Understanding self-harm
Page 6
Short Report
Common misperceptions regarding motivations behind acts of self-harm
Key findings:
- Most of self-harm is hidden from others and motivated by private therapeutic needs rather than performed to achieve social or manipulative ends.
- Although those who self-harm often feel suicidal when they harm, their intention is to seek relief from those feelings rather than to die. Self-harm is more an act of self-preservation, than it is an act of self-destruction.
Sometimes self-harm can be used to take control of a situation – for example, one participant wrote about using self-harm to avoid physical punishment. However, our results suggest that these and other manipulative motivations for self-harm are rare. It has been a widespread misunderstanding about self-harm that its primary motivation is a manipulative one, e.g. attention-seeking.
Several of the findings presented in this report indicate to the contrary: for one thing, the majority of those who self-harm apparently seek to hide it from their family (84%, n=692) and friends (66%, n=549). For another, the most important criterion for choosing a particular body part to harm was found to be ease of hiding the damage – this consideration often overrode a preference based on efficacy, for example. Further, only one in eight reported their first act of self-harm having been motivated by a desire to make others take notice or care, and this proportion fell to one in twelve for more recent acts.
Another common misperception about self-harm such as cutting or overdosing has been its identification with a failed suicide attempt. That self-harm is a risk factor for suicide is a well-documented fact to the point of being incontestable; Hawton et al . (2005) report that 25-50% of adolescents committing suicide have previously either engaged in self-mutilation or attempted suicide(1), and increased suicide risk has been shown in those who self-harm repeatedly(2).
There is no doubt, then, that self-harmers experience more suicidal thoughts and feelings than those who do not harm. But this does not mean that when someone self-harms they intend to commit suicide. On the contrary: for most of the time the majority of self-harmers do not want to die. Rather, they have persistent thoughts about death or suicide and the feelings associated with those thoughts, and they use self-harm to do away with them. Support for this claim comes from our study: over a hundred participants stated that self-harm helped them prevent suicide. Once it is more widely known and understood that self-harm is primarily an act of self-preservation rather than destruction, and that self-harm plays a role in emotion regulation, this mistake is likely to be made less frequently.
1. Hawton, K; James, A; Viner, R (2005) Suicide and deliberate self-harm in young people. British Medical Journal 330(7): 891-894
2. Zahl, DL; Hawton, K (2004) Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11,583 patients. British Journal of Psychiatry Vol. 185(1): 70-75