Self-injury: What is it? Why do people do it? How do you stop?

Cutting. Burning. Hitting yourself. Pulling your hair out. Approximately 2 million people in the U.S. engage in self-harm, and sometimes, they wind up dead.

While many people think the behavior is limited to adolescent girls, it happens with both genders, and it can happen at any age. Celebrities who have admitted to self-harm include Fiona Apple, Colin Farrell, and Johnny Depp.

Some people think Jack Dale Collins, who was recently killed by Portland Police, was engaging in self-harm by cutting his throat. Others think he was attempting suicide. But self-injury can lead to death even when the person does not intend it.

Why do people self-harm?

Portland therapist Casadi Marino, LCSW, CADC III, says that people may cut or harm themselves for a variety of reasons. “In general,” she says, “self-injury is a means of managing overwhelming emotions.” For some people, dealing with trauma, loss, and insecurity can lead to feelings of wanting to self-injure.

According to Marino, “Self-injury can distract from emotional pain, can help someone feel something if he or she is numb or dissociated, can ground individuals in strong sensation, can indicate self-hatred or a belief that the self should be punished, and can express strong feelings and marked needs through action and physical signs of distress.”

Sense of relief

Marino explains that self-injury may release certain brain chemicals (serotonin, dopamine, and endorphins) that are involved in mood regulation and addiction; and because of the quick, intense – and temporary – sense of relief that can follow, self-harm can become an addiction. agrees: “Self-injury is a behavior that over time becomes compulsive and addictive. Like any other addiction, even though other people think the person should stop, most addicts have a hard time just saying no to their behavior – even when they realize it is unhealthy.”

As Marino points out, self-injury is not necessarily an indication of suicidality. However, depression can deepen, leading to a suicide attempt, and sometimes self-injury goes too far, resulting in accidental death.

How to cope with the urge

If you’re dealing with an urge to hurt yourself, Marino suggests trying strategies of distracting, grounding, soothing, and communicating. These may not provide the instant relief that cutting can, but, says Marino, “over time they become strong and effective means of managing strong emotion.”

If you feel like you need to self-harm, Marino suggests the following techniques:

  • Distract: Try computer or video games, puzzles, crafts, exercise, anything that draws your attention and is not destructive.
  • Soothe: Listen to music, take a bath, burn incense, etc.
  • Ground: Choose an object and describe everything about it, hold ice in your hand and notice the strong sensation, simply focus on your breath and/or body sensations.
  • Express: Find a supportive person to talk to, draw on yourself with a red marker, draw about the feelings and urges, write in a journal.

Getting help

It may be hard to open up to someone else and admit that you sometimes self-harm, because there is so much secrecy and shame. Help is available, but you need someone who will give you care in a respectful way. It is important, says Marino, to find someone who helps you feel accepted and safe.

One option is Dialectical Behavior Therapy (DBT), which was developed by Marsha Linehan, Ph.D. Marino says this treatment can help you learn strategies for emotional regulation (so your moods aren’t all over the place) and distress tolerance (so that, when problems occur, you don’t feel crushed or devastated). Another possibility is Seeking Safety, developed by Lisa Najavits, Ph.D. Seeking Safety, says Marino, can be especially helpful for those with trauma histories and substance use issues.


You’re not alone.
Self-harming does not mean you’re a bad person.
There is help. It can be hard to ask, but it really is worth it.

For further information:

Self-Injury: You are NOT the only one

Self-Injury Homepage at

American Self-Harm Information Clearinghouse

Portland Dialectical Therapy Program, P.C.
5200 SW Macadam Avenue, Suite 580 • Portland, Oregon 97239
Referral Line: 503-290-3291

Seeking Safety providers in Oregon