6 Myths About Self-Injury

When you hear "self-injury," what do you think of? As a self-harm researcher and expert in dialectical behavior therapy (DBT), I've heard people say a lot of inaccurate things about self-injury. Unfortunately, these false beliefs cause harm.

Misconceptions that self-injury is always "manipulative" or "attention-seeking," that it's a moral failing, or that it's "just a teenage phase" can trigger shame in people who self-injure. They often dissuade people from getting mental health treatment that could help. It is vital that we stop viewing and talking about self-injury in these incorrect and problematic ways.

In honor of Self-Injury Awareness Month, let's address six common myths about self-injury.

What is Self-injury?

When people say "self-injury" or "self-harm," they're usually referring to nonsuicidal self-injury (NSSI). NSSI is intentionally engaging in behaviors that you know (or hope) will harm your body without the intent for those behaviors to kill you.

While many people only think of cutting when they think of NSSI, self-injury can take countless other forms: hitting, burning, biting, banging, scratching, or purposefully getting yourself into situations where you hope to get hurt. People can self-injure anywhere on their bodies.

Myth 1: Self-Injury Is Immature or Manipulative Attention-seeking.

Culture often paints people who self-injure as "acting out." Many people who self-injure, however, consciously and repeatedly try to hide their self-injury from others to avoid the stigma that surrounds self-injury. Research also consistently shows that the most common reason that people engage in self-injury is to manage stress, overwhelm, or otherwise cope with emotional pain [1].

Of course, some people do self-injure to communicate their pain to others or with the hope that their self-injury will get them out of social obligations. However, these people often use self-injury as communication because they have not been taught interpersonal skills or have previously been ignored or invalidated when trying to express their needs in other ways.

Myth 2: Self-Injury Is the Same as Suicidal Behavior. People Who Self-injure Want to Die.

As described above, the definition of NSSI specifically excludes any self-harming behaviors from which someone hopes they will die. Many people who self-injure struggle with thoughts of suicide, and NSSI is one of the strongest predictors of suicidal behavior [2].

But, many people who self-injure have never attempted suicide, and many people who self-injure have never had suicidal ideation or desire to die. It's also possible for someone to accidentally cause more physical damage to their bodies than they intend when self-injuring.

Clinicians (and laypeople) must understand that NSSI and suicidal behavior are not the same so that people who self-harm receive the most appropriate support for their needs. Of course, NSSI should be viewed as an important issue, even if the person is not suicidal.

Myth 3: Self-injury Is a Rare Problem.

While the exact rates differ between studies and time, research consistently shows that many people worldwide engage in self-injury at some point during their lives [3]. Up to 36% of adolescents report self-injuring [4], and 5% of adults report self-injuring [5].

Rates in certain communities are even higher. For example, LGBTQ+ people report significantly high rates of self-injury, likely due to homophobic and transphobic stigmas they face [6]. While the majority of people will not self-injure during their lifetime, self-injury is not a rare problem.

Myth 4: Self-injury Is a Teen Girl Problem.

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While rates of NSSI are usually higher in adolescents than in adults, self-injury is not limited to "angsty teens" in the way cultural stories may have you believe. As stated, up to 5% of adults report self-injury [5], and numerous teens who self-injure may continue to do so into their adulthood [7].

Similarly, self-injury was long viewed as a female problem. Still, more recent research, particularly studies that assess less "stereotypical" forms of NSSI, show that the difference between genders may not be as significant as once believed. Most studies continue to find cisgender girls and women self-injure at higher rates than cisgender boys and men [8], but people of all genders are at risk for self-injury.

Myth 5: If Someone Self-Injures, They Have BPD.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM), the diagnostic manual used by most American psychiatrists and therapists, self-injury is only officially mentioned as a symptom of borderline personality disorder (BPD). Consequently, many people incorrectly believe that self-injury is limited to people who struggle with BPD.

Many people with BPD do not self-injure, however, and many people who self-injure do not have BPD [9]. People struggling with a variety of mental health diagnoses or struggles may turn to self-injury to manage emotional distress.

Myth 6: Self-injury Is Not Treatable.

Numerous psychological and psychiatric treatments can help people who want to stop self-injuring. Some evidence-based psychotherapies, like dialectical behavior therapy (DBT), were designed to help people who commonly self-injure. Many of these therapies teach coping skills that people can use instead of self-injury to cope with painful emotions.

Other psychotherapies also can address self-injury by reducing the underlying emotional misery or mental health struggles (e.g., depression or anxiety) that trigger self-injury.

Conclusion

Self-injury is a notable public health concern for people of all ages, genders, and nationalities. Luckily, various evidence-based treatments can help. It's important to spread accurate awareness of NSSI and to challenge these myths to ensure that people receive the psychological support they need

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.