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The Basics of Self-Injurious Behavior

Updated on April 4, 2009

Self-Injurious Behavior, also known as Self-Mutilation (or more commonly Cutting), describes behaviors in which an individual causes physical harm to their own body. While making small cuts on one’s arms or legs is the more common example of this behavior, self-injury can also include head-banging, punching walls, burning one’s self, scratching one’s self and even punching one’s self in the head and face.

Self-Injurious behavior is directly related to emotional disturbances and is often a symptom of a deeper mental health issue. This can be associated with mood disorders and certain personality disorders (according to the DSM.)


Self-Injury is often mistaken for suicidal behavior, as minor cuts to the arms and wrists can physically resemble a suicide attempt. While ‘cutting’ and ‘burning’ can and will lead to scarring and permanent skin damage, these behaviors are not normally designed to inflict mortal or fatal harm to the body.

However, Suicidal Ideation can often co-exist alongside Self-Injurious behaviors in a person, and Self-Injurious behaviors can accidentally lead to more immediate danger if one ‘goes too far.’ Still, it is important to recognize the difference between suicide and self-mutilation.


There are four primary reasons why individuals habitually harm themselves in a non-suicidal manner:

1. The physical pain caused by self-injury distracts from more volatile emotional distress and emotional pain. It is used as a distraction.

2. The physical pain allows somebody to feel something, anything – in other words, to reduce dissociation, disconnectedness and emotional numbness. It is used as the opposite of an anesthetic.

3. The physical pain releases “endorphins” into the body. This is a less common reason but can be verbalized as a rationalization by cutters.

4. Peer pressure associated with certain subcultures and fads (some ‘goth’ and ‘emo’ cliques.)


Females tend to be Self-Injurers more than males, and teenagers and young adults tend to Self-Injure the most.

Almost all Self-Injurers have a history of physical, sexual, or emotional abuse. It is often these traumatic events that generate the extreme emotional pressure that becomes too much for a person to face or confront. Continued drug use or depression can lead to a flat affect or ongoing feelings of dissociation. Low self-esteem is also prevalent in populations of Self-Injurers.

One client I worked with was ‘triggered’ into wanting to hurt herself when she encountered men that reminded her of an extremely abusive ex-husband, or even when she became very frustrated. This was coupled with a history of sexual abuse and very low self-esteem.


Self-Injurers often hide their injuries from loved ones. They may wear long pants and tops with long sleeves to conceal scratches and cut marks. Most Self-Injurers harm themselves when they are alone and away from the watchful eyes of others.

A ‘hoarder’ is somebody who actively scavenges for sharp objects in which to use to cut themselves at a later time. This includes knives, scissors, shards of glass, and other objects. I personally worked with a cutter who smashed a light bulb in order to cut, and she would try to keep her fingernails long for scratching purposes.


Treatment for Self-Injurers takes place on a variety of levels.

First, the deeper roots of emotional distress need to be confronted. This is often done through psychotherapy in a safe environment, or through the teaching of specific DBT (Dialectical Behavioral Therapy) skills. Many areas have rape crisis hotlines that can provide immediate counsel to persons with a history of sexual abuse or trauma.

If one is struggling with the urge to Self-Mutilate, it makes sense for a trusted friend or family member to remove sharp objects and other potentially dangerous materials from their living space.

Another level of treatment involves either Avoidance or Replacement behaviors. A person can be encouraged to engage in something else, such as calling a loved one, writing in a journal, or taking a walk when the urge to Self-Harm appears. Physical exercise certainly can lead to a release of endorphins that far exceeds that which is caused by making superficial cuts on one’s skin. A replacement behavior may include wearing a rubber band or elastic hair-tie around one’s wrist and snapping it to cause a brief jolt of physical pain that does not cause any physical damage to one’s body.

Finally, certain antidepressants such as Prozac can numb the emotional distress one may feel and create a feeling of euphoria.

