Self-harm study

More than 900 people with first-hand experience of self-harm took part in the study, with over 500 participants still harming at the time of filling in the survey.

Most participants, when answering questions about self-harm, were thinking mainly of cutting/scratching or burning. The functions and motives of overdosing seemed to differ slightly from those associated with cutting and burning

In 2004, the National Institute for Health and Clinical Excellence (NICE) published the first treatment guideline on self-harm, revealing 170,000 people a year attended A&E departments with many being sent away with no proper help.

In response to this report SANE undertook this major self-harm research study which was published in 2008. Download the full report (PDF, 506 KB)

Despite being thought of as something that teenagers and young adults do, the results from our survey showed that self-harm affects people of all ages.

The age range of those who were still harming at the time they took part was 12 to 59 years of age. While some people were reporting that they had first started self-harming as young as four, others had not harmed until they were in their late fifties.

Although the majority were female, just over 100 men who had at some time harmed themselves took part in the survey – this made up 12% of all participants who had harmed.

It is still unclear whether self-harm is that much more in common in girls/women than in boys/men, or whether the former are just more willing to talk about it and seek help.

A study published in The Lancet in November 2011 found that one in 12 teenagers self-harm. In this video, Marjorie Wallace CBE, Chief Executive of SANE, can be seen below being interviewed by Sky News following publication of this study.

Key Findings

Self-loathing and need for punishment

• 55% of participants reported experiencing self-hate prior to harming.
• 43% reported self-hate being a motive for self-harm.
• 45% reported harming in order to punish themselves.
• Those who harmed more frequently (daily or weekly, rather than every few weeks or months) were significantly more likely to be motivated by self-loathing or a need to punish themselves than those who harmed less frequently.
• One in four participants reported feeling guilty, ashamed or embarrassed after an episode of self-harm.

Feeling too little or too much

• When asked how self-harm had helped them, 39% of participants wrote that it helped them regulate or release emotion.
• 62% experienced overwhelming emotions before harming and 63% had harmed to relieve mental pain.
• 34% had harmed in order to feel something.
• 42% of participants felt detached or unreal before harming.
• After harming, the positive effects felt most commonly were relief and release (47%), and a sense of calm and peace (24%).
• Those who harmed less frequently were more likely to cite ‘wanting to feel something’ or ‘wanting to feel real’ as a reason for their harm.

Secret self

• Feeling that your thoughts and feelings, if known by others, would be unacceptable to them was found to be associated with both current self-harm and a history of self-harm (and more strongly with the former).
• Feeling unable to let your thoughts and feelings manifest in your behaviour was found to be associated with both current self-harm and a history of self-harm (and more strongly with the former).
• Out of participants who were harming at the time of filling in the survey, those who thought their inner lives least acceptable and most in need of hiding tended to be those who harmed most frequently. Download this PDF (230KB) for more on the ‘Secret self’.

Control

• One in three participants had at some point harmed in order to feel in control.
• 17% used self-harm to control (rather than just release) emotions.
• 28% used self-harm to control their behaviour.

Common misperceptions regarding motivations behind acts of self-harm

• 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.

Self-harm from onset to termination

• Reported age of onset for self-harm ranged from four to 58 years. The mean age of onset was 17.
• Of participants who were still harming at the time of taking part in the survey, 47% had been harming for longer than five years.
• Some participants had learned the behaviour from others, but others’ first act of self-harm was an instinctive response to emotional distress.
• 44% of participants had identified a change in their motives for harming over time.
• When participants had found themselves harming without having the usual motives eg wanting to release emotion, it was most often a case of self-harm having become routine or habitual, but not necessarily an addiction.
• Just over a quarter of participants with a history of self-harm reported having ceased to harm themselves. The most common reason for stopping was social pressure (20% of those who had stopped), arising from eg the participant’s understanding of their role as a parent, an employee, a wife, or a husband.

