How to Recognize (And Treat) Different Types of Self-Harm

Learn how to recognize different types of self-harm so you can manage triggers and improve your mental health.

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Trigger warning: Self-harm, suicide. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact the National Suicide Prevention Lifeline 24/7 by calling or texting 988.

Self-harm is when a person intentionally hurts or harms themself. It’s often done as a way to cope with difficult feelings, memories, and situations, and it may be more common than you realize. Data suggest that approximately 5% of U.S. adults engage in self-harming behaviors, though rates are higher among teenagers and young adults. Below, we review different types of self-harm behaviors and how to cope with the urge to self-harm. 

Types of self-harming behaviors

“While we typically think of self-harm as direct and self-injury to the body, self-harm can also include behaviors that are subtler and less obvious at the onset, but still cause harm over time,” explains Jordanne Greenberg, MA, RYT, Charlie Health Contemplative Practitioner. The former is known as overt self-harm, whereas the latter is called covert self-harm. Here’s an overview of each type. 

Overt self-harm

Overt self-harm involves behaviors that are possibly obvious or visible to others, such as skin-cutting, while covert self-harm involves behaviors that are less noticeable, like self-induced vomiting. Here are some common examples of overt self-harming behaviors: 

• Cutting: Skin cutting involves using sharp objects to make scratches or cuts on parts of the body, including the arms, wrists, and thighs. 
• Biting: Biting parts of your body, such as your hand or wrist, can be a form of self-harm.
• Burning: Burning yourself with something like a lighter, cigarette, or candle is a type of self-harm that’s more common among people who identify as biologically male. In some cases, picking at those scabs can also be considered self-harm. 
• Hair-pulling: This involves pulling hair from your scalp, eyebrows, or other body parts.
• Hitting and punching: This can mean hitting or punching yourself or banging your head or other body parts against other surfaces. It might even involve intentionally breaking bones.
• Ingesting dangerous substances: Some people will consume objects or substances that can damage their internal organs and cause life-threatening issues. For example, bleach or detergent. 

Covert self-harm

Covert self-harm can include behaviors such as over-exercising, food restriction, over-eating, substance misuse, and too much screen time. It can also include emotional self-harm, which involves negative self-talk, self-sabotaging actions, and engaging in toxic relationships.

“While some of these behaviors may be considered symptoms of specific mental health conditions, they can also be understood more broadly as covert self-harming behaviors,” explains Greenberg.

“Covert self-harm behaviors may be more difficult to detect and are oftentimes overlooked because the impact to one’s health and well-being is less apparent and more prolonged — and even more so, some of these behaviors are socially reinforced, like exercising or dieting.”

It’s important to note that self-harming behavior, also known as non-suicidal self-injury, is not the same as suicidal behavior. Self-harm refers to deliberate self-harm behaviors without suicidal intent. Suicidal behavior, on the other hand, may involve suicidal thoughts or feelings, making a suicide plan, and attempting suicide. 

Can you engage in more than one type of self-harm?

Most people who self-harm engage in more than one type of self-harming behavior. In fact, Greenberg explains that it’s particularly common for people to engage in both overt and covert forms of self-harm.

“Self-harm doesn’t happen in a vacuum; it is a sign of emotional overwhelm, and it is reflective of a lifestyle that is ultimately unsustainable to one’s long-term safety,” says Greenberg. “If an individual is utilizing one type of self-harm, then this may indicate that they are lacking in emotion regulation or distress tolerance skills across the board, and are attempting to self soothe in the best ways that they know how,” she continues.

Why do people self-harm?

In many cases, self-harm is a way of coping with difficult feelings, painful memories, or overwhelming situations. People may engage in self-harming behaviors to:

• Distract themselves from negative feelings
• Express their emotions
• Feel more control over their life 
• Process their feelings and emotions 
• Punish themselves for perceived mistakes or wrongdoing 

Self-harming behavior is associated with a range of mental health conditions, including major depressive disorder, bipolar disorder, anxiety disorder, and borderline personality disorder. Other risk factors include being bullied, experiencing trauma, and struggling with low self-esteem.

Five ways to cope with self-harm

If you’re struggling with a cycle of self-harm, know that change and recovery is possible. According to Greenberg, “emphasizing well-being at the whole person level helps us to see that self-harming behaviors are habits which we have built over time.” She explains that focusing on behaviors that support long-term well-being may encourage people to reduce or end self-harming behaviors. Here are several examples of activities that can help serve this purpose. 

1. Find a new hobby

“Part of moving away from self-harming behaviors involves thinking about what we want to move towards,” says Greenberg. She suggests asking yourself,  “What fills my cup?” to learn more about your values, beliefs, and interests. This can help you find new hobbies and creative outlets to incorporate into your daily life. 

2. Practice mindfulness

Mindfulness involves being present and aware of your thoughts and feelings without judgment. For someone who self-harms, it can be a valuable tool for learning to manage harmful behaviors. “Understanding when and how we are triggered to self-harm gives us the information that we need to begin unpacking our why and build healthier habits,” says Greenberg.

3. Connect with your community

“Getting involved in a community of people whom you feel seen by and cared for can help to cultivate a sense of belonging or greater purpose,” says Greenberg. She explains that experiencing a sense of community can be a major protective factor against self-harm. If you’re not sure where to start, consider joining a local yoga class, volunteering at the library, or finding other opportunities to connect with people with shared interests or values.

4. Create a self-harm safety plan

A self-harm safety plan is a personalized resource that people can refer to when they feel the urge to self-harm. It might include self-harm triggers, healthy coping strategies, who to contact during tough moments, and emergency support resources. The goal of the plan is to empower people to feel more in control of their mental health and well-being. 

5. Seek professional support

If you’re ready to end the cycle of self-harm, know that you don’t have to do it alone. Working with a mental health professional can help you uncover the root cause of your behavior, as well as healthier coping mechanisms for navigating challenging feelings, situations, and relationships.

Manage self-harm with Charlie Health

If you or a loved one are struggling with self-harm, Charlie Health is here to help. Charlie Health offers comprehensive mental healthcare for those who need more support than once-weekly therapy. Our virtual Intensive Outpatient Program (IOP) combines individual and family therapy with group sessions to help adolescents, adults, and families.

No matter where you are in your mental health journey, we’re here to help you every step of the way. Our team of compassionate, experienced mental health professionals will partner with you to understand your triggers, create a safety plan, and discover alternative ways to cope with difficult emotions. Fill out this short form to get started today.