Content Warning: This post discusses self-harm, including its psychological and physiological effects. If this is a sensitive topic for you, please read with care and take breaks as needed.
If you are struggling with self-harm, please know that you are not alone, and support is available.
Read Time: Est. 12-14 Minutes
Self-harm is one of the most misunderstood and stigmatized coping mechanisms, and I understand why. From the outside, it can seem irrational-even impossible to grasp-why someone would intentionally inflict pain on themselves.
Many assume it’s just a reckless habit, a cry for attention, or an act of self-destruction. But in reality, self-harm is often about survival-a way to cope when emotions feel unbearable, when the pain inside needs an outlet, or when numbness becomes too heavy to bear.
While self-harm and suicidal thoughts can sometimes be linked, they are not the same thing. Many people who self-harm do so to avoid suicidal feelings, using it as a temporary way to cope with overwhelming emotions. However, over time, self-harm can increase feelings of hopelessness, making suicide risk an important concern.
In addition, I would like to say that the severity of the injury doesn’t necessarily reflect the depth of emotional distress. Even minor self-harm can be a sign of serious internal pain and should never be dismissed.
Today, I’d like to talk about why self-harm is actually so addictive, why the cycle can feel so difficult to escape, and why someone may turn to it in the first place. I will also talk about alternative coping mechanisms that can support anyone in quitting, and ways you may be able to support a loved one struggling with self-harm.
Beyond the obvious danger and harm, I want to talk about why, while it may provide relief in the moment, over time it will only deepen emotional distress and increase dependence on the behavior.
The Addictive Nature of Self-Harm
Addiction is now recognized as a brain disease, and self-harm is tied deeply to brain chemistry. For each neurochemical, I have linked an article or research study to its respective role in addiction.
I want this section to help anyone struggling to understand that this is not a personal failure, but a learned behavior that your brain has been trained to ‘need,’ crave, or rely on. I want you to know that it is not because you are weak or broken.
My hope is that this will be eye-opening for some. That it may help you to see that this behavior is not necessarily something you want, but rather something you have simply felt continuously compelled to do.
Here’s a rundown of the brain chemicals in play:
1. Endorphins: The Painkiller Effect
When the body experiences physical pain, it releases endorphins-the body’s natural opioids. These chemicals help to dull pain and induce a sense of relief or even euphoria.
This is the mechanism behind a “runner’s high” or the rush after a tough workout. However, in self-harm, the pain acts as a shortcut to accessing that relief quickly.
Beta-endorphins are a type of endorphin that specifically regulate pain and stress and are released in anticipation of self-harm, not just during it. This explains why the urge alone can feel calming before the act itself happens.
2. Dopamine: The Reward Chemical
Commonly known as the “feel good” hormone, dopamine is a neurotransmitter that, amongst other things, plays a crucial role in our reward system. It drives and motivates us in two main ways:
- Dopamine helps us experience pleasure or relief-the ‘reward’. If a behavior results in a release of dopamine, the brain learns to seek it out again.
- Dopaminergic activation in anticipation or expectation of said behavior motivates us further-in other words, thinking of, or planning to engage in the behavior also feels satisfying and rewarding.
Self-harm can trigger dopamine release, reinforcing the behavior in your brain as an action that you should seek out again.
3. Cortisol: The Stress Hormone.
If someone is in a heightened emotional state (anxiety, anger, sadness), their cortisol levels are often high.
Self-harm can initially increase cortisol in response to the pain, but then lower it afterwards, which can feel like a relief. Over time, this teaches the brain that self-harm is an effective method to regulate stress.
4. Serotonin: The Mood Regulator
Serotonin is a neurotransmitter that helps regulate mood, emotions, and impulse control, acting as a natural stabilizer for the brain. It plays a crucial role in overall well-being, and disruptions in serotonin levels are often linked to depression and addictive behaviors.
When serotonin is low, the brain may seek out external ways to regulate emotions. If self-harm provides even a temporary mood lift, the brain can quickly learn to rely on it for emotional regulation.
Because low serotonin is linked to depression and impulse control issues, and many people who self-harm already have serotonin imbalances, it can be harder to resist the urge.
