Why Do People Self-Harm? The 8+2 Reasons

Analyzing responses by 29,350 people who had a history of self-harm, researchers identified 8 major “themes” among the reasons people gave for self-harm, as well as two relatively neglected reasons.

Self-Harm Reasons: 8 Themes

The most widely researched reasons are managing distress and self-harm as a means of exerting interpersonal influence, followed by punishment and managing dissociation.

Less frequently described but nonetheless repeatedly endorsed are reasons to do with averting suicide, sensation-seeking, defining personal boundaries and expressing or coping with sexuality.

1. Managing distress/affect regulation. Typical reasons include “to get relief from a terrible state of mind,” “calming myself down,” “doing this relieved the emotional pain.”

2. Exerting interpersonal influence. Typical reasons include “to seek help from someone,” “to show how much you loved someone,” “letting others know the extent of my physical pain.”

3. Punishment. Typical reasons include “I wanted to punish myself,” “to punish myself for positive feelings.”

4. Dissociation. This included inducing a dissociative state in statements such as “I wanted to stop myself from feeling and be numb,” “produce a feeling of numbness when my feelings are too strong.”

5. Sensation-seeking. With reasons such as “to feel more alive,” “when I harm myself I am doing something to generate excitement or exhilaration.”

6. Averting suicide. With reasons such as “to stop myself from killing myself,” “it stopped me from killing myself.”

7. Maintaining or exploring boundaries. With reasons such as “to create a symbolic boundary between myself and others,”

8. Expressing and coping with sexuality. With reasons such as “to provide a sense of relief that feels much like sexual release.”

Two “Positive Reasons” for Self-Harm

Upon further analysis, researchers identified some “positive reasons” that can be grouped into two more themes – positive experience and defining the self, which do not readily fall under any of the 8 themes mentioned above.

Self-harm as a positive experience. Many responses include statements about the pleasurable feelings from self-harm, with statements such as “can be enjoyable or comforting,” “I like the blood, the blood itself, the appearance of the blood was a lot of the satisfaction.”

Self-harm as defining the self. Self-harm could be a way of demonstrating strength or toughness, for example in statements such as “I feel powerful that I am immune to being hurt by it [the cutting].”  A sense of self-validation was also evident – “You know, other people are afraid of doing that… They can’t imagine how or why you would do that, and … in an arrogant sense it puts me above them.”

Source:

Amanda J. Edmondson, Cathy A. Brennan and Allan O. House. 2016. “Non-suicidal reasons for self-harm: A systematic review of self-reported accounts.” In Journal of Affective Disorders, 191: 109-117.