What is self-harm?

Non-suicidal self-injury involves deliberately causing physical harm to oneself without necessarily intending to end one's own life. It can appear as a response to emotions that the person experiences as unbearable, such as sadness, anger, guilt, shame, anxiety, emotional emptiness, or a sense of disconnection.

For some people, self-harm can provide temporary relief. However, this relief is often short-lived and can give way to feelings of guilt, fear, shame, or isolation. For this reason, it is important to address the behaviour with understanding and professional support, without minimising or judging it.

Self-harm does not define the person. It is a sign that they need resources, support, and a safe space to understand what is happening.

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There are many reasons why someone might self-harm. It is often a way of coping with intense emotional pain that feels overwhelming. Some common reasons include: * **To relieve emotional pain:** Self-harm can provide a temporary distraction or release from difficult emotions like sadness, anger, anxiety, or emptiness. The physical pain can sometimes feel more manageable than the emotional pain. * **To feel something:** For individuals who feel numb or disconnected, self-harm can be a way to feel alive or to feel *something*, even if it's pain. * **To punish oneself:** Some people self-harm as a form of self-punishment, believing they deserve to be hurt for something they've done or that they are "bad." * **To communicate distress:** When someone feels unable to express their feelings verbally, self-harm can be a way to show others how much they are suffering and to seek help. * **To feel in control:** In situations where someone feels powerless or overwhelmed by their circumstances, self-harm can be an attempt to regain a sense of control over their body and their pain. * **To distract oneself:** The act of self-harm can serve as a distraction from distressing thoughts or memories. * **Past trauma or abuse:** People who have experienced trauma, particularly childhood abuse, are at a higher risk of self-harming as a coping mechanism. It's important to remember that self-harm is not a suicide attempt, although people who self-harm are at a higher risk of suicide. It is a sign of significant emotional distress and a cry for help. If you or someone you know is self-harming, seeking professional help is crucial.

There is no single cause that explains self-harm. Each person has a different history, set of circumstances, and emotional needs. In many cases, self-harming behaviour functions as an attempt to regulate intense emotion when the person feels they have no other tools available.

Among the reasons that may be related to self-harm are:

• Difficulty managing intense emotions such as sadness, anger, fear, guilt, or shame.
• Emotional emptiness or disconnection from oneself.
• Need to relieve accumulated psychological tension.
• Traumatic experiences, losses, or situations of intense stress.
• Problems with self-esteem and excessive self-criticism.
• A feeling of not being enough, of not fitting in, or of not deserving affection.
• Family, social, school or work-related conflicts.
• Difficulties in interpersonal relationships.
• Social isolation or feeling lonely.
• Presence of anxiety, depression, trauma, eating disorders or other psychological difficulties.

It's important to avoid simplistic interpretations, such as thinking that a person self-harms solely to get attention. Even when the behaviour seeks to communicate suffering, that need to be seen and cared for must be taken seriously.

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Self-harm and teenagers

Self-harm can appear at any stage of life, but it is more common during adolescence and youth. This stage involves numerous physical, emotional, and social changes, and some people may feel overwhelmed by academic pressure, family conflicts, the need to belong to a group, or constant comparison on social media.

In adolescents, self-harming behaviour can be related to:

• Difficulties expressing emotions.
• Problems with self-esteem or body image.
• Bullying at school or social exclusion.
• Family conflicts.
• Bereavement, parental separation or major changes.
• Difficult emotional relationships.
• Pressure to fit in or live up to expectations.
• Exposure to harmful content on social media.
• Anxiety, depression or trauma issues.

Early intervention can make a significant difference. Parents, teachers, and those close to a child can help by creating a space for listening, avoiding punishment, and facilitating access to specialised psychological care.

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Warning signs of self-harm

Self-harm is not always visible. Many people try to hide it out of fear, shame or concern about how those around them might react. It is therefore important to be alert to any emotional, behavioural or physical changes that might indicate that someone is going through a difficult time.

Some warning signs can be:

• Frequent use of long clothing even when it's hot.
• Wounds, marks, scars, bruises or injuries that do not have a clear explanation.
• Sudden mood swings.
• Isolation from family, friends, or usual activities.
• Irritability, impulsivity, or very intense emotional reactions.
• Frequent comments about feeling useless, hopeless or lacking in self-worth.
• Difficulty tolerating frustration.
• Sleep problems or changes in appetite.
• Decrease in academic or work performance.
• Feelings of guilt, shame, or constant self-criticism.
• Risky behaviours or alcohol and other substance use.
• Expressions related to not wanting to live, disappear, or self-harm.

No single sign confirms self-harming behaviour. However, if several signs are present or if the distress persists over time, it is recommended to consult with a mental health professional.

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Self-harm and suicide risk: important differences

Self-harm does not always involve suicidal intent. Many people injure themselves to temporarily relieve intense emotion, regain a sense of control, or express pain they cannot verbalise.

Nevertheless, self-harm can increase the risk of suicidal thoughts or more serious behaviours, especially when depression, hopelessness, isolation, substance misuse or traumatic experiences are present. For this reason, any self-harming behaviour should be assessed with sensitivity and seriousness.