A Cutter's Wrist


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    • profile image

      Robin 2 years ago

      Cutting, or scratching as that picture shows is not just for the young, I was 45 before I began to 'scratch' (pressing knives into my arms just enough to draw blood). I am diagnosed with a mood disorder with PTSD related symptoms.

      Why do I do it. It does take my emotional pain away, but it is also a HOPE that someone will see and understand the pain I go through. WHen people DO notice and say something it's aas though I feel relief.

      I experience the urge to do this during more stressful times of years, especially around Christmas which causes anxiety and depression.

      I've been unable to develope any coping mechanisms. It IS my coping mechanism.

    • profile image

      austin 3 years ago

      i have cut many times but yall people don't understand what life gots to offer i quit cuting for my family cause i don't want to have scars on wrist and my kid asks me daddy what did u do to have your wrist like that i couldn't lie to my kids and tell them i done it becaue i was depressed then they would ask y and say daddy please don't leave us so yea whoever in this group that cutes needs to stop

    • profile image

      Gabby 4 years ago

      "Self harmers have almost always had a history of emotional, physical, or mental abuse." Bullshit. I cut because it takes away the pain of reality and I've suffered no past abusement.

    • profile image

      Rachel 5 years ago

      I am visiting this page due to a human services project. I understand the majority of cutting is not for attention, that is ridiculous. People who cut tend to have a lot to deal with, they are anxious or stressed out. If I may make a suggestion, to compartmentalize your stress. I have never cut before, but I have scratched myself. It does feel good. Sometimes our brains are just on hyperdrive and that feeling of pain or pleasure, distracts your brain momentarily. I found that by using a calendar to organize my life, or writing down all my stress in a notebook helped me determine what took precedence. You can rank your tasks so you know what to do first. I still scratch sometimes, but it is not a habit. Does anyone think that these methods would help while you seek help from another source, therapy, confiding in a friend, writing a journal, talking to a counselor, etc.?

    • profile image

      glitterwhore 5 years ago

      My self harm is not good enough till i see the fat in my wrists/arms where ever. I feel like i have failed if its not deep enough. Its not for attention, ive been doing it for over 10 years now, its an addiction, its a release, its control over your life when everything is going to hell, it numbs the pain and makes you feel alive when you don't feel real anymore. Its not a fad, its a viscous circle that you will never leave.

    • profile image

      XxxJoannxxX 6 years ago

      First of all, people should stop being inmature on the subject.

      I for one, will openly admit that I have been physically harming myself since I was a young child.

      I used to bang my head against walls, rip my hair out, and bite at my skin until I began to bleed.

      Now I cut my wrists, ankles, and stomach. I have attempted suicide, and ended up in a behavioral health hospital... But did it help? FUCK NO!!

      Now I resort to punching myself in the face, as well as cutting.

      None of that SHIT has ever helped.

      Yeah, you know how people say "make it count" or "do it right the first time" ?? Well how about you try to kill yourself. It isn't very FUCKING easy when you actually WANT to be 6 feet under!!!!

    • profile image

      FemaleReader 6 years ago

      I read all the comments here. I have to agree the most with the comment directly above me (“me”) posted 4/25/12. Everyone with a self-harming issue has fallen into this for their very own very personal reasons. Be it trauma, abuse, etc.….How is it, a group of people so judgmental exist here? “Don’t judge us” you all say, but so many of you have judged the comments made before you. I thought feeds on this subject were so you could feel like you were not alone in this and possibly read some helpful information regarding the subject. Instead you have created a stressful environment and even I felt a little ashamed about myself reading the comments here. I have been a cutter for about 15 years now and have learned many thing to keep my mind away from it, even though I identify with the “cuts=relief”, I also know and fully understand that cutting is not a healthy way to deal with issues. I hope those who have just started on this adventure will find someone they trust and tell them what’s wrong in your life. Getting stuff out of your head often helps a lot. I find keeping regular activity’s going helps to keep me in a positive state of mind and keep the needles and blade away. The demons will go away you have to MAKE THEM LEAVE. I’m NOT A DOCTOR, I have only written based on my own life, and will appreciate only positive commentary…. Negative Nancy’s and Nolan’s stay home.

