Hello and thank you for your question. Hurting oneself is a truly complex problem and I have no simple answer for you except this: YES YOU CAN stop hurting yourself. I wonder if your therapist would make this the main issue for awhile, and if not, why not? It seems as though it’s a main issue for you.
Have you ever asked yourself what this self-harm is fundamentally about? Is it about wanting to feel the pain, see the blood? Or is it more about anger? When I ask this, I have to question people who are hurting themselves about who they are angry at, and who, deep down, they would like to hurt. Is it someone who hurt you deeply when you where a child? Even if they are dead, you can resolve issues with them. We are often afraid to express our anger outwardly, so we take it out internally.
Another issue is about control. When a person grows up in what may be a chaotic household, there is so much that they cannot control, nor can they escape. I often see patients who are frustrated and scared and resort to cutting themselves just so they can cry, or take control of a little segment of their own lives.
Is this the case with you? Does the self-harm give you a release from your torment for a few moments? You didn’t mention how you harm yourself, but the most common way is cutting. When I think of the physiology of cutting oneself, I consider what the act actually does chemically for a person. For one thing, it allows for the release of both endorphins (the feel-good chemical) and serotonin (the chemical that helps to fight depression). With a chemical reward like that, especially when there is little else to make you feel better, you might feel the need to continue cutting.
However, the problem is complex in that it’s socially not acceptable to cut oneself. There’s the embarrassment when the scars are revealed, and people who don’t understand human suffering won’t understand.
I would also wonder what antidepressants are you taking and whether the dose is high enough. Only your psychiatrist can help you with that. Typically a PCP won’t understand what is going on psychologically and may not know what you need. Talk with your therapist and your psychiatrist (and if you don’t have one, please find one you can trust).
If you don’t think your therapist is helping, then consider finding another one who specializes in trauma and self harming behaviors. You can find one in your area at Psychology Today. You can recover from harming yourself. This website might help as well: https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Self-harm
I hope this helps,
Dr. Diana Walcutt