Cutting and Self-Harm: Signs, Diagnosis, and Treatment
Cutting and self-harm can be difficult topics to talk about. Cutting is an often misunderstood behavior that can bring up a ton of difficult feelings. For those who self-harm, it’s common to feel a sense of shame, isolation, and self-loathing when thinking about it.
For the people closest to them, it’s easy (and normal!) to feel shock, confusion, and even fear when they discover that their loved one has been intentionally hurting themselves.
But we want to clear something up, right from the offset: self-harm isn’t anything to be ashamed about. Self-harm is closely linked with our mental health, and often the solution is access to the right support.
With this in mind, in this article, we’ll cover:
- What self-harm and cutting (and what they aren’t!)
- The signs and symptoms of cutting and self-harm
- The common causes and risk factors for self-harming behaviors
- How cutting and self-harm are diagnosed
- Treatment options and coping strategies for those struggling with cutting self-harm
What Is Self-Harm?
Self-harm is when a person hurts themself on purpose. Cutting involves using a sharp object like scissors, a razor blade, or a knife to cut or scratch the body.
The terms cutting and self-harm are often used interchangeably since cutting your body is the most common type of self-harm. However, there are many other forms of self-harm besides cutting. For example, burning or scratching your skin, head-banging, or taking risky behaviors.
It’s also important to make a distinction between self-harm, cutting, and suicide. While a history of self-harm can be a risk factor for suicide, a person who cuts is not typically attempting suicide and does not intend for the cutting and self-harm to result in death. As such, cutting is commonly referred to as a form of Non-Suicidal Self-Injury (NSSI).
Why Do People Self-Harm?
Self-harm is frequently used as a way to cope with overwhelming emotions and stress. From what research currently gathers, the physical pain felt through self-harm allows the person to escape or distract themselves from the overwhelming feelings they are experiencing in another area of life. For example, being in a stressful job or being bullied at school.
People often turn to self-harm when they don’t have access to the right support for them, or when they aren’t aware of other, healthier coping strategies. With professional help, people struggling with cutting and self-harm can learn new ways of dealing with challenging situations and healthier coping skills.
Fortunately, with the availability of convenient outpatient and telehealth programs, therapy is more accessible than ever before with appointments that work for anyone’s schedule.
Signs and Symptoms of Cutting and Self-Harm
The signs of cutting and self-harm are unique and deeply personal for each individual. A person with self-injury behaviors may use more than one method, and they may repeat the behaviors over periods of time.
- Cutting the skin with a knife or razor
- Piercing or scratching the skin with a sharp object
- Burning the skin with candles or cigarettes
- Hitting or punching oneself
- Banging the head against a hard surface
- Fresh cuts
- Multiple scars on one area of the body
- Unexplained bruises
- Bite marks that can be seen on the skin
- Burn marks
- Wearing long sleeves or pants, no matter the temperature or season
- Guilt
- Anxiety
- Shame
- Isolation
- Depression
- Worthlessness
- Helplessness
- Emotional instability
- Behavioral unpredictability
Understanding and removing the shame from these symptoms of self-injury, and instead seeing them as a call for help, can lead to better awareness and increased support for those who are struggling with self-harm behaviors.
Causes and Risk Factors for Self-Harm
Research indicates that there are often complex reasons for what causes self-harm. Self-harm risk factors include:
- Early childhood trauma such as physical or sexual abuse
- Difficulty expressing or regulating emotions
- Lack of effective communication or social skills
- Identify as bisexual or transgender
- Mental health conditions such as depression, anxiety, and personality disorders
While people of all ages can be at risk for cutting and self-harm, research shows that the behavior occurs more frequently in teenagers and young adults. One potential reason for this is that adolescence can be a difficult and tumultuous time filled with change and transition. The stress of the increased demands, responsibilities, and choices can feel overwhelming, and teens may use self-injury as a way to manage the emotional turmoil they’re feeling.
There’s also growing evidence that the increase in cutting and self-harm is linked to the ever-increasing use of technology. Today’s adolescents tend to have decreased in-person social interactions and frequently encounter instances of cyberbullying and toxic online environments. Social media may also exacerbate teens comparing themselves to others in ways that are damaging to their mental health.
Diagnosing Cutting and Self-Harm Behaviors
Self-harm does not need to be a lifelong condition. It’s possible to learn how to stop self-harm and discover healthier ways of coping. An important step is reaching out to a qualified provider for a professional mental health evaluation.
When diagnosing self-harm, a mental health provider will typically schedule an initial assessment. This usually involves a conversational interview to discuss how long the self-injury has been occurring and the types of methods used. The interview may also include a family history review to collect important background information such as self-harm behaviors in the family or the existence of mental health conditions.
Self-assessment tools may also be used to help develop insight and provide important information about potential coexisting mental health conditions.
