Know that it’s possible to get help for self-harm. Talk therapy, including CBT, can be one helpful form of treatment.
Self-harm is when someone deliberately hurts themselves. It is often a way of dealing with difficult feelings, memories, or situations. In many cases, therapy can provide support and relief.
The causes of self-harm vary between people and situations. Therapy can help by addressing the underlying issues that lead the person to self-harm and helping them develop more helpful coping mechanisms.
Research has suggested that therapy, including cognitive behavioral therapy (CBT), can be helpful for people who self-harm. Therapy can help you:
- work out the underlying issues that lead to self-harm
- identify factors that increase your desire to self-harm and find ways to reduce or manage them
- develop healthier ways to cope with difficult thoughts and feelings
When people get caught in unhelpful thought patterns, such as overgeneralizing or all-or-nothing thinking, it can cause distress and lead to challenging behaviors, including self-harm. CBT aims to help you identify and adjust these patterns.
For example, if you tend to catastrophize, you might imagine awful, disastrous, and unfixable events. CBT can help you identify these thought patterns. Your therapist might suggest pausing and trying to assess the situation rationally by asking questions like:
- What is the most likely outcome?
- What are some ways we can try to solve the problem?
- If you aren’t happy with how a certain situation went, how could we respond more helpfully next time?
A large-scale study published in the Cochrane Database of Systematic Reviews in 2021 looked at data from 76 trials, which included a total of 21,414 participants who engaged in self-harm. The study compared the outcomes of different forms of treatments for self-harm.
The study found that CBT‐based psychotherapy seemed to be quite an effective form of therapy for self-harm. Those who had CBT were less likely to repeat self-harming behavior. The authors noted that some of the studies were low in quality.
CBT for mental health conditions
CBT is considered an effective treatment for various mental health conditions, including those associated with self-harm. For example, it is commonly used for:
- generalized anxiety disorder
- eating disorders
- major depressive disorder
- substance use disorder
- bipolar disorder
- post-traumatic stress disorder (PTSD)
CBT can help with a range of mental health concerns, but a person doesn’t need to have a diagnosed mental health condition to benefit from CBT. This therapy can also help people cope with stress, grief, and social difficulties.
CBT typically addresses current, ongoing thoughts and feelings, not necessarily past traumas, although that might come up in therapy, too.
Self-harm refers to any intentional harm a person causes to their body. People sometimes self-harm due to trauma, stress, low self-esteem, and mental health. It can be an attempt to cope with frustration or anger. Social issues like bullying, rejection, or loneliness can also play a role.
Self-harm can describe a range of different behaviors, including:
- scratching or pinching
- pulling out hair
Someone who self-harms might have difficulty breaking away from it, even if they consciously want to stop. Therapy can be helpful for people who self-harm.
Although self-harm isn’t a sure sign that someone has a mental health condition, it can be associated with certain conditions, including anxiety disorders, personality disorders, and PTSD.
CBT is not the only potential treatment for self-harm.
If your symptoms are severe, you might benefit from a short inpatient program, which involves a stay in a healthcare facility. In some cases, you might benefit from prescription medication.
There are also self-care strategies you can employ to help yourself feel better.
These strategies can include:
- basic self-care, such as sleeping enough and eating regular meals
- developing healthy habits and routines
- finding healthy ways to cope with stress, such as exercise or meditation
- finding healthy ways to express your emotions, such as journaling or creative arts
- engaging in enjoyable, healthy hobbies
- working on your relationships with others
- joining a support group
- avoiding situations that may lead to self-harm, such as using alcohol or other substances
A therapist can advise you on creating healthy self-care strategies that work for you.
If you’re considering self-harm or suicide, you’re not alone
You can access free support right away with these resources:
- The National Suicide Prevention Lifeline. Call the Lifeline at 800-273-8255 for English or 888-628-9454 for Spanish, 24 hours a day, 7 days a week.
- The Crisis Text Line. Text HOME to the Crisis Text Line at 741741.
- The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text “START” to 678678, or chat online 24/7.
- Veterans Crisis Line. Call 800-273-8255, text 838255, or chat online 24/7.
- Deaf Crisis Line. Call 321-800-3323, text “HAND” to 839863, or visit their website.
- Befrienders Worldwide. This international crisis helpline network can help you find a local helpline.
It is possible to find help for self-harm and start feeling better. Making an appointment with a therapist is a good first step.
The following resources might be helpful for you:
- S.A.F.E. Alternatives (Self-Abuse Finally Ends)
- Self-injury Outreach and Support
- Anxiety & Depression Association of America: Support Groups
- Mental Health America: Find Support Groups
- The 6 Best Online Depression Support Groups in 2022
- Depression Hotline Numbers: Here’s Where to Get Help
- The 7 Best Online Help Resources for Depression in 2022