Be Kind to Yourself, Because You’re Listening

Guest post by Rachel Carpenter, clinical psychology doctoral candidate and my co-author of this research

Self-harm (SH), defined as intentionally harming one’s own body, is relatively prevalent, with an estimated 4% of adults in the United States having self-harmed. By engaging in SH, the person may be trying to obtain relief from a negative feeling or mental state, and most report that SH regulates high levels of emotional distress and negative emotions typically caused by anxiety or depression. Several known factors related to SH include adverse childhood experiences (ACEs; e.g., childhood abuse/trauma), substance use, and family history of mental illness, but researchers have also explored other factors relevant to cognition that may influence self-harming behaviors.

Our recent study explored additional factors such as rumination, self-criticism, and the role of working memory (e.g., a cognitive system that holds information temporarily) in their relation to SH. In a nonclinical college-aged population, the study showed a greater number of self-harming behaviors among those with higher depressive symptoms and higher rates of rumination. Working memory did not influence self-harming behaviors, but the single strongest predictor of self-harming behavior was self-criticism, and a belief that love needs to be continually earned from others.

One application of these findings is to improve SH interventions, by lowering levels of self-criticism and improving one’s ability to express self-compassion. Traditional treatments are typically educational, resource-based, and generally not highly effective. Self-compassion, specifically self-kindness, emphasizes being kind and understanding toward oneself in instances of pain or failure rather than being self-critical. By allowing oneself to fail without believing it is indicative of unworthiness to be loved, a person may not feel the need to use SH to regulate their emotional state. While no known therapies exist that use self-compassion to target SH, specific interventions can utilize self-compassion training to treat SH behaviors. Treatments incorporating self-compassion with Compassionate Mind Training or Dialectical Behavioral Therapy (DBT) may address the underlying mechanisms that can trigger SH behavior. Indeed, one of the main components of these treatments is obtaining emotion-regulation skills that challenge self-critical thinking and cultivate a more balanced emotional response pattern. For those with high rates of self-criticism, targeting these emotional effects of self-criticism by learning emotion regulation skills may reduce self-harming behavior.

Regardless if SH is present, “cognitive distortions (i.e., faulty or inaccurate belief)” or self-critical thoughts are relatively common. If you find yourself thinking negatively about yourself, it may be helpful to ask yourself questions like “Who told you that?” or "Would you say that same thing to a loved one or a friend?” If not, then maybe you shouldn’t say it to yourself.