Content Warning: This blog post discusses self-harm.

Written by: Savvanah Neves, Clinical Trainee at ACS

Imagine you’re standing in the middle of a storm, rain pouring down, wind howling, and the thunder crashing all around you. You’re drenched, your heart racing, and it feels like you might be swept away at any moment. You may start to feel powerless, overwhelmed, and maybe even lost. Now, imagine that in the midst of this, you find something, ANYTHING, that allows you to regain some sense of control, even if only for a brief moment. It might not stop the storm, but it helps you feel like you’re still standing. 

For many individuals who struggle with non-suicidal self-injury (NSSI), that ‘something’ they turn to is self-harm. It’s not a solution to the storm, but it can provide temporary relief, a way to regain control. NSSI is a way of trying to manage unbearable emotions, whether it’s pain, anger, or sadness, by turning inward and using the body to cope. 

But here’s the catch: while this action may seem like a lifeline (the only way to feel better), it often becomes part of a dangerous cycle. NSSI, while it can regulate intense emotions in the short term, doesn’t stop the storm. Instead, it becomes a way of surviving within it. Over time, it can reinforce itself as a go-to coping mechanism, even though it doesn’t address the root of emotional turmoil. 

When someone is struggling with self-harm, one of the most important questions we can ask is not simply, “How do we get them to stop?” but “What is this behavior doing for them?” 

NSSI refers to intentionally hurting oneself without the intention of dying. People may engage in NSSI for many different reasons, including managing overwhelming emotions, communicating distress, feeling something when they feel numb, or punishing themselves. NSSI is different from suicidal behavior, although someone who engages in NSSI may also experience suicidal thoughts or behaviors. 

Understanding the function of NSSI can help us move beyond judgment and toward more effective support. 

Why Might Someone Self-Harm? 

NSSI does not look the same for everyone. Two people may engage in similar behaviors but have very different reasons for doing so. 

Research has identified several functions of self-injury. For some people, NSSI provides temporary relief from intense emotions such as sadness, anger, anxiety, shame, or frustration. For others, it may help them feel something when they are emotionally numb or disconnected. NSSI can also serve as a form of self-punishment or a way to communicate emotional pain that feels difficult to put into words. 

This does not mean that self-harm is a healthy or safe coping strategy. Rather, it means that the behavior may serve a purpose. When a behavior temporarily changes how someone feels, it can become a pattern that is difficult to break. 

That is why simply telling someone to “stop” may not address the underlying problem. 

What Happens Before and After? 

One helpful place to start is getting curious about the moments surrounding NSSI. 

Ask yourself: 

• What was happening right before I wanted to self-harm? 

• What emotion was I experiencing? 

• What was I hoping would change? 

• How did I feel immediately afterward? 

For example, someone might notice that they tend to experience urges to self-harm after an argument because they feel overwhelmed and angry. Someone else might notice that the urge appears when they feel emotionally numb and disconnected. 

The answer can help determine what kind of coping strategy might actually be useful. 

Finding a Safer Replacement 

There is no single replacement behavior that works for everyone. Instead, try choosing a strategy that addresses the same need that NSSI was meeting. 

If you are trying to manage overwhelming emotions: Try strategies that help bring emotional intensity down, such as paced breathing, taking a cold shower, listening to your favorite music, exercising, grounding yourself in your surroundings, or talking with someone you trust. 

If you are feeling numb or disconnected: Try activities that help you reconnect with the present moment. Notice what you can see, hear, smell, taste, and touch. Moving your body, spending time outside, engaging in art, or listening to familiar music may also help you feel more connected. 

If you are experiencing intense self-criticism or shame: Try putting some distance between yourself and the thoughts telling you that you deserve to be hurt. Ask yourself, “Would I talk to a friend the way I am talking to myself?” Writing down the thought and developing a more compassionate response can be a place to begin. 

If you are using NSSI to communicate that you are struggling: Try communicating the distress directly. You might text someone you trust, write down what you are feeling, or simply say, “I am having a really hard time right now and I need some support.” 

What If the Replacement Doesn’t Work? 

Finding alternatives to NSSI is a process. A coping strategy may work one day and not another. It may also take time to figure out which strategies help. 

The goal is not to find one perfect replacement. Instead, the goal is to build a toolbox of coping strategies that can be used in different situations. 

It can also be helpful to identify what makes urges stronger. Stress, conflict, isolation, sleep difficulties, substance use, or other emotional challenges may increase vulnerability to self-harm. Recognizing these patterns can make it easier to intervene earlier, before an urge becomes overwhelming. 

You Don’t Have to Figure It Out Alone 

Self-harm can be difficult to talk about, but talking about it is an important step. If you or someone you know is engaging in NSSI, consider reaching out to a trusted adult, school counselor, therapist, doctor, or other mental health professional. 

And remember: the goal is not simply to take away a coping behavior. The goal is to understand the pain underneath it and help build new ways of responding to that pain. 

If you are concerned about immediate safety or someone may be at risk of suicide, call or text 988 for the Suicide & Crisis Lifeline. 

Learning to cope differently takes time. With support, curiosity, and practice, it is possible to develop alternatives that are safer and more sustainable. 

How Can Parents and Adults Help? 

If you discover that a young person is self-harming, your initial response matters. 

Try to remain calm and avoid punishment, threats, or statements that communicate shame. Instead, let them know that you are glad they told you and that you want to understand what they are experiencing. 

Questions such as “What was happening before you felt like hurting yourself?” or “What does self-harm do for you when you are having a really difficult time?” can open a conversation without assuming that you already know the answer. 

Professional support can also help adolescents understand the function of NSSI and develop safer, more sustainable ways of managing distress. 

References 

Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27(2), 226-239. https://doi.org/10.1016/j.cpr.2006.08.002 

Nock, M. K. (2009). Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18(2), 78-83. https://doi.org/10.1111/j.1467-8721.2009.01613.x