What Is Self-Harm?

Self-harm is the deliberate damaging of body tissue, more often than not, without conscious intent of  suicide. It has also been described as "self-mutilation", "self-injury", "auto-aggression", "delicate self-cutting", and a number of other terms.

Little is known about self-harm and yet it is quite a common act of abuse. Most see it as "attention-seeking" or "manipulative" but it can be better described as the expression of an inner scream.

Cutting the skin with razors, scalpels or broken bits of glass are the most commonly seen methods of self-harm, although other methods include burning, scratching, carving the skin, interfering with wounds, punching oneself (or punching walls), and also pressing objects (including needles) into the skin. Often the body's natural 'pain killers' will take over so that when a person harms themselves they frequently do not feel 'realistic' pain.

This self-inflicted injury could be viewed as a symbolic way of expressing deep distress - a non verbal form of communication in which feelings are expressed through self-injurious actions, where they can be dealt with in a more visible way, yet because of its very visibility, self-harm is often treated with mistrust and prejudice.


What help can I get?

If experiences were so painful they forced you to deal with your emotions by hurting yourself, you may now seriously doubt whether you can deal with them in any other way. But people do move forward, to grieve over past events or a lost childhood and work through the fear and confusion surrounding them. With plenty of support, they learn that they can cope with the pain, anger and rage which need to surface.

The important thing is to find ways to start talking to someone you trust. It could be to a friend, a family member, a professional counsellor, a psychologist or a psychotherapist.

A professional should have the training to listen to you and help you reach your feelings and manage them in a different way. Problems in the present and from the past all need to be addressed. If you can, find someone who specialises in treating people who self-harm, who have eating problems or who have been abused.

Talking to your GP

you should be offered a full assessment of your physical, psychological and social needs, by a professional who has been trained in the treatment of people who harm themselves, in an atmosphere of respect and understanding. If your GP is dismissive or unhelpful, you can contact the Patient Advice and Liaison Services (PALS), listed in your phone book under the local NHS Trust. You have a right to change your GP, if necessary.

Your GP may offer you a number of treatment choices, including various forms of counselling or therapy. One option might be cognitive behaviour therapy (CBT), which is a practical treatment that involves looking at what happens just before you self-harm, encouraging you to keep a diary of self-harming episodes and finding other channels for your feelings. CBT does not usually explore, in depth, the underlying causes of self-harming (see Making sense of cognitive behaviour therapy).

If your self-harming is severe, you may be referred to psychiatric services for further assessment, treatment and support. In an emergency, you may be taken into hospital. People's experience of these services is very variable. Even though guidelines are designed to improve the treatment people receive, when time and resources are limited it may be easier for staff to make snap judgements, use diagnostic labels and offer medication, than to spend time looking for the underlying causes of distress. If you find that this is the case, you may need an advocate, who can speak for you and ensure you are properly treated. This could be a friend, relative or a professional .

What can I do to help ?

What can parents and other adults do to help an adolescent who self-harms?

  • Don't panic or get angry if you discover your teen is engaging in self-injurious behaviors. Address your teen calmly and lovingly. Reacting loudly or angrily can often push your teen further away and increase the self harming behaviors.
  • Remember that most teenagers engaging in self-injurious behavior are not attempting suicide.
  • Do not judge or blame your adolescent for what has happened. They are already condemning themselves.  They don’t like being a self-injurer.
  • Avoid issuing ultimatums and asking your adolescent to stop self-injuring – you may be removing the only coping mechanism they have. An alternative and healthier coping mechanism needs to be found first. 
  • Acknowledge that the behavior is a coping mechanism and not just a bizarre habit.
  • Understand that this is not the time for discipline or punishment.
  • Be aware that your teen’s behavior is only a symptom of a more serious underlying problem.
  • Understand that your teen may not be able to explain why he or she engages in this behavior.
  • Try hard to cover any feelings of disgust associated with cutting or burning.  Reacting with horror is likely to exacerbate your teen's struggles.
  • Try to listen to what your child is saying. Spend time with your teenager. Numerous self-harmers suggest that feeling invisible to their parents was a major contributor to their self-mutilation.
  • Assure your teen that you love and care for her/him and will assist them in getting help.
  • Remember to seek help for yourself.  Caring for a child who self-harms is difficult.  Don’t be afraid to seek extra support while you are helping your child.
  • (School staff) Keep an individual focus rather than a group focus on self-injurious behavior at school in order to avoid imitating behaviors. Any activities that detail self-harm behaviors (movies, television programs, support groups, etc.) can trigger self-injury in at-risk adolescents.    
  • Know that counseling for a teen that self-injures is crucial!  Addressing the pain that underlies self-injury most often requires professional help for both teens and parents.   