    • profile image

      Me 6 years ago

      I think it it Very immature for a group of people who all cut, to judge others on there style of cutting. just except the fact that everyone has to deal with life. not everyone will know our pain, weather we were abused or not, but why argue over who has it worse, pain is pain, love is matter the measure, we are all human, and we deserve to be heard, and not told that a certain style of cutting is wrong, it is what it is, all we can do is learn to love ourselves rather than be hateful to others because of our own pain. i may still cut when i am 50, but i refuse to let the people in my past control my future, and i refuse to let people tell me who and what i am.

    • profile image

      ally 6 years ago

      I don't cut. Whoever said it was for attention up there ^ Is probablly wrong. If the person is doing it for attention, they are getting negative attention. The people who hurt themselves are letting their emotions out. People express them differently than others. I punch walls sometimes, but not as hard because if I do, I need to have surgery on my right hand all the way to my elbow. People who hurt themselves need help. I am a very happy person though, if I hit something, something is obviously wrong. If I were a cutter, I'd want to hide them too. I've dated people who have cut, someone I loved and I knew about it. Everytime that person would cut, I'd want to break down into tears or hit something. But I write poems and do art and sports, That helps ALOT when it comes to physical and emotional problems!

    • profile image

      Mattie 6 years ago

      Wow... this is stupid... this makes me feel like im a psycho or something thanks...

    • profile image

      Andrea 6 years ago

      I started scratching myself in July, and at first it was enough. A couple of months ago the cutting started. I don't understand why I do or why I started, I just felt really empty all the time and eventually it got to the point of near suicide. I'm on Honour roll and part of student council so I did a good job of hiding it. People didn't suspect it coming from me.

      It's strange, after you start. The cuts don't hurt. I mean, you feel "pain" but not in a traditional sense. It makes you feel better. For that little moment as you watch that little bit of blood start seeping out, there's a relief. I know there's something wrong with me for saying it, but right now it's the only thing I have for me.

      I'm getting "help" right now, but they don't know that I'm still doing it. It is nice to have someone know though, that you have a problem. It lessens the urge to cut, but it won't stop it completely. I guess my advice, do tell someone. Who knows, it might not help you at all depending on the circumstance, but you don't know until you try.

    • profile image

      deepestcut23 6 years ago

      i started cutting when i met a guy who goes through hell everyday. he told me his life story of getting beat and yelled at ever since he was born. i started cutting bc when we started dating everyone was telling me all he was going to do was hurt me and make my life horrible. i didn't belevie them and as the months went on i kept getting more bullshit so much that i couldn't take it any more and so i started cutting. after that my life went down hill. my brother dissowned me and my parents started to fight constentantly then my boyfriend life me and started rumors about me. i came close to sueisied but then though my life isn't bad enough to end it so i started cutting worse. and all the people who say we do it for attention its not true we do it because we don't have anyone to turn to that we can tell. it keeps our mind off the pain of our life and puts it on the pain of our rist. so stop judging till you yourself has been in our shoes! thanks from deepestcut23

    • profile image

      unknown person :D 6 years ago

      I understand cuting is wrong but it is a way to make some pain go away.

      i have done it, it makes me feel better about stuff.

      But i only do it when i am in pain and im crying my self asleep ever night.

    • profile image

      Randomperson 6 years ago

      Cutter and I do it cause it helps numb the emotions. Emotionally stressed cause I have "tiger parents" and I don't do it for attention, I do it to relieve shit. Try living with those kinds of parents... I've noticed that the most happiest people in the world tend have the darkest history....

