Understanding and treating “self-injury”

by Alison Li, L.I.S.W., therapist at the Des Moines Pastoral Counseling Center

Alison Li, L.I.S.W.

(June 2017) People cope with stress and emotional pain in many ways: exercise, alcohol, eating chocolate, meditation, using drugs, therapy, self-injury. All of these can be effective coping mechanisms in the short-term; not all, however, are effective in the long-term.

Self-injury, also called deliberate self-harm, is the act of intentionally hurting one’s body for purposes that are not socially recognized, and without suicidal intent. The most common form is cutting, although it can take many forms. It usually starts early in life, around adolescence. Studies have found that 12-24 percent of young adults have self-injured, and that around 6 – 8 percent chronically self-injure.

The reasons for self-injuring are diverse, but share a common theme of providing a release or relief for overwhelming negative emotion or emotional pressure. Sometimes, it is a way of feeling physical pain in the face of overwhelming emotional pain, or as a way to “feel something” when an individual feels emotionally numb. It can also be used as a means of coping with anxiety.

Self-injury is often misunderstood as suicidal behavior. In fact, individuals who self-injure are doing so in order to cope with overwhelming negative feelings, and most studies find that self-injury is often used as means of avoiding suicide. Self-injury is also often misunderstood by family and friends as a means of getting attention, or as “manipulative” behavior. While attention is often a result of an individual injuring themselves, this is usually an unintended outcome – most people who self-injure do so in private, make great attempts to hide their injuries, and often feel shame or guilt about the injurious behavior.

Effective treatment of chronic self-injury ideally involves working with a therapist to address not only the cutting or injurious behavior, but also the underlying triggers and causes. In addition, it can be very helpful for family members to participate in the therapy, in order to educate themselves about how to best support their loved one through the recovery process.

To learn more about self-injury, an excellent resource is the Cornell Research Program on Self-injury and Recovery. They provide information for individuals who self-injure, as well as family, friends, and youth serving professionals. They can be found online at http://www.selfinjury.bctr.cornell.edu.


Alison Li is one of 26 clinicians at the Des Moines Pastoral Counseling Center. One of her treatment specialties is self-injury. To make an appointment with her, or another counselor at the Center, call 515-270-4006. The Center’s mission is to bring hope, healing and understanding to people of all ages through mental health counseling, psychiatry and education. For more information please visit our website: www.dmpcc.org or find us on Facebook.


For more Health tips from the Center: www.dmpcc.org/healthtips