The Self-Harm Cycle of Dependency
I call this a cycle because thats exactly what it is. Self-harm provides relief in the moment, which reinforces it in your brain as effective method of coping with negative emotions.
However, the relief doesn’t last long, and inevitably the self-harm intensifies and escalates the negative emotions. When that happens, what do you turn to?
The cycle of dependency:
1. A trigger leads to emotional overload
- Something happens that causes distress-whether its sadness, frustration, numbness, or anxiety.
- The person feels overwhelmed and unable to cope in a healthy way.
2. Self-harm provides immediate relief
- Engaging in self-harm triggers the endorphin-dopamine release, providing a rush of relief.
- Cortisol (stress) drops, and the person feels calmer or emotionally reset.
3. The short-lived relief leads to guilt or shame
- The relief is temporary, often lasting minutes to hours.
- Many people feel guilt, shame, or frustration afterwards, deepening negative emotions and dependency on the behavior.
4. The brain remembers the relief, and the urge returns
- Because self-harm provided a temporary escape, the brain associates it with relief.
- When distress arises again, the urge to self-harm becomes stronger because the brain now sees it as a “solution.”
5. Tolerance builds, leading to escalation
- Just like with any addiction, over time, the brain builds a tolerance-meaning the same level of harm no longer provides the same relief.
- This often leads to an increase in severity or frequency, making the cycle harder to break.
The Psychology of Self-Harm
I chose this subject to talk about because this week in therapy we dove a little deeper into my own personal history with it. I never really recognized why exactly I kept coming back to self-harm, I just did. But for the first time, I felt that I had an understanding of what exactly this behavior was providing for me at the time.
In my experience, it was a product of severe body image issues. When starving myself inevitably led to an out of control binge, I used self-harm primarily as a form of punishment. It gave me back some semblance of control, and allowed me to feel like I was ‘doing something about it.’
It was a release of the negative emotions that I felt I wasn’t capable of handling on my own, and a way to cope with my struggles surrounding body image and food.
Self-harm is deeply rooted in emotional regulation, and there are many reasons that a person may feel a need to engage in the behavior.
Here’s a breakdown of what it can offer psychologically:
A Sense of Control
- When life feels chaotic, self-harm can provide a controlled, predictable outcome.
- Unlike external stressors (relationships, work, trauma), self-inflicted pain is self-directed, giving a false sense of autonomy.
- It creates the illusion of control, even when everything else feels uncontrollable.
Emotional Release (The “Pressure Valve” Effect)
- When feelings like anger, frustration, sadness, or numbness build up, self-harm acts like a pressure release valve, offering temporary release.
- Some people describe self-harm as “letting out” negative emotions.
A Way to Feel Something (Breaking Through the Numbness)
- Some people don’t turn to self-harm because they feel too much-they turn to it because the feel nothing at all (emotional numbness, dissociation).
- The physical pain grounds them in their body, making them feel alive, present, or real.
Punishment & Self-Hatred
- If someone struggles with self-loathing or guilt, self-harm can become a form of self-punishment.
- It reinforces negative self-beliefs (“I deserve this,” “I’m worthless,” “I need to be punished).
- This creates a dangerous cycle: self-harm temporarily relieves guilt, but then adds to the guilt afterwards.
A Physical Expression of Emotional Pain
- Some people feel like their emotional pain is invisible or invalid, and self-harm provides a tangible way to externalize it.
- In some cases (not all), it’s a way to seek help without verbalizing pain directly.
A Temporary Escape or Coping Mechanism
- Just like drugs, alcohol, or overeating, self-harm can serve as a maladaptive coping strategy.
- It distracts from emotional pain, turning attention to something physical instead.
- The ritual of self-harm can provide temporary comfort, routine, or familiarity.
Social & Identity Factors
- For some, self-harm can be tied to social belonging-especially if they are in environments where it is normalized or discussed among peers.
- It may also become a part of one’s identity (“I’m a person who self-harms”), making it harder to imagine life without it.
The Withdrawal
Like any behavior that affects brain chemistry, quitting self-harm can come with withdrawal effects. Since it can temporarily regulate emotions through the release of dopamine, endorphins, and stress hormones, stopping can leave the brain feeling dysregulated for a time.
