. Emotional self-harm is tied to past events that occurred in childhood or adolescence. Maybe one’s parents were too strict, or there was a history of neglect, sexual abuse, a history of bullying, or maybe there was a coach or a teacher who always gave negative criticism. Emotional self-harm also occurs when the individual’s emotional needs are not met during their formative years. After years of being neglected or being told, one is not good enough; it becomes ingrained in their head to the point that the individual begins to believe it. As a result, they may seek out unhealthy co-dependent relationships, may engage in disordered eating to cover up their emotions or may sacrifice their own happiness at the expense of others because they so desperately want to be liked and accepted.

Reasons individuals engage in self-harm

  • To feel a sense of control
  • Express pain
  • As a distraction
  • As punishment
  • To feel pleasure
  • To feel anything at all

The psychology behind the treatment for self-harm

Psychotherapy is the mainstay treatment for individuals who engage in self-harm behaviors, whether it is physical or emotional self-harm. A recent study identified that psychological treatments specific to self-harm have better success than those that are more general in nature. Cognitive-behavioral therapy (CBT) is a short-term treatment approach that is very goal-oriented. This treatment approach focuses on identifying dysfunctional emotions, behaviors, and thoughts underlying the self-harm behaviors and then analyzing them and replacing them with more positive and healthier ways of dealing with the underlying triggers and stressors that are contributing to the self-harm behaviors.

For instance, an individual may tend to magnify a negative situation rather than seeing it as part of reality. Cognitive-behavioral therapy (CBT) would work to identify that negative thought pattern, challenge it, and replace it with a thought pattern that is more realistic and positive.

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