Self-Injury and Cutting Causes and Treatments

Causes, Warning Signs and Treatments

Sad teenager listening to music in a bar

Self-injury involves self-inflicted bodily harm that is severe enough to either cause tissue damage or to leave marks that last several hours. Cutting is the most common form of SI but burning, head banging and scratching are also common. Other forms include biting, skin picking, hair pulling, hitting the body with objects or hitting objects with the body.

Why Do People Self-Injure?

Although suicidal feelings may accompany SI, it does not necessarily indicate a suicide attempt. Most often it is simply a mechanism for coping with emotional distress. People who select this emotional outlet may use it to express feelings, to deal with feelings of unreality or numbness, to stop flashbacks, to punish themselves, or to relieve tension.

Who Self-Injures?

Although SI is recognized as a common problem among the teenage population, it is not limited to adolescents. People of all sexes, nationalities, socioeconomic groups and ages can be self-injurers.

Warning Signs

People who self-injure become very adept at hiding scars or explaining them away. Look for signs such as a preference for wearing concealing clothing at all times (e.g. long sleeves in hot weather), an avoidance of situations where more revealing clothing might be expected (e.g. unexplained refusal to go to a party), or unusually frequent complaints of accidental injury (e.g. a cat owner who frequently has scratches on her arms).


Medications such as antidepressants, mood stabilizers and anxiolytics may alleviate the underlying feelings that the patient is attempting to cope with via SI. The patient must also be taught coping mechanisms to replace the SI. Once the patient is stable, therapeutic work should be done to help cope with the underlying problems that are causing their distress. Some experts say that hospitalization or forced stopping of the SI is not a helpful treatment. It may make the doctor and involved friends and family feel more comfortable, but does nothing to help the underlying problems. Further, the patient is generally neither psychotic nor actively suicidal and will benefit more from working with a doctor who is compassionate to the reasons that they are hurting themselves. A desire to cooperate and get well is a major factor in recovery.

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