Self-injurious behavior – causes, treatment

Selfharming behaviour

Up to 20 percent of all young people hurt themselves, with girls being more likely to be affected. Self -harm often occurs as a symptom of mental disorders or illnesses.

What is Self-Harming Behavior?

Self-injurious behavior refers to actions in which the surface of the body is deliberately damaged. This means that the person concerned repeatedly injures himself. This can happen consciously or unconsciously. Self-injury is not an independent clinical picture, but a symptom of disorders.

However, these self-harms do not have a suicidal background. They are most commonly caused by cuts with pointed or sharp objects, such as a razor blade, a knife or broken glass. This cutting or tearing occurs mostly on the arms and legs. Burns or chemical burns are also a form of self-injurious behavior.


The causes of self-injurious behavior include highly stressful events and experiences, which are often long-lasting. These include, for example, neglect by parents that leads to a lack of security, separation from parents, which children often cannot cope with, sexual abuse, low self-esteem, a tendency towards emotional instability and the inability to deal with feelings, tension or anger to express it in a different way.

Adolescents with mental health problems or disorders have a very high risk of developing self-injurious behavior. Other causes are mental illnesses such as depression , anxiety , panic , obsessive- compulsive , eating or borderline personality disorder . There are many reasons for self-injury. Rarely is there a single trigger for this.

This often hides numerous causes and feelings that the person concerned associates with the behavior. In this case, the emotional burden is relieved by physical pain. The body reacts to pain by increasing the release of endorphins, which results in a feeling of relief and relaxation. Self-injurious behavior often develops into an addiction, which those affected have to pursue again and again. Without outside help, the urge to hurt cannot be curbed.

diseases with this symptom

Symptoms, Ailments & Signs

Self-injurious behavior usually involves multiple injuries. These are primarily cuts or scratches that are performed on easily accessible areas, such as the extremities. The depth of the injury is usually the same and the injuries are often grouped, lined up in parallel or symmetrically.

Regarding the shapes, lines, letters, and words are commonly observed. It is difficult for parents to recognize the signs of this behavior, since those affected usually hide their injuries under clothing and do not tell anyone out of shame. It is therefore very important to react to possible warning signs in order to get help at an early stage.

Diagnosis & History

In addition to the physical damage, which can be minor but sometimes just as severe or even fatal, self-injurious behavior can also lead to psychosocial impairments, since feelings such as shame, guilt, stigmatization or reduced self-esteem can arise. Those affected often suffer from disturbed sleep and mood swings . They neglect friends or hobbies and withdraw.

Due to the resulting scars, which they want to hide, they wear long clothes even on warm days. The diagnosis is made based on the injuries inflicted on the body. Severe forms of illness are caused by repeated injury over a longer period of time. Self-injurious behavior often develops into an addiction, which those affected have to pursue again and again. Without outside help, the urge to hurt cannot be curbed.


As a rule, if self-injurious behavior is not treated, the afflicted person often ends up injuring themselves to a very high degree and causing relatively great harm to themselves. Such people most often injure themselves on the skin or in other places. When this behavior is left untreated, people often do not realize the harm they are doing to themselves and do not stop on their own.

In the worst case, it can also lead to suicide or injuries, which can be life-threatening for your own body. These people often do not think about the consequences of self-harm and commit it to themselves without realizing that in the worst case they could die from it.

Treatment for self-injurious behavior usually involves medication and talking to a psychiatrist . Most of the drugs used have strong side effects. These include tiredness, headaches or listlessness. These side effects are not particularly serious, their primary purpose is to prevent the person from further harming themselves.

As progress is made, weaker drugs that do not have as severe side effects can be used. In severe cases, treatment can also result in a stay in a closed psychiatric ward.

When should you go to the doctor?

