Borderline Personality Disorder (BPD)
A guide to symptoms, treatment and recovery for BPD
Do you want to stop hurting yourself? Learn about self-injury and how you can feel better without harming yourself.
Self-harm can be a way of dealing with deep distress and emotional pain. It may help you express feelings you can’t put into words, distract you from your life, or release emotional pain. Afterwards, you probably feel better—at least for a little while. But then the painful feelings return, and you feel the urge to hurt yourself again.
Self-harm includes anything you do to intentionally injure yourself. Some of the more common ways include:
Self-harm can also include less obvious ways of hurting yourself or putting yourself in danger, such as driving recklessly, binge drinking, taking too many drugs, or having unsafe sex.
Injuring yourself is often the only way you know how to:
Whatever the reasons for self-harming, it's important to know that there is help available if you want to stop. You can learn other ways to cope with everything that's going on inside without having to hurt yourself.
“It puts a punctuation mark on what I'm feeling on the inside!”
“It's a way to have control over my body because I can't control anything else in my life.”
“I usually feel like I have a black hole in the pit of my stomach, at least if I feel pain it's better than feeling nothing.”
“I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”
The relief that comes from cutting or self-harming is only temporary and creates far more problems than it solves.
Relief from cutting or self-harm is short lived, and is quickly followed by other feelings like shame and guilt. Meanwhile, it keeps you from learning more effective strategies for feeling better.
Keeping the secret of self-harm is difficult and lonely. Maybe you feel ashamed or maybe you just think that no one would understand. But hiding who you are and what you feel is a heavy burden. Ultimately, the secrecy and guilt affects your relationships with friends and family members and how you feel about yourself.
You can hurt yourself badly, even if you don't mean to. It's easy to end up with an infected wound or misjudge the depth of a cut, especially if you're also using drugs or alcohol.
You're at risk for bigger problems down the line. If you don't learn other ways to deal with emotional pain, you increase your risk of major depression, drug and alcohol addiction, and suicide.
Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.
The bottom line is that cutting and self-harm won't help you with the issues that made you want to hurt yourself in the first place. No matter how lonely, worthless, or trapped you may be feeling right now, there are many other, more effective ways to overcome the underlying issues that drive your self-harm.
If you're ready to get help for cutting or self-harm, the first step is to confide in another person. It can be scary to talk about the very thing you have worked so hard to hide, but it can also be a huge relief to finally let go of your secret and share what you're going through.
Deciding whom you can trust with such personal information can be difficult. Choose someone who isn't going to gossip or try to take control of your recovery. Ask yourself who in your life makes you feel accepted and supported. It could be a friend, teacher, religious leader, counselor, or relative. But you don't necessarily have to choose someone you are close to. Sometimes it's easier to start by talking to someone you respect—such as a teacher, religious leader, or counselor—who has a little more distance from the situation and won't find it as difficult to be objective.
When talking about cutting or self-harming:
Focus on your feelings. Instead of sharing detailed accounts of your self-harm behavior focus on the feelings or situations that lead to it. This can help the person you're confiding in better understand where you're coming from. It also helps to let the person know why you're telling them. Do you want help or advice from them? Do you simply want another person to know so you can let go of the secret?
Communicate in whatever way you feel most comfortable. If you're too nervous to talk in person, consider starting off the conversation with an email, text, or letter (although it's important to eventually follow-up with a face-to-face conversation). Don't feel pressured into sharing things you're not ready to talk about. You don't have to show the person your injuries or answer any questions you don't feel comfortable answering.
Give the person time to process what you tell them. As difficult as it is for you to open up, it may also be difficult for the person you tell-especially if it's a close friend or family member. Sometimes, you may not like the way the person reacts. Try to remember that reactions such as shock, anger, and fear come out of concern for you. It may help to print out this article for the people you choose to tell. The better they understand cutting and self-harm, the better able they'll be to support you.
Talking about self-harm can be very stressful and bring up a lot of emotions. Don't be discouraged if the situation feels worse for a short time right after sharing your secret. It's uncomfortable to confront and change long-standing habits. But once you get past these initial challenges, you'll start to feel better.
If you're not sure where to turn, call the S.A.F.E. Alternatives information line in the U.S. at 1-800-366-8288 for referrals and support for cutting and self-harm. For helplines in other countries, see “Get more help” below.
In the middle of a crisis?
If you're feeling suicidal and need help right now, read Suicide Help or call the National Suicide Prevention Lifeline in the U.S. at 1-800-273-8255. For a suicide helpline outside the U.S., visit Befrienders Worldwide.
Understanding what triggers you to cut or self-harm is a vital step towards recovery. If you can figure out what function your self-injury serves, you can learn other ways to get those needs met-which in turn can reduce your desire to hurt yourself. Self-harm is most often a way of dealing with emotional pain. What feelings make you want to cut or hurt yourself? Sadness? Anxiety? Anger? Loneliness? Shame? Emptiness?
If you're having a hard time pinpointing the feelings that trigger your urge to cut, you may need to work on your emotional awareness. Emotional awareness means knowing what you are feeling and why. It's the ability to identify and express what you are feeling from moment to moment and to understand the connection between your feelings and your actions. Feelings are important pieces of information that our bodies give to us, but they do not have to result in actions like cutting or self-harming.