Disclosing self-harm

• 84% of participants sought to hide their self-harm from their family, and 66% sought to hide it from their friends.
• Young age was associated with disclosing to friends.
• The most common reason given for hiding self-harm from family was to avoid the negative emotional impact a disclosure was expected to have on them (38% of non-disclosers). This was also the second most commonly given reason for hiding self-harm from friends (21%).
• Lack of understanding on behalf of family (26%) or friends (22%) was cited second-to-most often as a reason for hiding self-harm.
• Participants who sought to hide their self-harm from their families most often expected them to react with anger (31%), upset (21%) or shock/horror/fear (16%).
• Participants who sought to hide their self-harm from their friends anticipated shock/horror/fear reactions (20%) to disclosure, or their friends being confused or bewildered about it (13%).
• One in five participants who sought to hide their self-harm from their friends did so despite anticipating that the friends would be supportive if they were told about it.
• Only 10 to 15% of participants who sought to hide their self-harm expected their family and friends to recognise mental distress as the main reason for self-harm.
• Most commonly, participants who sought to hide their self-harm expected family and friends to think that they were seeking attention (22% and 19%) or mentally ill (19% and 25%).

Support

What can I do if I self-harm and want to stop?

Get talking
Try talking to your friends or family. SANE services can also provide you with support through a number of channels.

Learn how to manage the urge to harm
It is often possible to distract yourself before the need to harm becomes overwhelming. It can also be possible to substitute another activity for self-harm.

Get professional help
Your GP may be able to refer you to a talking therapy such as cognitive behavioural therapy or psychotherapy. You could also ask about mindfulness-based cognitive therapy.

Get inquisitive
Try to become interested in what is going on with you. Ask yourself what self-harm is doing for you, and see if you can work out what kinds of situations or thoughts typically lead to you feeling the need to harm.

Download What can I do if I self-harm and want to stop? (PDF 91KB)

What can I do if I self-harm and I don’t feel ready to stop?

Self-harm safely
Minimise risk by arming yourself with information about anatomy and physiology, learn to recognise the symptoms of infection and teach yourself about wound care.

Learn about self-harm and what it is doing for you
Take advantage of the calm and clear moments after self-harm to reflect on what is going on with you.

Combine self-harm with other forms of help
Therapies, talking to professionals and family members or friends, art and exercise might offer longer term solutions.

Download What can I do if I self-harm and I don’t feel ready to stop? (PDF 114KB)

What can I do if I know someone who self-harms?

Try to create a calm space in which thoughts and feelings can be expressed freely and self-harm can be talked about in a non-judgemental atmosphere
This may require some pretty challenging emotional control from your part. You need to be able to contain your own feelings sufficiently so that you can focus on the person and their feelings.

Give the person some privacy
It is good to try and be aware of how the person is feeling and what is going on in their lives. But it isn’t good to forget that they are as entitled as anyone else to have secrets and time for themselves.

Acknowledge self-harm, but don’t let it become a focal point
That someone self-harms isn’t the most important thing to know about them and, although the topic shouldn’t be avoided, it shouldn’t become the centre of all conversations.

Remember that self-harm has a function that is not easily fulfilled by other means and, for that reason, it is not reasonable to expect someone to stop harming overnight
Making someone promise they’ll never harm again or devising no self-harm contracts may contribute to feelings of guilt and lead to an increase in harm and in hiding it.

Help them to get help
You could help with getting an appointment and offer a lift or just your company when they go and see healthcare professionals – but always keep in mind that seeking help is their choice.

Get involved in a joint project of trying to understand self-harm
Help them to question what they learn as well as absorb it. Debating research findings may be a good way to acknowledge their expertise and give them the confidence to begin healing themselves.

Learn about methods, anatomy and first aid
Some self-harm is lethal and some can lead to permanent damage, so it is important to get an idea when it would be appropriate to go to the A&E. You might also be able to help the person to shift towards less dangerous methods.

Download What can I do if I know someone who self-harms? (PDF 114 KB)