    • profile image

      damnmaggots 6 years ago

      I am a cutter and my teacher was talking about cutting in class the other day. I wanted to rip her head off so bad. She does not understand what a relief it is to cut and either does this "blog". I like to cut! I cut everyday! People call me emo and I tell the truth! My mom found four razor blades with a minimum amount of dry blood on it. She checked my wrists and found slits on my wrists and my arms. She refuses to let me have scissors, blades, knives, etc. but I have a secret stash hidden in a lock box. She checks my history on my mac and finds out my wallpaper--which is a razor blade. I tell her I forgot to change my wallpaper, but I do delete my history and delete all my cookies. I do not do it (cut) for attention. I cut to let my feelings out. Strange? NO! My life is in my control and whoever says I am crazy, fuck you. Live your own life.

    • profile image

      Papaya 6 years ago

      Strange...the picture shown is more along the lines of a scratcher and not a cutter. If it really was a cutter, then the cuts should have been spaced out and vertical, the right way to cut one's self. I hate it when some amateur comes along and cuts their wrist Demi Lovato. She's a poser with her sliced wrist because she cut it the wrong way. The correct way is up and down, not side to side...get it right morons! Well, as for my opinion on why people cut, I started cutting when my parents announced their divorce. They fought all the time and started to ignore me and my siblings. I met a girl, one day, and found out she cut her wrists, legs and stomach because her nerves were shot. She told me she just wanted to feel something. (having your nerves shot means you can't feel anything anymore) Don't get me wrong, at first, I was freaked out, but then I got curious. The rest is just obvious; I ended up becoming addicted to cutting. It helped me dull the stress of being ignored. It helped me go numb. No, I didn't want attention, so I bought several wrist guards and established them as my style at school. I use a letter opener to cut myself. Oh, and don't use the term 'Self-mutilation' makes us sound like we want to hurt our selves and if you for one second think that we actually want to do that, then you're sadly mistaken because that's bullshit. Well, bye and get your facts right...change the picture.

    • Jimmy Evola profile image

      Jimmy Evola 6 years ago from Australia

      Interesting hub, keep up the writing

    • profile image

      .. 6 years ago

      That picture looks like someone who has cut themselves with scissors, but is probs around their first time of doing it. I would know, the first time i cut, i did that, and that's what it looked like. But I'm not a scratcher so, i cant say what that looks like, but i know what cutting looks like. and the only way i would beleive this article, is if the author, has been through this themselves.

    • profile image

      Kirsten 7 years ago

      Don't cut. Trust me once u start u can't stop and ya i hate everyone who says o she does it for attension and stuff. Its bullshit. THey say taht cuz they have nothing better to do. Why can't they just shut up.

    • profile image

      AprilViktoria 7 years ago

      I really doubt that's a cutter's wrist, more like a stratchers wrist .. I admit yeah, i've cut before, for many reasons. Some people think I do it for attention but I really don't. They just don't understand the things that are going on in my life. The people who do it for attention are sick. Why can't people just leave us alone...Cutting is the only way I can distract myself from the pain that is going on in my life. It makes me feel human, makes me forget about everything that's going on...I'm not mental, i'm not a physco i'm just someone who doesn't know how to deal with everything, so i cut to forget all the pain. If people don't understand that then why do they bother taking the mik out of us.

      This page is aload of bullshit!! They think they know everything but they really don't. They wont know what it's like until that's the only thing they can do to help them with the pain in their lives.

    • profile image

      Freudulant 7 years ago

      Cutting / self-injury / self-mutilation is obviously done by different people for different reasons. No two people are the same, although there are unfortunately many similar horror stories that people have lived through in this world. One common connection is the correlation between 'cutting' or another form of self-injury and unhappy life situations.

      It is perceived by general society and mental health professionals that self-injury is a maladaptive behavior. It is certainly not a 'physically' healthy behavior, as far as the human body is concerned. Whatever the emotional or mental benefits of self-injury or the emotional toll, I think we can all agree that at least on the physiological level, it is a negative.

    • profile image

      lizzie 7 years ago

      I self harm. I sometimes hate the fact i do it, it's embarrassing and scary. When I cut myself I go out of control and into a kind of daze. I come out of it thinking 'what the hell have I just done' but why do I feel such relief when I do it? I don't want to go to a counsellor, I'm not crazy, I'm just a normal girl, I'm not a poser or an 'emo' I'm just a girl who has a big secret, and i hate making a big fuss about myself.

