The majority of people who self-harm carry great shame regarding their method for managing emotions. Therefore, there are not clear statistics on the prevalence self-harm. However, estimates range from 13-24% of the population.
Self-harm typically begins in adolescence and the primary purpose is to regulate one’s emotional experience. It occurs in many forms such as: cutting, scratching, head banging, burning, branding, etc.
Warning Signs of Self-Harming
The following factors individually do not guarantee that someone is self-harming, however, they are common signs of self-harm behavior:
- Wearing long sleeves or pants, even in the summer heat
- Refusal to wear a swimsuit or participate in activities that require showing skin
- Spending a lot of time in the bathroom or in particular the shower
- Going through many disposable shavers
- Isolating immediately after a fight or stressful event
- Reports of an unusual number of accidental injuries or bruises (i.e. “My cat scratched me.”)
- Scars from cutting or burns
- Having a box with sharp items (razor blade, tacks, exact-o blade refills, paperclips), bandages and first aid supplies
- Blood on sheets
- Great difficulty managing emotions (“Kids who self-injure have the emotional engine of a Ferrari with the transmission of a Toyota Corolla.” –Michael Holland, PhD, from the book Helping Teens Who Cut)
Just like with many difficult subjects in life (such as miscarriage, death, illness, divorce) people feel fearful and uncertain of how to respond when they suspect a loved one is self-harming. Will I make it worse if I call attention to it? Will they get mad at me? What do I say? Maybe it is just a phase and it will go away?
But, just as with other difficult life events, acknowledging the issue is a caring and supportive act. When we don’t ask if someone is hurting they often feel more isolated, alone, and invisible.
How to Talk to Someone You Think May Be Self-Harming
- First sit with, and be mindful of, your own emotions and reactions. Ask yourself, am I scared, nervous, angry?
- If you don’t feel safe or comfortable approaching the person, such as another student at school, seek out an adult to share the information with, such as a school counselor or parent.
- Approach your loved one and express concern, being mindful to not make an accusation or assume that your concern is fact. Because people who cut feel intense shame regarding their cutting, approaching with accusation or anger will typically lead to lying or further isolation. Lean on expressions of love, care and concern for their well being.
- Express and promote that there is meaning in life and hope in the future.
- Validate that they must be in great emotional pain.
- Help with researching and referral to medical and/or mental health treatment.
Self-Harm is a Risk Factor for Suicide – Both Accidental and Intentional
Because of this, it is important to address the concern anytime you think someone may be engaging in self-harm. For more information on self-harm and suicide, consider reading:
Helping Teens Who Cut: Understanding and Ending Self-injury, Michael Hollander
Previous Pine Rest blogs on self-harm
Understanding Self-Harm, a Pine Rest publication
Kathy DeVries, LMSW, CAAC, is a Licensed Master Social Worker and Certified Advanced Addictions Counselor with over 10 years of experience in human services. She is the Program Coordinator for the Pine Rest Dialectical Behavior Therapy (DBT) Program treatment team.