Question 1

What is self harm?

Accepted Answer

Self-harm (also termed non-suicidal self-injury, NSSI) refers to the deliberate, direct damage to body tissue without suicidal intent. The most common forms include cutting, burning, hitting, scratching, or hair-pulling. It functions primarily as an emotional regulation strategy — providing a rapid but temporary reduction in overwhelming emotional pain, dissociation, numbness, or self-punishing feelings.

Question 2

What do people commonly experience with self harm?

Accepted Answer

Cutting, burning, or hitting the body to achieve temporary relief from overwhelming emotional distress; concealing wounds; feeling shame about the behaviour alongside the compulsive urge to repeat it.

Question 3

What lifestyle changes can help with self harm?

Accepted Answer

Building alternative coping strategies — distress tolerance skills from DBT (TIPP, ACCEPTS, self-soothe), physical activity, cold water exposure, art, music — provides alternatives to self-harm. Social support and trusted relationships are protective. Safety planning — identifying triggers, warning signs, and crisis contacts — reduces impulsive acts during peak distress. Reducing access to means (restricting sharp objects during high-risk periods) is a harm-reduction strategy. Self-compassion practices counteract the self-punishment function of self-harm.

Question 4

What integrative approaches support self harm?

Accepted Answer

DBT (dialectical behaviour therapy) has the strongest evidence base for NSSI, particularly in BPD, targeting the emotional regulation deficits underlying self-harm behaviour. CBT, mentalisation-based therapy (MBT), and compassion-focused therapy also have evidence. NICE guidelines recommend individual psychological therapy (minimum 3 months) as first-line. Safe messaging guidelines apply to clinical and public communication about self-harm. Physical wound care is an important component of acute management alongside psychological support.

Question 5

When should I seek professional support for self harm?

Accepted Answer

Anyone experiencing self-harm should be encouraged to seek support without shame. doctor, mental health services, crisis lines, and emergency departments are all appropriate depending on urgency. If wounds require medical attention, A&E attendance is appropriate and will include mental health assessment. Suicidal ideation should always be assessed alongside self-harm.

Self Harm

Self Harm at a glance

Patterns of Self Harm

Evidence context: self-harm

Staying safe

Featured practitioners

William Michael Forbes

Articles & insights

Polyvagal-Informed Therapy: Research Evidence and Clinical Applications

Polyvagal-Informed Therapy: A Practitioner's Guide to Nervous System Healing

What It Feels Like to Experience Polyvagal-Informed Therapy

Evidence & Research

Find Self Harm practitioners you can trust