What is self-injury?

Self-injury (SI) is defined as any intentional injury to one's own body. This disorder also is called self-harm or self-mutilation. Usually, self-injury leaves marks or causes tissue damage. Self-injury can involve any of the following behaviors:

  • Cutting.
  • Burning (or "branding" with hot objects).
  • Picking at skin or re-opening wounds.
  • Hair-pulling (trichotillomania).
  • Head-banging.
  • Hitting (with a hammer or another object).
  • Bone-breaking.

Most who engage in self-injury act alone rather than in groups. They also attempt to hide their behavior.

What causes a person to engage in self-injury?

Self-injury can occur in either sex and in any race of people. The behavior is not limited by education, age, sexual orientation, socioeconomic status, or religion. However, there are some common factors among people who engage in self-injury. Self-injury occurs more often among:

  • Adolescent females.
  • People who have a history of physical, emotional, or sexual abuse.
  • People who have co-existing problems of substance abuse, obsessive-compulsive disorder, or eating disorders.
  • Individuals who were raised in families that discouraged the expression of anger.
  • Individuals who lack the skills to express their emotions and lack a good social support network.

Even though there is the possibility that a self-inflicted injury might result in life-threatening damage, self-injury is not considered to be suicidal behavior. Self-injury usually occurs when people face what seems like overwhelming or distressing feelings. Self-injurers might feel that self-injury is a way of:

  • Temporarily relieving intense feelings, pressure, or anxiety.
  • Being real, being alive, or feeling something.
  • Being able to feel pain on the outside instead of the inside.
  • Being a means to control and manage pain – unlike the pain experienced through physical or sexual abuse.
  • Providing a way to break emotional numbness (the self-anesthesia that allows someone to cut without feeling pain).
  • Asking for help in an indirect way or drawing attention to the need for help.
  • Attempting to affect others by manipulating them, trying to make them care, trying to make them feel guilty, or trying to make them go away.

Self-injury also might be a reflection of a person’s self-hatred. Some self-injurers are punishing themselves for having strong feelings that they were usually not allowed to express as children. They also might be punishing themselves for somehow being bad and undeserving. These feelings are an outgrowth of abuse and a belief that the abuse was deserved.

What are the symptoms of self-injury?

The symptoms of self-injury include:

  • Frequent cuts and burns that cannot be explained.
  • Self-punching or scratching.
  • Needle sticking.
  • Headbanging.
  • Eye pressing.
  • Finger or arm biting.
  • Pulling out one's hair.
  • Picking at one's skin.

Warning signs that an individual might be engaging in self-injury include:

  • Wearing pants and long sleeves in warm weather.
  • The appearance of lighters, razors or sharp objects that one would not expect among a person’s belongings.
  • Low self-esteem.
  • Difficulty handling feelings.
  • Relationship problems.
  • Poor functioning at work, school, or home.

Last reviewed by a Cleveland Clinic medical professional on 02/04/2013.


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