If someone expresses suicidal ideation, talks about suicide, has a plan to harm themselves, or is in immediate danger, it is necessary to contact emergency services or go to the A&E department. In Spain, the 024 suicide prevention helpline is also available.

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How to talk to someone who self-harms

Discovering that a child, partner, friend, or loved one is self-harming can cause fear, anger, sadness, or helplessness. However, the way you approach the conversation can influence whether the person accepts help.

Some helpful recommendations are:

• Speak from concern and affection.
• Listen without interrupting or judging.
• Avoid threats, punishments, shouting, or reproaches.
• Don’t play down the problem with comments such as “you’ll get over it” or “it’s not that big a deal”.
• Avoid demanding immediate explanations if the person cannot speak.
• Ask what they need and how you can help.
• You don't have to face the problem alone.
• Facilitate contact with a psychologist or psychiatrist.
• Keep calm, even if the situation turns out to be shocking.
• Seek professional support for the family as well, if necessary.

“I've noticed you're going through a difficult time. I don't want to judge you or force you to talk, but I care about you and want to help you find support.”.

You might want to read: Emotional management

What should you avoid doing when faced with self-harm?

While the concern is understandable, some reactions can increase a person's embarrassment or isolation.

It is best to avoid:

• To accuse or to blame.
• Ridicule the conduct.
• Threatening with punishment.
• Force the injuries to be displayed.
• Compare your suffering with that of other people.
• Discussing behaviour in front of other people without consent, unless there is a risk.
• To think that a person can stop it solely through willpower.
• Turning every conversation into an interrogation.
• Ignore comments relating to death or suicide.

The priority must be to create a sense of security, reduce isolation and facilitate access to professional support.

Psychological treatment for self-harm

The treatment of self-harm should be tailored to each person's needs. Psychological therapy allows for an understanding of the function of the behaviour, identification of emotional triggers, and the development of safer alternatives for coping with distress.

During the therapeutic process, we can focus on:

• Identify the emotions, thoughts and situations that precede self-harm.
• To improve emotional regulation.
• Learning strategies to tolerate discomfort.
• Reduce impulsivity.
• To boost self-esteem and self-compassion.
• Work through traumatic experiences when necessary.
• Improve communication and interpersonal relationships.
• Develop resources for asking for help.
• Preventing relapses and creating a safety plan.

Among the psychological approaches that can be useful are cognitive behavioural therapy, dialectical behavioural therapy, mindfulness-based therapies and, where there are traumatic experiences, specific interventions such as EMDR.

Discover: EMDR (Eye Movement Desensitisation and Reprocessing) is a psychotherapy technique.

In some cases, a psychiatric assessment may be necessary, especially if there is severe depression, serious anxiety, suicidal thoughts, or other symptoms that require medical attention.

Dialectical behaviour therapy and self-harm

Dialectical behaviour therapy is an approach particularly used when there are significant difficulties with emotional regulation, impulsivity, or recurrent self-harming behaviours.

This type of therapy helps to develop skills for:

• To tolerate intense emotions without acting impulsively.
• To identify and regulate difficult emotional states.
• Improve communication and relationships.
• Reduce harmful behaviours.
• To build a more stable life that is consistent with one's own values.

The aim is not solely to eliminate self-harming behaviour, but to understand the suffering behind it and to offer tools that enable the person to feel more secure with themselves.

Discover: Dialectical Behavioural Therapy

How to prevent self-harm?

There is no single formula for preventing self-harm, but there are factors that can protect mental health and reduce risk.

Some preventive measures include:

• Encourage open and respectful family communication.
• Teaching to identify and express emotions.
• Normalise requests for psychological help.
• To strengthen self-esteem and a sense of belonging.
• Promote safe social relationships.
• Establish clear and consistent boundaries at home.
• Pay attention to persistent changes in behaviour.
• Talking about social media and content that can normalise harm.
• Offer healthy conflict resolution models.
• Seek professional help if you experience signs of intense emotional distress.

Prevention isn't about controlling every one of a person's behaviours, but about creating environments where they can feel heard, valued and supported.

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Psychologist for self-harm in Fuengirola and Mijas

At CALMA Psicólogos, we offer psychological support for people who self-harm, teenagers, adults and families who need to understand and address this situation.

Therapy can help reduce emotional suffering, improve emotional regulation, and develop safer ways to cope with difficult times. We offer in-person sessions in Fuengirola and Mijas, as well as online therapy.

If you or someone close to you is going through a situation of self-harm, asking for help can be the first step towards regaining safety, well-being, and hope.

Discover the professional who will value your case: Samara Valenzuela

Psychologist for self-harm in Fuengirola and Mijas

At CALMA Psicólogos, we offer psychological support for people who self-harm, teenagers, adults and families who need to understand and address this situation.

Therapy can help reduce emotional suffering, improve emotional regulation, and develop safer ways to cope with difficult times. We offer in-person sessions in Fuengirola and Mijas, as well as online therapy.

If you or someone close to you is going through a situation of self-harm, asking for help can be the first step towards regaining safety, well-being, and hope.

Discover the professional who will value your case: Samara Valenzuela

Frequently asked questions about self-harm