Cutting-edge: Understanding People who Self-harm by Barbara Melton, M.Ed., LPC

Barbara Melton, M.Ed., LPC

Cutting-edge: Understanding People who Self-harm by Barbara Melton, M.Ed., LPC

Cutting-edge: Understanding People who Self-harm by Barbara Melton, M.Ed., LPC

Barbara Melton, M.Ed., LPC
Barbara Melton, M.Ed., LPC

Self-harm not a new thing. There is just a lot more attention paid to it now that children are at the forefront of the research on this particular topic. Statistics from indicate one out of every 200 kids self-harm — and the numbers seem to be on the rise. Whether the person who self harms is a child or an adult, I still hear that the person feels overwhelmed by feelings they don’t want to feel, and that the self-harm is a coping mechanism.

Coping Mechanism? Yes, self-harm is a coping mechanism for when feelings become too overwhelming. The act of self-harm causes a distraction of sorts — in different ways with different people. Everyone is unique. When someone self-harms, it causes them to have new, different feelings and not the ones that drove them to the self-harm in the first place.

Best Friend. People who self-harm often describe it as their best friend. It has never failed them. It is there 24/7. It never rejects you. It is always there. Often I am told that the self-harm keeps the person from doing something worse, like complete suicide. Even if well-meaning loved ones take sharp objects out of the house like razors, scissors and knives, there is always a way of self-harming. They may just have to get more creative.

The issue of Control. People who self-harm often tell me that it is one thing they are in control of, that no one can take away from them, and they control whether something will hurt, how much it will hurt, how long it will hurt, and how deeply it will hurt.

Contracting for Safety. In therapy, if a client expresses suicidal feelings, we usually work with them to create a safety plan and then contract with them not to complete suicide while we are working with them in the therapy process. Self-harm is a different animal. If you tell someone they have to give up the self-harm, you have become the enemy, and you probably won’t win that battle. The best you can hope for initially in dealing with someone who self-harms is to work with them to create an arsenal of other coping mechanisms they can use rather than damaging themselves.

“The problem is not the problem.” Colin Ross, M.D. in his book The Trauma Model talks about the fact that just because self-harm seems to be the presenting problem, in fact it is only the solution to the real problem, the feelings they are having. Self-harm is an attempt at mood state regulation. So we have to understand the individual, which usually takes us back to their family of origin and their early years, to understand the root of the real problem that causes the overwhelming feelings.

Understanding the Reasons for Self-Harm. There is no one reason why some people self-harm. Many people say they don’t know why they do it — and initially I believe they were telling the truth. Through introspection and therapy, people understand themselves and their behavior/actions and can move towards healing rather than hurting themselves. People who self-harm usually don’t communicate their feelings well. They know how to speak, but they have a hard time expressing their needs. Instead, they hold things in and bleed them out. They ‘talk’ with their skin. Since understanding is key to helping a person who self-injures, I am listing here some of the reasons I have gleaned from clients over the years. And the same person can have all of these feelings, even if they are polar opposites.

  • “Pain makes the bad feelings go away”
  • “Being in control of my pain makes me feel powerful”
  • “The pain proves to me I am alive”
  • “When I feel pain, I dissociate and don’t have to feel”
  • “It feels good !” (some people can actually feel the rush of endorphins to the injury site)
  • To punish self
  • To punish others
  • To relieve stress/anxiety (like an overinflated tire)
  • To elicit nurturing — from self or others
  • To stave off bad memories
  • To relieve loneliness
  • To mirror actions of someone who perpetrated against them (trauma bonding)
  • To prove they need help (their action speak for them)
  • To seek relief from emotional pain by having to focus on physical pain
  • To create a distance or scare off others (related to attachment issues)
  • To elicit admiration
  • It has been a habit/addictive behavior

What you can do if you know someone who self-harms. Someone who self-harms needs help figuring out alternative coping mechanisms so that they don’t have to continue damaging themselves to survive.   They need to know you are concerned, care, and want to help, and that you are not judging them. Then you can offer your support by helping them find someone to work with them on enhancing their communication skills and creating new coping mechanisms. But just asking them to stop is not the answer.

About Barbara Melton: Barbara Melton is a Licensed Professional Counselor and has had a private practice in Charleston, South Carolina since 1991. One of her specialty areas is working with people who self-harm, and she has been working with this population over the past decade. She has been a speaker at state, national and international conferences on this subject and is also the co-author of a book called What in the World are your Kids doing online: Understanding the Electronic Age your Children Live in which was published by Random House/Doubleday and is available on amazon. You can read more about her on her website at