      I'm not anyone to judge but we all have different minds, we all deal with things in our own ways. I think it's a bit stupid when people ridicule and judge eachother about 'how they cut' or why they do it or what their scars turn out like. Who says there's a right way to self harm? Everybody has their own story, just as we all have a unique fingerprint.

    • profile image

      Katie 7 years ago

      Coming from a cutter. i Realized it was never for attention, my reasons. are of these. Like them or not, i don't care either way but its the truth. Having the power to control one thing in my life was all i had, something i could control, the depth, the width, the whole Rush of it was in my hands, no one can fully understand it. The sad truth is, that so many kids today are doing it for attention, pulling away from the kids that really do need it. I look at that picture and laugh, thats not even a scracthers wrist, but a poser. Look at real scars, and you can see, the jagged torn into scars.

      Im not ashamed of mine at all. But time to time i do look back and think to myself, how did i let myself fall to this leval? but the truth is, it was all i known.

      I had no one to say WAKE THE FUC* up kid, this isn't right.I wouldn't have changed a thing, because i can help people and actually be able to say i understand, one thing i hated most was someone who had no idea, actiling like they did..

    • profile image

      Michaela 7 years ago

      I'm a cutter, and you don't have to be emo or goth to cut. Hell, I bet half my friends cut, but they just don't want to say anything. It's not FOR attention. Thank you bullshit article for wasting my time. And the post above is right, that's a scratchers wrist.

    • profile image

      jill 7 years ago

      just so ya know that goth emo part is crap...

    • profile image

      Not named 7 years ago

      I wrote a journal. My parents found it. Therapy time for me! Whop di hoo.

    • profile image

      soccerbabe78512 7 years ago

      omgosh. yes i am a cutter. it is such a relief to cut. i have a totally suckish life. yes i want to die but i wont hurt those around me so im not going to commit suicide. i HIDE the cutts. believe it or not i am afraid of hurt but i will sit there for hours cutting away with a stinkin pen if its all i have to give me the relief i need

    • profile image

      7 years ago

      Wow. Some of the things people have written on here really make me laugh. Whoever said something about wanting it for attention, fuck you. It's not funny at all. All of you who think it's bad, it's horrible to do it, who are you to judge it? It's our lives, why do you even care about it? Live your own life. Or, maybe, try going through what we have and then tell us to stop.

    • profile image

      XoXihateyou.1547 8 years ago

      I started cutting like maybe 3 weeks ago...because I've had a lot of ruff tmes. And I still do but I lov cutting . it takes all of the pain away from me and me and my bestfrend both do this but ya we do keeep it a secret from some people but for some it's obious but I don't do this for attention at all. that's just stupid because well if ur willing to go thru this all for attention then your a retard and trust me ur not getting the attention u want.

    • Disturbia profile image

      Disturbia 8 years ago

      I'm a cutter and I have had years of therapy for that as well as other issues which I won't go into here. I must say that some of the comments on this hub are so over the top that I wounder if they are for real. The hub was certainly factual, if somewhat dry and clinical. What I found unusual is that the hub writer did not respond to a single comment. Why write a hub on such an emotional subject, if you're just going to drop of the planet?

    • profile image

      jace 8 years ago

      why for emotion? i do it for the pain makes me ffeel like im human, pain is the only thing i ever feel anymore

    • profile image

      Clockman 8 years ago

      Not everyone cuts themselves because they have issues mentally or hate themselves. I know this as a fact because I know that one of my best friends and I have done it for the attention, and another friend did it spontaneously.

    • gramon1 profile image

      Guillermo Ramon 8 years ago from Miami

      In my experience treating SIB's, I don't think that self injurious behaviors (SIB) even relate to pain in the physical way. People who produce these behaviors tend to have rage inside. The rage is bigger than any pain. The SIB is a futile attempt to extinguish the rage. The SIB does mitigate the rage in the same way a cigarrette mitigates the need for nicotine.