It is always a good idea to see a doctor if you experience self-injurious behavior. If a doctor is not consulted, the affected person can sustain serious and life-threatening injuries. In the worst case, it can also lead to suicidal thoughts and ultimately to suicide. As a general rule, self-injurious behavior should always be evaluated and treated by a psychologist . It can take a long time before the cause of the behavior is found.

In many cases, the patient does not realize that he needs treatment and that he is suffering from the disease. In these cases, friends and family must enforce treatment and evaluation. It is also possible to carry out the treatment in a closed clinic. Urgent action is especially necessary if the patient has already sustained injuries and has been suffering from self-injurious behavior for a long period of time. In the case of acute injuries, the emergency doctor can be called or the person concerned can be taken to a hospital.

Treatment & Therapy

Those affected are often unable to free themselves from the self-injurious behavior. There is a good chance of getting rid of it through psychotherapy or behavioral therapy . The underlying problems are worked through here, because it is fundamentally very important that the basic faults are recognized and eliminated. The person concerned is supported in developing new coping strategies with which to react to stressful situations.

Furthermore, they learn to talk about emotions instead of expressing them in the form of self-injurious behavior. The earlier the therapy begins, the better the chances of recovery, although there are also people who cannot be treated. The prerequisite for healing is always a secure relationship of the person concerned, for example with a partner, a family member, friend or therapist. The therapy can be supported by medication if, for example, severe depression, an anxiety disorder or compulsive characteristics are present.

Relaxation techniques such as yoga can also help to strengthen inner balance. The motivation to change the self-injurious behavior is primarily decisive for the success of the therapy. Therapy that takes place against the will usually does not help. Accusations and reproaches on the part of the relatives are not advisable, because this can increase the addiction to self-harm. Showing understanding is a greater help.

Outlook & Forecast

The outlook and prognosis for self-injurious behavior are highly dependent on the severity of the symptom and the will of the patient and therefore cannot be universally predicted. In most cases, therapy with a psychologist is necessary to treat this behavior.

It usually takes several months for behavior to change. However, success cannot always be assumed. This is also highly dependent on the patient’s background and will. It is not uncommon for those affected to have to be treated in special clinics. In this case, there is often a positive course of the disease and the fight against the symptom.

If the self-injurious behavior is not treated, the patient will continue to injure themselves. Often the behavior is accompanied by an aggressive mood. The affected person turns away from friends and family and restricts himself socially. This leads to social exclusion and often to depression and suicidal thoughts. In the worst case, the patient can injure himself so badly that he commits suicide. Therefore, those affected should be left alone as little as possible to avoid life-threatening injuries.


In principle, a change in the perception of pain cannot be prevented. However , people who suffer from pain insensitivity can learn to avoid injury. First and foremost, it is always important to have a stable environment in which there is love and security, in order to avoid the development of psychological problems from the start.

Reacting to any signs promptly can prevent the self-injurious behavior from developing into an addiction. Relaxation techniques and exercise can also help with prevention, as this is a good way to switch off, relieve frustration and anger, and clear your head.

You can do that yourself

First, it is important to learn new coping strategies that can be used in place of self-harm. These should help to deal with the strong feelings without harming the body. If the urge to self-harm is acute, working out during sport can serve as an outlet. A creative pursuit, such as painting, can also serve as an outlet.

Distraction or relaxation exercises are also conceivable to control the strong feelings. If possible, contact can be established with a trusted person. A conversation about the current emotional state does not help to be alone. Doing something good for yourself, treating yourself to something, can help those affected to reduce the tension and the pressure to harm themselves. If necessary, alternative actions to self-injury can be used, which are physically stimulating but do not harm the body. For example, a cold shower , something spicy to eat or a rubber band that those affected can strap on their arm are conceivable.

Which strategies help in individual cases must be tried out. In the longer term, it makes sense to deal with the triggers of self-injurious behavior. Psychotherapy in particular can be of great help. If, despite everything, you have injured yourself, it is important to take good care of the wounds and seek medical help if necessary.

Lisa Newlon
 | Website

Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.