This might look like increased anxiety, irritability, restlessness, or even a stronger urge to self-harm in the short term. For some, it may even come with physical symptoms like headaches, body aches, exhaustion or insomnia.
But it’s crucial to understand that this doesn’t mean you’re failing, or that you’ll always feel this way. Your brain is adjusting, learning new ways to regulate emotions without self-harm.
And just like with any cycle, the more time and distance you create, the easier it becomes. You can get through this, and there are healthier coping tools that can help bridge the gap while your brain heals.
Alternative Coping Strategies
Earlier in this post, I referred to self-harm as a maladaptive coping strategy. These are coping behaviors that may provide short-term relief, but harm long-term wellbeing. They are destructive or ineffective ways of dealing with stress or overwhelming emotions that may feel easy or good in the moment, but will ultimately worsen the situation.
Beyond the obvious harm, a maladaptive coping strategy is one that does not address the root cause of the issue.
Understanding the emotional function of self-harm may be crucial for healing. If self-harm is meeting a deeper emotional need, then that need must be met in healthier ways for long-term recovery.
Just as your brain has learned to rely on this coping behavior, it can learn not to. You are not stuck, and you are capable of living a life without self-harm.
A grounding plan may also help you in understanding and recognizing your triggers. Many people find it helpful to have a plan set in place for when triggers or urges come up.
Here are some healthy alternatives to meet each emotional need:
If You Self-Harm for Control, Try Creating Structure and Rituals
- Establish a daily routine (even something small like making tea every morning).
- Organize or clean a space-decluttering can provide a sense of control and accomplishment.
- Create a “ritual” that is soothing, like lighting a candle, doing skincare, or journaling at the same time every day.
If You Self-Harm for Emotional Release, Try Externalizing the Feelings in Another Way
- Physical release: Go for a run, punch a pillow, scream into a blanket, or do an intense workout.
- Creative release: Write a letter (you don’t have to send it), paint, scribble aggressively, or rip up paper.
- Verbal release: Vent to a trusted friend, therapist, or even just yourself (saying things out loud helps).
- Crying on purpose: Watch a sad movie or listen to emotional music to let emotions surface in a controlled way.
If You Self-Harm to Feel Something (Numbness), Try Sensory Stimulation
- Temperature changes: Take a hot or cold shower, hold ice, or dip your hands in cold water.
- Touch stimulation: Use a fidget toy, squeeze a stress ball, or wrap yourself in a weighted blanket.
- Music therapy: Blast loud music, let the bass vibrate through you, or focus on the rhythm.
- Taste stimulation: Suck on something sour (like a lemon), eat something spicy, or chew ice.
If You Self-Harm for Self-Punishment, Try Self-Compassion Practices
- Write down the negative thoughts you have about yourself-then challenge them with logic.
- Use affirmations, even if they feel fake or first (e.g. “I don’t deserve pain, I deserve healing”).
- Practice self-care as an act of rebellion-instead of harming your body, take care of it with a bath, lotion, or rest.
- Visualize someone you love-would you want them to hurt themselves? Offer that same compassion to yourself.
If You Self-Harm to Make Emotional Pain Feel “Real,” Try Externalizing in a Different Way
- Draw or write on yourself with a marker instead of cutting.
- Create art that represents you emotions.
- Use body movement-dance, shake, or do a movement that matches how you feel on the inside.
- Track your emotions visually (mood tracker, journaling, or color coding feelings).
If You Self-Harm for Temporary Escape, Try Healthy Distraction Techniques
- Engage in a hobby (even if you don’t feel like it at first-just start).
- Watch a tv show or movie that you’ve seen before (comfort shows can be grounding).
- Listen to a podcast or audiobook that holds your attention.
- Go outside-changing environments can shift your mindset.
If Self-Harm Feels Like Part of Your Identity, Try Reframing Who You Are
- Start redefining yourself-write down traits you want to embody (e.g., “I am someone who heals”).
- Find a new identity anchor-explore art, music, fitness, or a community that resonates with you.
- Remind yourself that you are more than your pain. The fact that you are even looking for alternatives means that you are already healing.
