What Causes Self-Harming Behaviors?

Normally people go out of their way to avoid feeling pain, so it is difficult to understand why some people engage in self-harming or self-injurious actions.

While it’s not that unusual for people to engage in behavior that might cause them pain or injury—skiing, rock climbing, bungee cord jumping, dating—in those cases, the purpose is not to be injured; it’s just a risk they are willing to take for the adrenaline or dopamine rush.

If they bang their head against a wall or cut or burn their skin, pain is guaranteed. So, the question is “Why do people deliberately hurt themselves?”

There are two parts to this question:

  1. What are they trying to accomplish by hurting themselves? Assuming they are not masochists, what is their end game? What positive result do they expect from hurting themselves?
  2. Is there an underlying cause compelling them to hurt themselves? It would be more understandable if self-harm was the result of a mental illness or the use of some substance such as alcohol or fentanyl or LSD. With a few exceptions, however, most researchers believe self-harm is a behavior, not a mental illness, an addiction, or the side effect of an addiction.

It turns out that self-harm is an attempt to treat other, painful situations, primarily emotional or psychological. It’s not a good solution, certainly not in the long-term, but it is logical in their minds.

Self-injury can result from an inability to:

  • Deal with psychological pain. Self-harm is a way to distract the mind, to focus it elsewhere so that they can avoid thinking about or dealing with it. In the Gillian Flynn novel Sharp Objects, the journalist protagonist has carved words all over her torso, arms and legs due to childhood trauma and abuse.
  • Handle emotions in a healthy way. Uncontrollable feelings—ranging from guilt to anger, grief to self-hatred—may trigger self-harm.

As to what pre-existing conditions might lead to self-harm, one is being young. Eighteen percent of adolescents in the United States harm themselves deliberately every year, and more young women than young men.

Mental health issues also may predispose an individual to self-harm. Even though self-harm is not a mental illness, the two sometimes co-occur. Substance abuse, too, is often comorbid with self-harm and mental illness. It’s common enough that it is known as a dual diagnosis.

To detect whether or not someone you know commits self-injury, look for symptoms and signs, such as frequent injuries—scars, burns, cuts—or wearing heavy clothing that hides their skin, even in hot weather.



mayoclinic.org – Self-injury/cutting
center4research.org – Self-Injury Is Increasing in Teenage Girls: What Can Parents Do?
sunshinebehavioralhealth.com – Dual Diagnosis Treatment Programs | Dual Diagnosis Treatment Centers