The idea of paying attention to your feelings—rather than numbing them or releasing them through self-harm—may sound frightening to you. You may be afraid that you'll get overwhelmed or be stuck with the pain. But the truth is that emotions quickly come and go if you let them. If you don't try to fight, judge, or beat yourself up over the feeling, you'll find that it soon fades, replaced by another emotion. It's only when you obsess over the feeling that it persists.
Self-harm is your way of dealing with unpleasant feelings and difficult situations. If you're going to stop, you need to have alternative ways of coping so you can respond differently when you feel like cutting or hurting yourself.
If you self-harm to express pain and intense emotions, you could:
If you self-harm to calm and soothe yourself, you could:
If you self-harm because you feel disconnected or numb, you could:
If you self-harm to release tension or vent anger, you could:
The help and support of a trained professional can help you work to overcome the cutting or self-harming habit, so consider talking to a therapist. A therapist can help you develop new coping techniques and strategies to stop self-harming, while also helping you get to the root of why you hurt yourself.
Remember, self-harm doesn't occur in a vacuum. It exists in real life. It's an outward expression of inner pain-pain that often has its roots in early life. There is often a connection between self-harm and childhood trauma. Self-harm may be your way of coping with feelings related to past abuse, flashbacks, negative feelings about your body, or other traumatic memories-even if you're not consciously aware of the connection.
Finding the right therapist may take some time. It's very important that the therapist you choose has experience treating both trauma and self-injury. But the quality of the relationship with your therapist is equally important. Trust your instincts. Your therapist should be someone who accepts self-harm without condoning it, and who is willing to help you work toward stopping it at your own pace. You should feel at ease, even while talking through your most personal issues.
While cutting and self-harming occurs most frequently in adolescents and young adults, it can happen at any age. Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury in a friend or family member can be hard to detect. In any situation, you don't have to be sure that you know what's going on in order to reach out to someone you're worried about. However, there are red flags you can look for:
Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
Blood stains on clothing, towels, or bedding; blood-soaked tissues.
Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person's belongings.
Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
Needing to be alone for long periods of time, especially in the bedroom or bathroom.
Isolation and irritability. Your loved one is experiencing a great deal of inner pain—as well as guilt at how they're trying to cope with it. This can cause them to withdraw and isolate themselves.
Because cutting and self-harm tend to be taboo subjects, many people harbor serious misunderstandings about their friend or family member's motivation or state of mind. Don't let these common myths get in the way of helping someone you care about.
|Four myths about cutting and self-harm|
|Myth 1: People who cut and self-injure are trying to get attention.
Fact: The painful truth is that people who self-harm generally hurt themselves in secret. They aren't trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.
|Myth 2: People who self-injure are crazy and/or dangerous.
Fact: It is true that many people who self-harm suffer from anxiety, depression, eating disorders, or a previous trauma—just like millions of others in the general population. But that doesn't make them crazy or dangerous. Self-injury is how they cope. Sticking a label like “crazy” or “dangerous” on a person isn't accurate or helpful.
|Myth 3: People who self-injure want to die.
Fact: When people self-harm, they are usually not trying to kill themselves—they are trying to cope with their problems and pain. In fact, self-injury may be a way of helping themselves go on living. However, there is always the risk of a more severe injury than intended and, in the long-term, people who self-injure have a much higher risk of suicide, which is why it's so important to seek help.
|Myth 4: If the wounds aren't bad, it's not that serious.
Fact: The severity of a person's wounds has very little to do with how much they may be suffering. Don't assume that because the wounds or injuries are minor, there's nothing to worry about.
Perhaps you've noticed suspicious injuries on someone close to you, or that person has admitted to you that they're cutting. Whatever the case, you may be feeling unsure of yourself. What should you say? How can you help?
Deal with your own feelings. You may feel shocked, confused, or even disgusted by self-harming behaviors—and guilty about admitting these feelings. Acknowledging your feelings is an important first step toward helping your loved one.
Learn about the problem. The best way to overcome any discomfort or distaste you feel about self-harm is by learning about it. Understanding why your loved one is self-injuring can help you see the world through their eyes.
Don't judge. Avoid judgmental comments and criticism—they'll only make things worse. Remember, the self-harming person already feels distressed, ashamed and alone.
Offer support, not ultimatums. It's only natural to want to help, but threats, punishments, and ultimatums are counterproductive. Express your concern and let the person know that you're available whenever they want to talk or need support.
Encourage communication. Encourage your loved one to express whatever they're feeling, even if it's something you might be uncomfortable with. If the person hasn't told you about the self-harm, bring up the subject in a caring, non-confrontational way: “I've noticed injuries on your body, and I want to understand what you're going through.”
If the self-harmer is a family member, prepare yourself to address difficulties in the family. This is not about blame, but rather about communicating and dealing with problems in better ways that can benefit the whole family.
S.A.F.E. Alternatives (Self-Abuse Finally Ends) – Organization dedicated to helping people who self-harm, with a helpline at 1-800-366-8288.
Mind Infoline – Information on self-harm and a helpline to call at 0300 123 3393 or text 86463.
Kids Help Phone – A helpline for kids and teens to call for help with any issue, including cutting and self-injury at 1-800-668-6868.
Kids Helpline – A helpline for kids and young adults to get help with issues including cutting and self-harm. Call 1800 55 1800.
Helpline (India) – Provides information and support to those with mental health concerns in India. Call 1860 2662 345 or 1800 2333 330.
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