      SIB's tend to be triggered by things that get the person angry. If the anger arousing situation relates closely to the initial situation(s) that generated the anger, then the bouts of self injury will peack fast and be triggered often afterwards.

      People do not caress the blade to commit the SIB. The caressing of the blade is a means to punish the people who are shocked by the behavior. SIB's have nothing to do with suicide - absolutely nothing.

      Initial SIB's tend to be mild. Then, there is a process called desensitation. During this process, the person learns to cope with the pain the SIB produces. In many cases, the pain blends with pleasure. Therefore, the person really ends up enjoying it. At that level, the frequency and duration of SIB's may last longer than the recuperation periods. SIB's are seldom produced as cuts in proportion to other SIBs. In my experience, head banging, hair pulling, self-biting, and scratching are much more common.

      Not every body could develop SIB's. Norrmally people with this problem tend to have unique sensory systems. They grow up in a world in which adults teach them about sensory experiences as felt by the majority of people. But the SIB child experiences things somewhat differently. Their resistance to stimulus stimulation is unique. In some areas, they can not cope with as intense stimuli as most people, while in some other areas, they may cope much better.

      Treatment should always be based on an analysis of the person being treated. I look for the roots, coping skills, and cognitive and environmental factors that trigger the SIB's.

    • profile image

      tckgentleman 8 years ago

      Do you really want to know what it feels like? To be able to caress that blade, then softly sink it into your skin? Do you fucking know what a relief it is? Go to hell. You guys know shit. I'm not saying that it's a smart way to deal with pain, but it IS a way. Just not the best.

    • profile image

      Jessi 8 years ago

      ^ u r so rite. i dnt rly think that they want to die..well some do but think. when they cut its to releive some pain and help stop thinking about emotion. but when u cut it just makes u more sad n suicidal cause u feel like ur letting someone down with each cut. trust me i no.

    • profile image

      AngryGod-damnedMAN 8 years ago

      This page 'The Basics of Self-Injurious Behavior' is just a Bullshit opinion page. Lets state facts shall we...

      #1 Diagnosis should be left to a real expert in this area... not to some pill popping and dealing motherfucker who thinks they know everything

      #2 People such as myself who have cut and not just that, but ripped hair out, bitten chunks of skin out of their arms, among other things, hate the term SELF-MUTILATION for the simple fact it makes us sound as if we are trying to destroy ourselves... when really it's the opposite... we are trying to save ourselves from destruction

      #3 People like us are no worse and in fact are using better techniques than the people that drown their problems in alchohol and taking drugs in any form (legal or not). Why I say this is they cover their feelings and the way they deal with them destoys them in every way. As for us the only bad thing about what we do is it leaves a physical scar. Big fucking deal

      Thankyou Bias pieces of shit....

    • profile image

      marlajane 8 years ago

      I'm sorry to hear that both of you^ feel the way you do. I know that cutting sucks, but some things do help, and I don't know anybody who does it for attention. That's bullshit. People who think cutters just do it for attention are flat out wrong. The only attention they want is for somebody to help them. They tell you that people do it for attention because they don't like to admit the fact of the matter. YOU'RE a pansy for hiding behind a lie!

    • profile image

      cleetushyne 8 years ago

      You know what, if anyone who cuts their wrist for attention should just die. Do it the old fashion way and shoot yourself, pansies! If you don't succeed at killing yourself by cutting your wrist, then you have no reason to be in this world, just face it you'll fail at everything else if you cant doi the simple task of killing yourself.

    • profile image

      ano 8 years ago

      You guys wont be able to understand why someone cuts until you have to resort to it!! So don't sit here and act like you know why, how, and who cuts!! You don't know anything!!!! Therapy doesn't work and niether does sending us to a psychward!!! It just makes us want to cut more!!! And in that picture that's not a cutters wrist that's a scratchers wrist!!! There's a difference!


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