Self-harm

Also known as self-injury

Self-harm is when you damage or injure your body on purpose. It is a way of coping with intense emotions or distress brought on by difficult situations. Although it usually provides immediate and short term relief, it has many downsides.

Key points

  1. Self-harm is not uncommon, especially in young people.
  2. If you self-harm you are not weak or crazy or attention seeking. It just means you are overwhelmed by how you are feeling right now and this is a way you have found to cope.
  3. Some people who self-harm are at risk of suicide but harming yourself doesn't necessarily mean you want to end your life.
  4. Self-harming can make you feel better in the short term but doesn’t usually help in the long term. This is because, while self-harm takes away the painful feelings, it means you don’t learn other, healthy strategies for dealing with them. You also don’t figure out solutions for the problems causing them in the first place. It can also cause scarring, which many people who self-harm dislike. Fortunately, there are other things you can do that will help you start to feel better both now and in the long term.
  5. If you are harming yourself, talk to someone you trust. It’s up to you to decide if you’re ready to stop and who you want to talk to. Remember though, it’s a lot easier on yourself if you can find someone you trust to talk things through with. A close whānau member, your doctor or your school counsellor can be good people to talk to.
  6. If you don’t want to talk to someone in person, you can call a helpline where you can remain completely anonymous, but can talk to someone who understands what you are going through:
  • Call or free text 1737
  • Call Lifeline on 0800 543 354
  • Call Youthline on 0800 376 633, or text 234
  • Call Samaritans on 0800 726 666

If you have seriously injured yourself, taken something poisonous or overdosed on medicine or drugs, call 111 and ask for an ambulance.
If you are trying to stop yourself from hurting yourself right now, you can get help from your local DHB’s mental health crisis assessment team. Find your local service by looking online at Get help in a crisis or free call or text 1737.

Why do people self-harm? 

There are many reasons why someone might self-harm. Most people self-harm as a way of coping with overwhelming emotions. These can include intense sadness, anxiety, anger and shame. Sometimes it’s just to feel something in response to feeling numbed out. These strong feelings or numbness can be triggered by a whole array of stressful life situations from work or study stress to having a fight with someone you love and everything in between. The main thing to remember is that the situation is difficult for the person experiencing it and it produces a strong emotional response.

What treatments are there for self-harm? 

In most cases talking therapy such as Dialectical Behavioural Therapy (DBT) is recommended for people who self-harm. Talking therapy involves attending sessions with a therapist to talk about your thoughts and feelings, and how these affect your behaviour and wellbeing. You also learn healthier ways of managing difficult thoughts and feelings, and how to cope better with distress. 

You can ask your GP to recommend someone or find a counsellor yourself. You can find a health practitioner who has a kaupapa Māori approach to wellbeing in this directory.

There are also online therapy modules listed below where you can learn different ways of managing difficult thoughts and emotions. 

If you have other health problems as well, such as significant anxiety or depression, your treatment plan may involve medicines to treat these. 

How can I look after myself if I am self-harming? 

Getting help for self-harm using the contacts above is really important, but it’s up to you to decide when you’re ready to stop self-harming and who you’d like to help you. In the meantime, here are some small things you can do:

  • Learn what your triggers are – what are the situations that are overwhelming you? It could be places, certain behaviours in other people, times of day, etc. Keep a journal to build up a picture over time. This will be helpful when you want to work with someone on stopping self-harm.
  • Staying connected to family, whānau and friends can help you feel better. If you are spending a lot of time with people who self-harm, find other people to be with and do things together that you enjoy.
  • Learn to recognise the warning signs of how you feel before you experience the urge to self-harm – physical sensations, such as a racing heart, shallow breathing, feeling ill, starting to feel as though you aren’t in your body or strong emotions like anger, or sadness or desperation. Make a note of these in your journal too.
  • Think about what sorts of things you can do to distract yourself if you feel the urge to self-harm. Try exercise, music, talking on a helpline, putting ice on your forehead, having a very cold drink, drawing or painting. No matter how strange it may be, if it works for you it’s important. The Calm Harm App has a list of distracting and comforting activities that you can use to ride out the wave of the urge to self-harm.
  • Learn slow breathing as this is a great tool to calm yourself when you are distressed. Try the Calm Harm Breathe Activity on the Calm Harm App.
  • Write a list of the things that work for you and keep it with you to remind yourself when you notice your warning signs. Some apps, eg, Virtual Hope Box, allow you to create your own reminders for different situations. 
  • Look after yourself – get enough sleep, eat regularly and get some exercise every day. Cut down on, or stop, taking alcohol and recreational drugs. Neglecting any of these simple things makes you much more vulnerable to overwhelming feelings and the urge to self-harm.
  • Find a support group ­– ask your doctor or counsellor if there is a support group near you for people who self-harm. Or try an online support group, eg, the self-harm group on the Mental Health Forum or togetherall. 
  • Don’t ignore any difficult feelings you have – have a plan for those times. Talk to a counsellor or learn skills for managing emotions on one of the websites listed in the online resources below.
  • It’s wise to keep taking any medication your doctor prescribed for you and keep attending all your appointments. If you have concerns about any medicines you are taking it is better to talk to your doctor before stopping them.

See also how to support someone who is self-harming.

What support is available for someone who is self-harming?

Helplines 

  • Need to talk? Free call or text 1737 any time for support from a trained counsellor
  • Lifeline 0800 543 354 (0800 LIFELINE)
  • Depression Helpline 0800 111 757
  • Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO) – for people in distress, and people who are worried about someone else
  • Samaritans 0800 726 666
  • Youthline 0800 376 633, free text 234 or email talk@youthline.co.nz
  • What's Up 0800 942 8787 – for 5 to 18-year-olds, phone counselling is available Monday to Sunday, 11am-11pm. Online chat is available Monday to Sunday 11am-10.30pm.
  • OUTLine NZ 0800 688 5463 (0800 OUTLINE) – provides confidential support for sexuality or gender identity issues

Online resources

  • Calm Harm app provides activities that help people manage the urge to self-harm in the moment.
  • Virtual Hope Box an app that contains simple tools to help people cope with strong, unpleasant emotions.
  • PTSD coach provides a range of useful tools for coping with strong emotions including anxiety caused by Post Traumatic Stress Disorder.
  • Togetherall free for Auckland DHB residents. A UK-based professionally facilitated, peer support community of people who are experiencing common mental health problems.
  • An online training module from the Australian Centre for Clinical Interventions to help you learn how to tolerate distress better. 
  • DBT self-help modules on managing a range of issues including self-soothing, building self-compassion and facing your feelings.

Learn more

Self-harm KidsHealth, NZ, 2018
Online NZ support to strengthen wellbeing Ignite , NZ
Small Steps Whether you’re looking to maintain wellbeing, find relief or get help, Small Steps can support you and your whānau with practical tools, strategies and advice.

References

  1. Self-harm NHS, UK, 2015
  2. The health and wellbeing of NZ secondary school students in 2012 The University of Auckland, NZ, 2013
  3. Self-harm Mental Health Foundation, NZ

Reviewed by

Kris Garstang is consulting clinical psychologist at Life Mind Psychology. She has practiced as a registered clinical psychologist for over twenty years and is a fellow of the New Zealand College of Clinical Psychologists. She has expertise in different evidence based psychological therapies including cognitive behavioural therapy, acceptance and commitment therapy and dialectical behaviour therapy. Areas of interest include primary mental health, e-therapies, mental health leadership and workplace wellbeing.
Credits: Health Navigator Editorial Team. Reviewed By: Kris Garstang, Clinical Psychologist, Life Mind Psychology Last reviewed: 05 May 2022