Coping tips and distractions

It may be that you've tried a number or alternatives to self-harming and they don't work - but perhaps there's something you've not tried, or it's just that you're not sure how best to do it. There's several ways you can cope with self-harming, whether it's by distracting yourself, or by finding a substitute for self-harm.



Is using an alternative as bad as self-harming itself?

Using alternatives to self-harm will help you get through an intense moment when you may feel a strong urge to hurt yourself. But it's never going to be easy, especially when you're trying to break the cycle for the first time. Doing something like squeezing ice won't cure the roots of your distress, but it may help you to use a more productive coping mechanism and show you that you can cope with stress in a less harmful way. You'll have to make a conscious effort to not hurt yourself, but the important thing is that if you do decide to use an alternative, you've made that choice yourself.

Minimise self-harm damage

If you feel an even stronger urge to self-harm, try the following harm minimisation tips:

  • Use a red felt tip pen to mark where you might usually cut
  • Hit pillows or cushions, or have a good scream into a pillow or cushion to vent anger and frustration
  • Rub ice across your skin where you might usually cut, or hold an ice-cube in the crook of your arm or leg
  • Put elastic bands on wrists, arms or legs and flick them instead of cutting or hitting
  • Have a cold bath or shower

"One of the reasons young people say they self-harm is that something has happened in their life that has made them feel contaminated or polluted by that event, whether it's physical or emotional," says Frances McCann, mental health practitioner. "It becomes a way of 'letting something out' and dealing with feelings of self-disgust or low self-esteem."

If you are going to harm yourself:

  • Avoid drugs and alcohol as these can lead you to do more damage than you intended
  • Get your tetanus vaccination up-to-date
  • Try to avoid doing it when in a highly distressed state as you may cause more damage than you intended
  • Learn basic first aid
  • Self-harm is private, but think about how you can quickly access help if you seriously hurt yourself
  • Avoid using tablets or medicines - there is no such thing as a safe overdose

The A-Z of distractions

Often the best thing is to find out what has worked for other people who understand where you're coming from. asked young people from young people's mental health service 42nd Street to come up with some of the alternatives that help them. 

  • Alternative therapies: massage, reiki, meditation, acupuncturearomatherapy
  • Bake or cook something tasty
  • Clean (and won't your folks/housemates be pleased!)
  • Craftwork: make things, draw or paint
  • Dance your socks off
  • Eat sweets or chocolate for an instant sugar rush (but be careful of the dip in your mood once it's over)
  • Exercise for a release of endorphins and that feel-good factor
  • Forward planning - concentrate on something in the future, like a holiday
  • Go for a walk (preferably further than the local pub)
  • Go online and look at websites that offer you advice and information
  • Hang out with friends and family
  • Have a bubble bath with lots of bath bombs fizzing around you
  • Have a good cry
  • Hug a soft toy
  • Invite a friend round
  • Join a gym or a club
  • Knit (it's not just for old people you know)
  • Listen to music
  • Moisturise
  • Music: singing, playing instruments, listening to (basically making as much noise as you can)
  • Open up to a friend or family member about how you are feeling
  • Pop bubble wrap
  • Phone a helpline or a friend
  • Play computer games
  • Play with a stress ball or make one yourself
  • Read a book
  • Rip up a phone directory (does anyone actually use them these days?)
  • Scream into an empty room
  • Shop 'til you drop
  • Smoke - smokers find that having a fag can help
  • Spend time with babies (when they're in a good mood)
  • Tell or listen to jokes
  • Use the internet
  • Visit a zoo or a farm (animals do the best things)
  • Volunteer for an organisation (will make you feel all warm inside)
  • Watch TV or films - particularly comedies
  • Write: diary, poems, a book
  • Write negative feelings on paper, then rip them up
  • Yoga: meditation, deep breathing - this might help you relax and control your urges
  • Zzz - get a good night's sleep



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