If you’re reading this list and thinking, none of this will give me the same relief, I want you to know-I understand. The truth is, at first, these alternatives might not feel like enough. They might not give the same immediate release, and that can be frustrating.
And while self-harm may offer immediate relief or comfort, the pain will come back, even stronger than before. And you do deserve better than that. Healing is about retraining your brain, about slowly finding new ways to regulate emotions that don’t come at the cost of your well-being.
It’s important to remember that breaking the cycle isn’t about stopping overnight. It’s about gradually replacing the behavior with healthier coping mechanisms. Even if you don’t feel ready to stop completely, trying just one alternative in a moment of distress is a huge step to strengthening your resilience overall.
And while quitting may feel daunting, my hope is that this information has helped to reframe the behavior for you. Not as something that you want or need to survive, but as a behavior that your brain has been trained to want and depend on.
Ways to Support A Loved One Struggling
If someone you care about is struggling with self-harm, it can be difficult to know what to do or say. You might feel helpless, scared, or even frustrated-but the most important thing you can offer is understanding, patience, and non-judgmental support.
Here are some key ways to support them:
1. Create a Safe Space for Open Conversation
Many people who self-harm feel intense shame, making it difficult to open up. Instead of pushing for details or trying to “fix” their pain, focus on creating a space where they feel safe expressing their emotions.
- What to say: “I’m here for you, and I want to understand what you’re going through. You don’t have to go through this alone.”
- What not to say: “Why would you do this to yourself?” or “Just stop, it’s not that hard.”
2. Avoid Reacting with Shock, Anger, or Guilt
Hearing that someone you love is hurting themselves can be painful, but reacting with strong emotions can make them shut down. Instead, try to listen calmly and validate their feelings.
- If you feel overwhelmed, take a breath before responding.
- Remind yourself that self-harm is a coping mechanism-it’s not about seeking attention or trying to hurt you.
3. Encourage Professional Support, but Don’t Force It
Therapy can be life-changing, but not everyone is ready to seek help right away. Instead of pressuring them, gently offer resources and remind them that support is available whenever they’re ready.
- What to say: “Would you be open to talking to someone about this? I can help you find support if that feels overwhelming.”
- What not to say: “You need to see a therapist or I can’t help you.”
4. Help Them Build Alternative Coping Strategies
Since self-harm often provides emotional relief, quitting can be incredibly difficult. Encouraging healthier coping mechanisms (without shaming them for struggling) can make a big difference.
You can even ask them directly: “Is there anything that helps, even a little? I’d love to support you in finding other ways to cope.”
5. Set Boundaries While Still Offering Support
Loving someone who self-harms can be emotionally heavy, and it’s okay to set boundaries for your own well-being. You can’t take responsibility for their healing, but you can be a source of compassion and encouragement.
- Example boundary: “I care about you so much, and I want to support you, but I also need to take care of my own mental health. Let’s talk about how I can best be there for you.”
6. Remind Them That They Are Not Alone
Sometimes, the most powerful thing you can do is remind them that their pain is seen, their feelings are valid, and they are not alone. Your love and support might not stop their struggle overnight, but it can be a crucial part of their healing.
- A simple but meaningful message: “I love you, and I’m not going anywhere. No matter how hard things feel, you’re not alone in this.”
Breaking the Cycle: Healing is Possible
Quitting self-harm may be difficult, but healing is possible. It is never out of reach. The cycle is powerful, but so are you.
It may not happen overnight, but healing is never linear. Setbacks are expected-they do not mean that you’re failing, and they do not erase your progress. Quitting is about finding your way forward one step at a time.
I cannot stress enough the importance of self-compassion during this journey. No matter what, and no matter who you are: you are worthy of healing, of self-compassion, and of a life beyond self-harm. Up to this point you may have been just surviving, but you deserve so much more. You deserve a life of peace and love for yourself.
If you are struggling, please consider reaching out for support. You are never alone in this, there are many people who understand your pain and care enough to help you through it.
While self-help strategies are powerful, professional support can make a world of difference. Therapists trained in DBT (Dialectical Behavior Therapy) or trauma-focused care can help break the cycle in a way that’s safe and supportive. If therapy feels overwhelming, crisis text lines or peer support groups can be a gentle first step.
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