Dear Alice,

The general consensus is that self injury is emotionally unhealthy, but I don't understand how. Are there reasons besides religious ones and that it is socially unacceptable?

Dear Reader,

Self-injury is a coping mechanism used to deal with emotional distress and pain, anger, shame, frustration, low self-esteem, and sadness. It comes in many forms, such as cutting or burning the skin, head banging, biting, hitting or punching, skin picking, breaking bones, and hair pulling. The practice is usually done without suicidal intentions, and is instead a mechanism to achieve a temporary release of tension. In general, self-injury is perceived as emotionally unhealthy in the medical and psychological communities because it provides very short-term relief at the cost of involving high-risk behaviors that can quickly escalate or cause permanent damage.

Individuals who self-injure may engage in the behavior for a variety of reasons: to feel control over their bodies, convey inner feelings externally, punish themselves for their perceived shortcomings, express emotional distress to others, or, perhaps, to escape emotional pain through physical pain. The primary reason why self-injury is perceived as “unhealthy” is because it is dangerous. Cutting, for example, can result in excessive blood loss, infections, disease spreading through shared cutting instruments, and in the worst cases, fatality. Punching, hitting, and head banging can result in loss of consciousness, severe bruising, concussion, and breaking bones.

In some cases, an individual will experience one or two isolated incidences of self-injury and move on to alternative methods of releasing negative feelings. For others, self-injury becomes a long-term pattern that some describe as “addictive.” Usually, self-injury is associated with underlying psychological stresses and disorders, such as borderline personality disorder, depression, eating disorders, and post-traumatic stress disorder (PTSD). In general, treatment for self-injury is based on the underlying cause of the behavior, such as depression, personality disorders, or anger management concerns. However, some self-injurers appear to be well-functioning and have no active psychological diagnoses — therefore, treatment in these cases may be more complex.

Recovery from self-injury may be a lengthy and difficult process. Learning to engage in healthy coping mechanisms requires time and dedication — and the first step is the desire to get support. Sometimes, dramatic lifestyle changes, such as moving away or changing schools or jobs, are necessary to avoid triggers. However, steering clear of triggers, making use of less risky coping patterns, and ultimately achieving recovery are well worth the effort. If you or someone you know engages in self-injury, it’s a good idea to reach out to a compassionate and experienced counselor who is able to properly diagnose and treat the behavior.

Take care,


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