A professional evaluation can also determine if the self-injury diagnosis coincides with mental health conditions such as:
While it’s normal to feel nervous about seeking help, a mental health professional can best assess the level of support needed for safety and recovery. Compassionate and empathetic care is an essential part of reducing the stigma associated with a self-injury diagnosis.
Treatment Options for Cutting and Self-Harm
There is a wide range of self-injury therapy options for self-harm treatment. Treatment for cutting and self-harm can include both individual and group therapy as well as coping and self-care strategies.
Therapy for cutting is available through traditional outpatient settings or through convenient virtual therapy and telehealth solutions.
Therapy for Cutting and Self-Harm
Mental health professionals at Mission Connection Healthcare personalize therapy options for cutting to best meet the needs of each individual client. Here are some commonly used therapies:
- Cognitive Behavioral Therapy (CBT) focuses on reshaping negative thoughts and behaviors and offers strategies for long-term change such as healthier coping skills and thinking patterns.
- Dialectical Behavior Therapy (DBT) helps empower clients to navigate life’s complexities with resilience by learning how to effectively handle overwhelming emotions, including mood regulation and improving relationships with others.
- Group Therapy is led by a licensed therapist who helps connect people experiencing similar challenges and incorporates therapies to support everyone’s mental health needs.
Outpatient Treatment for Cutting and Self-Harm
Outpatient treatment programs allow clients to remain at home while visiting a clinic for regular support. When it comes to these programs, there are two options:
- Intensive Outpatient Programs (IOP) provide therapy while allowing clients to return home daily, supporting their mental health while offering flexibility.
- Partial Hospitalization Programs (PHP) provide more intensive forms of support but don’t require that patients be hospitalized full-time.
Telehealth and Virtual Therapy for Cutting and Self-Harm
If increased flexibility is needed, telehealth for self-harm treatment allows clients to engage in self-injury therapy through talk therapies while they’re at home.
Telehealth for self-harm treatment gives clients access to licensed therapists through secure video meetings. This is ideal for those who need the convenience of home-based therapy.
Virtual therapy for self-harm can involve both one-on-one counseling as well as access to virtual support groups to connect with others who are also overcoming self-harm.
Coping Strategies for Managing Self-Harm Behaviors
While a compassionate therapist will help personalize self-injury coping strategies, there are self-harm alternatives that can be used immediately.
Some alternatives to self-harm include:
- Squeezing a stress ball to help release stress and tension.
- Journaling about difficult feelings in a notebook or diary.
- Drawing or doodling to distract from challenging emotions or situations.
- Going for a walk outdoors to remove oneself from a stressful experience.
It’s also important to reach out to friends, family, and other supportive people for encouragement when life feels overwhelming. This support network can include therapy group members and a mental health therapist.
Incorporating mindfulness strategies can also help when managing daily stressors. Some ways to integrate mindfulness include:
- Practicing Self-compassion. Think about supporting a close friend or family member who is going through similar difficulties. Then take that same kindness and care you would give to them and apply it to yourself. Tell yourself the same encouraging words you would say to another person in your situation.
- Being Aware of the Importance of Breathing. Remember to pause and take a deep breath during stressful situations. This can help ease anger, anxiety, and other emotional responses. Simply remembering to slow down and breathe can help the mind and body become more relaxed and calm.
When to Seek Professional Help for Cutting and Self-Harm
If you see the signs and symptoms of self-injury in yourself or a loved one, it’s time to seek help. Professional help is especially important if there is severe emotional distress or if the self-harm behaviors are escalating and worsening.
You can find self-injury help by reaching out to Mission Connection Healthcare’s support line and speaking with a caring, compassionate, and empathetic member of our team. We offer confidential support, advice, and information about our treatment center, resources, and services.
Remember that you’re not alone as you seek treatment to stop cutting and self-harm. Let us help you at Mission Connection Healthcare and receive the highest level of care and support as you or your loved one begins the journey to recovery.
Contact us today at 866-619-7530 for support that suits you.
References
International Society for the Study of Self-Injury. (2024, November). What are the impacts of self-injury? https://www.itriples.org/aboutnssi/what-are-the-impacts-of-self-injury
Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 565–568. https://journals.sagepub.com/doi/epdf/10.1177/070674371405901101
Lurigio, A. J., Nesi, D., & Meyers, S. M. (2023). Nonsuicidal self injury among young adults and adolescents: Historical, cultural and clinical understandings. Social Work in Mental Health, 22(1), 122–148. https://doi.org/10.1080/15332985.2023.2264434
Moutier, C. (2023, July). Nonsuicidal self-injury (NSSI). Merck Manual Professional Edition. https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi
Substance Abuse and Mental Health Services Administration. (2023, April 24). Self-Harm. https://www.samhsa.gov/mental-health/self-harm
Twenge, J. M. (2020). Increases in Depression, Self‐Harm, and Suicide Among U.S. Adolescents After 2012 and Links to Technology Use: Possible Mechanisms. Psychiatric Research and Clinical Practice, 2(1), 19–25. https://doi.org/10.1176/appi.prcp.20190015
