Digital Self Harm: What it is and How to Help

Many teens and parents are familiar with physical self harm behaviors like cutting, head banging, hitting, or burning oneself. Far fewer may know about the related, though distinct, digital form of self harm. 

The concept of digital self harm first appeared in medical literature in a 2012 report from Bridgewater State University researcher Elizabeth Englander. A year later, it entered public awareness when a 14-year-old died by suicide after sending hurtful messages to herself. A few years later, a 15-year-old also died by suicide after similar circumstances.

How did physical self harm cross over into the digital realm? While digital self harm is a fairly new phenomenon, here’s what we know about it so far.

What is digital self harm?

The definition of “digital self harm” varies across studies, but researchers have defined it as “anonymous online posting, sending, or otherwise sharing of hurtful content about oneself.” 

The term digital self harm encompasses the act of sending oneself hurtful content through:

• Text
• Email
• Social media
• Gaming consoles
• Web forums
• Any other virtual platforms

Digital self harm might look like someone creating a fake account to post mean comments on their own Instagram photos, send insulting tweets, or emailing cruel messages to themselves.

Other research has described the phenomenon using the terms “fictitious online victimization,” “digital Munchausen,” “self-cyberbullying,” and “self-trolling”. 

(Digital Munchausen refers to an online version of Munchausen Syndrome—a disorder in which a person attempts to gain attention and sympathy by pretending to be physically ill.)

Why is digital self harm considered “fictitious”?

In simple terms, the “fictitious” in “fictitious online victimization” reflects the theory that digital self harm is made-up. “Digital Munchausen,” another term used to describe digital self harm, also suggests that someone who is digitally self harming is only pretending to do so. But is digital self harm fake or made-up? Not exactly. 

The idea that digital self harm isn’t “real” stems from the fact that it’s often self-created and/or anonymous. While this may seem counterintuitive, people (especially teens and young adults) often digitally self harm to alleviate uncomfortable feelings or emotional pain. Instead of undermining the idea of digital self harm, self-creation and anonymity are actually definitive characteristics of digital self harm.

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For example, a 2022 review of the existing literature on digital self harm highlighted a study in which people recovering from eating disorders purposely viewed or created online content about restriction and other forms of disordered eating to continue to encourage them to harm themselves. In some studies, the umbrella category of digital self harm also encompasses this behavior.

Is digital self harm the same thing as cyberbullying?

No, digital self harm is unique from cyberbullying. While cyberbullying can be defined as repeated, intentional person-to-person harm via technology, with digital self harm, the sender and receiver of the hateful messages are the same individual. Digital self harm messages typically come from an anonymous or pseudonymous account rather than one that’s known to be attached to the receiver.

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How common is digital self harm among teens and young adults?

According to one 2017 study that analyzed a data sample representative of Americans ages 12-17, around 6% of the population had engaged in anonymous digital self harm. The rate was higher among those assigned male at birth. 

Let’s put this stat into perspective: The percentage of youth who have reported engaging in digital self harm (6%) is higher than the approximate percentage of youth who have been diagnosed with depression (4.4%).

What are the possible risks of digital self harm?

Researchers are still studying the adverse outcomes that are directly related to digital self harm. They have identified relationships (though nothing directly causal) between digital self harm and other detrimental behaviors such as:

Physical self harm

Digital self harm is distinct from physical self harm, but both behaviors can (and often do) occur together. People who have a history of self harm are significantly more likely to digitally self harm.

Suicidality

Over the past decade, we’ve seen a sharp rise in suicidal ideation and attempts among teens. As experts in digital self harm have discovered, the behavior is positively correlated with suicidality. 

A 2022 survey was conducted by researchers to understand the relationship between digital self harm and risk of suicidal thoughts and attempts. The researchers concluded that digital self harm was associated with a 5-7x increase in the likelihood of suicidal thoughts—and a 9-15x increase in the likelihood of suicide attempt.

Researchers agree that more comprehensive investigations are needed into the prevalence, origins, and consequences of digital self harm. 

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What other signs and behaviors have been associated with digital self harm?

