Student Self-help Library

Self-Injurious Behavior

Self-injurious behaviors (also known as "Non-Suicidal Self Injury," or NSSI) are behaviors that people intentionally engage in that cause physical bodily harm to themselves. Self-harm is often carried out when individuals attempt to deal with difficult or overwhelming emotions, and are not sure how to more effectively manage their emotions. Self-injury may take on several forms, most commonly cutting, scraping, burning, biting or hitting. Physical and emotional scars may be left as a result of self-injury. Self-destructive behaviors are not to be confused with body piercing or tattoos that are sought for the purpose of self-decoration.

Based on research, people who engage in self-injurious behaviors claim to experience little to no pain while they are hurting themselves. Rationales for self-injury include feeling anger toward themselves or others, or relieving pain, anger and tension.

Not necessarily--but be aware. Individuals who engage in self-injurious behaviors are most likely feeling a lot of pain and may be experiencing symptoms of anxiety or depression. Since there is a strong link between suicidality and depression, it is important for concerned others to invite open communication about self-injury and suicidality. A common myth is that asking individuals if they are contemplating suicide affects their likelihood to attempt or complete suicide. Rather, asking about self-injury or suicide may help people know that you care about them and welcome open communication. If you have concerns about the endangerment of somebody’s life, whether they self-injure or not, contact a local hospital, police, the Counseling & Testing Center or the Dallas Suicide and Crisis Center.

First, people generally do not wish to hurt themselves, but see no better way of managing their emotions. The suggestions below are for people who have made the decision to quit self-injuring, and are looking for alternative strategies to deal with their emotions. Author Deb Martinson suggests looking at the emotions behind the urge (e.g., anger, frustration, restlessness, sadness, melancholic, craving sensation, wanting to see blood, wanting to focus) to help determine which strategies you might try.

Techniques to Try to Quit Self-Injuring:

  • Distract yourself. Get away from the situation you are in, and do something else.
  • Talk with someone who is supportive, such as a family member, friend, RA, hall director, minister or counselor.
  • Engage in another activity that requires stimulation. Give yourself a massage, take a warm or cool shower, squeeze ice, finger paint, or squish Play-dough.
  • Exercise is a way of quickly managing emotions. Go for a brisk walk or run, punch a pillow, swim, lift weights, or engage in other aerobic activities that require physical exertion.
  • Pamper yourself by doing something soothing. Read, listen to music, take a relaxing bath, look at the moon or clouds, open a window to get some fresh air.
  • Make a list of activities to engage in that have been helpful in the past when you have had the urge to self-injure. Keep this list handy to refer to in the future should you have the urge to self-injure.

  • Rate the intensity of your urge to hurt yourself on a scale from 1-10.
  • Identify which emotions you are feeling.
  • Rate the intensity of each emotion on a scale from 1-10.
  • Identify the situation you were in prior to your urge to hurt yourself.
  • Identify the unhelpful/impulsive thoughts present when you had the urge to hurt yourself.
  • Identify more helpful/more realistic thoughts to dispute the unhelpful ones.
  • Rate the intensity of your emotions a scale from 1-10 after completing this log.

You may notice that working through this activity helps you to more closely identify what you are feeling and thinking, and how a situation that occurred before the desire to self injure may be connected to the urge. Some people find that the urge to self injure greatly decreases after going through this step-by- step process.

It may also be helpful to think about the first time self-injury occurred, the situations and emotional factors at that time, and how you coped with them.

A first step is to recognize that there is hope beyond self-injury and that Counseling Services can be of great support. People often fear that self-injury will be seen as shameful or secretive. It does not have to be. A counselor can be the empathic encourager helping individuals meet their goals. A counselor can work with individuals to help increase coping mechanisms, and to provide support as people look more deeply at their emotions, thoughts, and behaviors. By looking at factors associated with self-injury, and underlying concerns, many can begin to break free from self-injury. Additionally, seeking assistance from Counseling Services or another health care professional, such as a psychiatrist, may be beneficial, as there is research that suggests that medication in addition to therapy may help those who self-injure.

It can be difficult to know that ones you care about deliberately injure themselves. It can be difficult to refrain from rushing in to “save” them from their pain. People engaging in self-injurious behaviors need to be the ones making the decision to change their behaviors. You can share your concern and urge them to ask for help. You can also let them know that you are available to call if they have the urge to self-injure, feel emotionally overwhelmed, or want to be with someone. Unconditionally showing them that they do not need to self-injure to get love and attention from you can be helpful. Asking if you can take them out to a movie, or to get a snack is a way to provide a distraction, and gives them the chance to receive your support.

If you are living in the residence halls, asking an RA or hall director to become a part of a support team can be an important step in empowering the person self-injuring. Also, please feel free to consult with professionals at Counseling Services by going to the second floor of the Dr. Bob Smith Health Center.

Map to Dr. Bob Smith Health Center: https://goo.gl/maps/FPZ3UVHmPQz

If you have a concern for yourself or someone else, you can contact the following for help:

  • SMU Counseling Services: 214-768-2277
  • Suicide and Crisis Line of North Texas: 214-828-1000 or 866-672-5100
  • National Suicide Prevention Lifeline: 800-273-8255

IF YOU HAVE AN EMERGENCY, PLEASE CALL 911 OR CAMPUS POLICE AT 214-768-3333.

  •  You can also come to the Counseling Services department on the 2nd floor of the Dr. Bob Smith Health Center and schedule an appointment to speak with one of the counselors, M-F (8:30 am - 5:00 pm)
  • Map to Dr. Bob Smith Health Centerhttps://goo.gl/maps/FPZ3UVHmPQz
  • Talk to your primary care provider who can discuss the range of treatments available to you, including medication.

  • Website by Deb Martinson:
    http://www.palace.net/~llama/psych/injury.html 
    This website offers a comprehensive look at self-injury, strategies for coping with the urge to self injure, and how to support someone who engages in self-injury. This website offers first-aid tips, but is not a substitute for professional medical care.
  • The Scarred Soul: Understanding and Ending Self-Inflicted Violence
    Book by Tracy Alderman, Ph.D. 
    This self-help book provides information and exercises to work through self-injury, and to increase coping mechanisms.
  • Bodily Harm: The Breakthrough Treatment Program for Self-Injurers 
    Book by Conterio, Lader, & Kingson Bloom
    ISBN 0-7868-8504-1
  • A Bright Red Scream: Self-Mutilation and the Language of Pain
    Book by Marilee Strong 
    ISBN 0-14-028053-7
  • Self-Injurious Behavior General Information
  • Self Abuse Finally Ends Safe (S.A.F.E.) http://www.selfinjury.com/
    Understanding Self-Injury and Treatments http://www.helpguide.org/mental/self_injury.htm