Self-harm: key facts
1 in 10 of us self-harms by taking tablets, cutting,
burning, piercing or swallowing objects. It is more common in young
people, women, gay and bisexual people and in some sub-cultures.
Some people self-harm regularly - it can become almost an
What makes people self-harm?
It usually happens when you feel very distressed. This can be
caused by abuse, feeling depressed, feeling bad about yourself or
relationship problems. You may do it because you feel:
- not listened to
- out of control
You are more likely to self-harm if you were abused in
How does it make you feel?
Self-harming can help you to feel in control
and less tense. So, it can be a 'quick fix' for feeling bad.
What help is there?
- Talking: Talking can help you to feel less
alone, to see your problems more clearly and think about them
- Self-help groups: People with similar
problems can provide support and practical advice – and, believe it
or not, sharing your problems in a group does help.
- Help with relationships: Group
therapy can often help you to sort out difficulties in getting on
with other people.
- Talking Therapy: Problem-solving,
Cognitive Behavioural, Psychodynamic psychotherapy or Dialectical
Behaviour therapy are all types of therapy that can help.
What works best?
All these treatments help. Some evidence suggests that
problem-solving/Dialectical Behaviour therapy may be best.
What if I don't get help?
1 in 3 people who self-harm will do it again within a year.
People who self-harm are 50 times more likely to kill themselves.
The more time you self-harm, the greater the risk. Cutting can
cause scarring, numbness or paralysis.
How can I help myself ?
When you want to harm
yourself: See if you can ride out how you
feel without self-harming, the feelings will usually go after a few
hours. You can talk to someone, distract yourself by going out,
sing or listen to music, or do anything (harmless) that interests
you. Try to relax and focus your mind on something pleasant. Find
another way to express your feelings such as squeezing ice cubes
(make them with red juice to mimic blood if that helps), or draw
red lines on your skin. Give yourself some 'harmless pain' - eat a
hot chilli, or have a cold shower. Focus on positives. Be kind to
yourself – get a massage. Write a diary or a letter, to explain
what is happening to you – no one else needs to see it.
When the urge has gone: Think about
the times that you have self-harmed and what (if anything) has
helped. Go back in your mind to the last time when you did not want
to self-harm, and move forward in your memory from there. Where
were you, who were you with, and what you were feeling? Try to work
out why you began feeling like you did. Did your self-harm give you
a sense of escape, or relief, or control? Try to work out something
to do that might give you the same result, but that doesn't damage
you. Make a recording by talking about your good points and why you
don't want to self-harm. When you feel bad, play this back to
remind you of the parts of you that are worthwhile. Make a
'crisis plan' of what to do when you feel bad.
What can I do if I don't want to
If this is the case, try to reduce the damage you may cause
yourself. If you cut, use clean blades. Find ways of hurting
yourself that don't damage your body (see above).
If you can say YES to at least 3 of the
questions below, it's worth trying to stop.
- Are there at least two people who are willing to help me
- Do I have friends that I can go to if I get desperate?
- Have I found at least two safe ways that reduce the feelings
that make me self-harm?
- Can I really say to myself that I want to stop hurting
- Can I tell myself that I WILL tolerate feelings that make me
want to self harm?
- Is there a professional who will support me and help in a
If I harm myself and need treatment?
You have the right to be treated with courtesy and respect by
the doctors and nurses in the Accident and Emergency department.
Many departments have a psychiatric liaison nurse, or a social
worker, who can talk with you. You can ask to be treated by a male
or a female member of staff if you have a preference. Staff may
want to go through a questionnaire with you as a way of judging how
at risk you are.
What can I do if I know someone who
- Listen to them without being critical. This can be very hard if
you are upset or angry. Try to focus on them rather than your
feelings – this can be hard.
- Try to understand their feelings, and then move the
conversation to other things.
- Take the mystery out of self-harm by helping them find out
about self-harm on the internet or at the library.
- Help them to think about their self-harm not as a shameful
secret, but as a problem to be sorted out.
- If you are caring for someone who self-harms, and you would
like some emotional support, you can request this from your GP or
the mental health services if they are involved.
- Try to be their therapist – you have enough to deal with as
- Expect them to stop overnight – it's difficult and takes
- Get angry - this may make them feel worse. Talk calmly
about the effect it has on you - in a way that shows how much you
care for them.
- Struggle with them when they are about to self-harm – it's
better to walk away and to suggest they come and talk about it
rather than do it.
- Make them promise not to do it again or make your involvement
conditional on them stopping.
For more in-depth information see our main leaflet: Self-harm
This leaflet reflects the most up-to-date evidence at the time
Produced by the RCPsych Public Education Editorial Board.
Series Editor: Dr Philip Timms
Reviewed by Dr Amy Green
© January 2014. Due for review: January 2016. Royal College of
Psychiatrists. You can link to, download, print, photocopy and
distribute this leaflet free of charge. But you must not change it
or repost it on a website.
a catalogue of public education materials or copies of our leaflets
Department, The Royal College of Psychiatrists, 21
Prescot Street, London E1 8BB. Telephone: 020
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