About Self-Injury

What is Non-Suicidal Self-Injury (NSSI)?

Also called self-harm, self-mutilation, or self-inflicted violence (SIV), NSSI is defined as the purposeful destruction of bodily tissue in an effort to alleviate emotional pain.  Typically, NSSI shows up in the form of cutting on the body with blades, knives, scissors, or other sharp instruments.  NSSI can also be burning, scratching, hitting, banging, bone-breaking, or interfering with wound-healing.  Generally speaking, tattooing and piercing are not considered NSSI.

One of the scariest things about NSSI is that a lot of people think it’s a suicide attempt, especially since cutting often happens on the arm, very near the wrist and important arteries.  This is a common misconception.  NSSI is not suicidal behavior, even though it can sometimes look like it.  On the contrary, self-injurers have found a way of coping with difficult emotions—which is a statement of survival, not despair.  However, if self-injury goes untreated for long enough, eventually those intense feelings can lead to despair, and suicide is a possible outcome, albeit a rare one.  Self-injurers should seek help from a professional with whatever it is inside that feels so overwhelming.

There are several different kinds of self-injury.  Very severe and dramatic injuries to the body, such as limb amputation and eyeball enucleation, are associated with severe mental illness such as schizophrenia.  This kind of self-injury is most often seen in psychiatric hospitals, and is treated with intensive therapy and psychiatric medication.  Repetitive head banging and skin picking are another kind of self-injury, often associated with disorders such as autism and intellectual disability.  In these cases, specially trained occupational and behavioral therapists work with the individual and the family in controlled environments to reduce the frequency of injury from the behavior.

The more common type of self-injury, seen often in elementary and high schools, is called “episodic” or “superficial” self-injury.  This is the kind we work with here at SII.  It is characterized by purposeful self-destructive behavior, such as cutting or burning, that is often hidden by the self-injurer due to shame and embarrassment.  The key word here is “purposeful.”  On the outside, these individuals are known to be bright, creative, non-confrontational, helpful, and friendly.  On the inside, they are suffering a great deal, and use NSSI as a way to soothe their internal pain.

Are you worried about someone you love?  Answer these questions to find out if your loved one might be engaging in NSSI.

Are you worried about yourself?  Answer these questions to find out if it’s time to call a therapist about NSSI.


We regularly post our thoughts and opinions about NSSI. Click on any title to the right to read our recent articles.

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