Because digital self harm typically happens anonymously, there aren’t necessarily visible signs that a parent or other loved one can look out for in their teen. However, the behavior is often an indicator of underlying mental health challenges that are more likely to be observable from the outside.

In addition to increased rates of physical self harm and suicidality, digital self harm has been associated with the following experiences and challenges:

• Bullying (at school or online)
• Depressive symptoms
• Negative emotions
• Substance use
• Stealing
• Violence
• Low self-esteem
• Decreased satisfaction with life

Like the connections between digital self harm, physical self harm, and suicidal ideation, these behaviors are not necessarily the direct cause or effect of digital self harm. Some behaviors, for example, share common intermediary factors (such as negative emotions).

Why might teens or young adults digitally self harm?

Since digital self harm is a somewhat new concept, there isn’t a very clear understanding of exactly why a young person may do it. However, researchers have hypothesized a few motivating factors:

• Social development
  Those who digitally self harm may be doing so to see if their friends are their “real” friends, to prove that they’re tough and can deal with online hate, or to start a fight with another person.
• Personal gain
  Teens may choose to digitally self harm for sympathy or attention from friends or family members. In some cases, they may even be trying to elicit a reaction that they consider to be funny.
• Emotional release
  The last category of motivating factors covers anything based in emotions, such as the behavioral manifestation of negative thoughts and feelings or an attempt to manage those negative thoughts and feelings.

The motivating factor for digital self harm that’s the most concerning as it relates to adolescent mental health is emotional release. Since digital self harm is significantly associated with many negative emotions, as well as physical self harm and suicidality, some form of emotional release may be one of the most common reasons for the behavior.

Teens who are LGBTQIA+ or have a mental or physical disability are also more likely to digitally self harm through anonymous cyberbullying. In general, digital self harm may be more prevalent among those who’ve been ostracized or stigmatized by their peers.

The first study on digital self harm from 2012 and another from 2019, which involved New Zealand teens, both found that over one-third of participants who had digitally self harmed reported achieving the outcome they were looking for through the behavior.

Is there a treatment for digital self harm?

One of the best treatments for teens engaging in physical self harm is dialectical behavior therapy (DBT), a type of psychotherapy focused on better understanding and regulating emotions and providing skills to better cope with negativity and stress. However, to our knowledge, there hasn’t been any research specifically reviewing the effectiveness of different interventions for digital self harm. We do, however, know which modalities work best for the conditions that are often associated with digital self harm. 

Depression and substance use are often addressed using cognitive behavioral therapy (CBT), a form of psychotherapy designed to identify and change harmful thoughts and behaviors.

At Charlie Health, our expert clinicians incorporate a broad range of evidence-based modalities, including DBT skills and CBT, to help teens and young adults who are dealing with harmful patterns of thoughts and behaviors.

Supporting teens and young adults who engage in digital self harm

When it comes to supporting young people who may be engaging in digital self harm, it’s important to recognize that the behavior is likely a symptom of an underlying mental health concern. It’s less about ending the digital self harm itself and more about addressing what’s underneath.

According to this article, parental involvement is a critical part of addressing digital self harm and underlying issues: “Parents should seek to cultivate the kind of relationship with their child(ren) that enables frank and open conversations about what is going on online (and off). Our research has shown that children engage in digital self harm to get attention, to get a reaction, or because they are sad or depressed,” he wrote. “No matter the reason for participating, they need help. Parents and other adults who care for youth need to be available to support them when mental health challenges arise.”

How can Charlie Health help teens and young adults who engage in digital self harm?

Charlie Health’s virtual Intensive Outpatient Program (IOP) addresses many of the mental health conditions and issues that may be linked to an adolescent’s engagement in digital self harm , including depression, anxiety, and physical self harm. 

Our IOP incorporates individual therapy, supported groups, and family therapy so that clients can work with a mental health professional to determine their unique paths to healing. Teens and young adults are able to connect with peers who have similar histories and mental health challenges, all from the comfort of home.

If your teen is engaging in digital self harm or experiencing other difficult mental health concerns, get in touch today.

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