Trigger warning: The following article deals with sensitive topics and contains graphic mentions of self-injury.
All quotes are from people with lived experience of self-injury.
When non-suicidal self-injury is mentioned, attention is often focused on the act itself: that an individual harms their body, often to cope with negative feelings. This is true, but it can ripple much deeper than that. Seeing self-injury as a mere coping mechanism overlooks many aspects of great importance to people with experience of it. Self-injury doesn’t stop as the act of injuring oneself ends. It can linger through thoughts, reminders, and consequences. Let’s explore some of the many ways self-injury can impact people and their daily life.
Self-injury impacts someone’s appearance
One distinctive aspect of self-injury is that while it is a psychological issue, it can have physical consequences. The body bears the marks of emotional struggle through wounds and scars. Scars in particular can affect the way many people see themselves, in a society where mental health issues often remain misunderstood. As a result, individuals with scars often struggle with poorer body image1 and shame2, stemming from stigma and judgement3,4. This manifests itself across all types of day-to-day situations, such as work, job interviews, during medical appointments, or even walking down the street. Because self-injury scars often reflect emotional turmoil, they can represent a very personal aspect of the self, and it can be difficult to expose them publicly.
Something as mundane as choosing an outfit for the day can be complicated for these reasons. Finding clothes that hide scars and injuries isn’t always easy, particularly during the summer or when dress codes are enforced. Fresh wounds can also stain clothes or bed clothes, adding another aspect to be considered.
I’m fed up with having to choose my clothes so that scars on my arm don’t show.
I cut myself again because I was feeling depressed and bored, but the blood ran through the bandage and stained my pajamas.
Self-injury doesn’t just impact the way an individual presents themselves, it can also influence their own self-image.
When self-injury becomes part of identity
Because self-injury impacts so many aspects and remains misunderstood, some feel it makes them different and that it is a part of their identity5. They may refer to themselves as a “self-harmer” or “cutter” to really distinguish themselves from others. Though not everyone sees things the same way. Others may reject this type of normalization, claiming they are not defined by their self-injury. It’s best to avoid using words that attach the behavior to the person except if they request those terms to be used, since it may reduce them to the behavior.
For many, self-injury also takes a toll on social interactions. It can be very isolating as others may not understand their struggles, or even be judgemental. Arguments and tensions may arise, such as parents becoming angry upon discovering that their child harms themselves, or someone expressing disappointment in their partner relapsing. Sometimes, intimate relationships may be avoided entirely out of fear of their scars being noticed6. Additionally, some fear their parents may be informed by school staff if a faculty member discovers their injuries, or they may be sent to a psychiatric hospital. In essence, people affected by self-injury often live in secrecy.
I’m afraid that [telling friends or family about my self-injury] changes the image they have of me.
To cope with this isolation some find relief online, developing connections with peers7. Within these online communities, specific self-injury slang can only be understood by people who are part of the community8. Therefore, self-injury can also change the way someone uses words.
Self-injury changes the way you think
While these online communities are often meant to be supportive, some can become an echo chamber in which self-injury is not only normalized, but to some extent romanticized. Since self-inflicted wounds are associated with emotional distress, some people may feel the need to hurt themselves more severely, or more painfully, to receive validation from members of the community. Pain tolerance and severe wounds can become a badge of honor, a way to prove oneself as an authentic “self-harmer” whose suffering is legitimate. Some members of these communities look down on what they perceive as less severe injuries and use derogatory slang to refer to them. After someone stops harming themselves, this way of seeing things can still inadvertently remain, suggesting self-injury can influence the way they think. Even outside of these online communities, it isn’t uncommon that people who injure themselves perceive severe injuries as preferable to less severe ones, or see strong pain tolerance as a sign of strength.
[With] SH there is this kind of wish to do more, this idea that it is not enough, you need to get more blood, to cut deeper
[A]s a self-harmer I’m annoyed because I want to cut deep and can’t, but as someone who takes a step back […] I’m glad to some extent, because better not to cut deep.
Sometimes, people may have thoughts that enable them to remain in denial, minimizing and normalizing self-injury. This can take the form of resorting to what they perceive as lighter forms of self-harm to avoid feeling they relapsed for example.
I did things that I didn’t deem SH but were to some extent. For example I was trying to stop but couldn’t stand the urge so I poured boiling water from the tea on my arm, just to release tension. It didn’t feel as SH on the moment, as it didn’t even have a blister, but my skin was hot and then peeled.
In the following quote, the person doesn’t want to acknowledge the seriousness of their issue with self-injury:
Yesterday I went to the shop […] and hesitated to buy a […] disinfecting cream, just in case I [self-harmed] again. But then I preferred not to buy it because I thought it would make the problem too official.
But the normalization of self-injury doesn’t always last once the person feels better and stops harming themselves, giving a sense of hope to those who feel they may never feel better.
Now it seems completely crazy to me.
Living with self-injury
For people affected by self-injury, even the simplest activity can become difficult. We’ve already discussed getting dressed, but there are many other examples. For instance, self-inflicted injuries can sting during the shower. Some may skip activities that reveal scars6 like sports or going to the beach. Even common everyday objects can become a trigger or a reminder of self-injury, such as the use of a knife for cutting food.
It hurts in the shower.
Urges, self-harm thoughts, and the weight of secrecy are already heavy on their own, but self-injury can also be both time-consuming and costly. People may harm themselves during their time alone, instead of relaxing, studying or sleeping. This can affect general well-being and performance.
I had very strong urges to the point when I couldn’t even focus in class.
Treating wounds can also take time, and require attention for days. Bandages and antiseptic products can also be expensive, and scar-covering procedures like laser, surgery or tattooing even more.
These many aspects of self-injury are often unheard by people who don’t have lived experience. And yet they are part of the daily life of those who struggle with it. By understanding that the consequences of self-injury go beyond its mere physical harm, we can not only understand its complexity, but also adopt an understanding, non-judgmental approach. Ultimately, recognizing the diversity of these negative consequences can help those affected by self-injury to understand they could benefit from seeking support and professional help.
References
[1] Dyer, A., Hennrich, L., Borgmann, E., White, A. J., & Alpers, G. W. (2013). Body image and noticeable self-inflicted scars. The Journal of nervous and mental disease, 201(1), 1080-1084. https://doi.org/10.1097/nmd.0000000000000057
[2] Stacy, S. E., Lear, M. K., & Pepper, C. M. (2017). The importance of origin: Differences in interpretation of self-inflicted versus environmentally-inflicted scars. Personality and Individual Differences, 116, 92-95. https://doi.org/10.1016/j.paid.2017.04.035
[3] Shaw, C. (2013). Living with Scars. Asylum, 20(2), 4-6.
[4] Sternudd, H. T. (2012). Photographs of self-injury: production and reception in a group of self-injurers. Journal of Youth Studies, 15(4), 421-436. https://doi.org/10.1080/13676261.2012.663894
[5] Anna Gradin Franzén & Lucas Gottzén (2011) The beauty of blood? Self-injury and ambivalence in an Internet community. Journal of Youth Studies, 14(3), 279-294. https://doi.org/10.1080/13676261.2010.533755
[6] Lewis, S. P., & Mehrabkhani, S. (2016). Every scar tells a story: Insight into people’s self-injury scar experiences. Counselling Psychology Quarterly, 29(3), 296-310. https://doi.org/10.1080/09515070.2015.1088431
[7] Guccini, F., & McKinley, G. (2022). “How deep do I have to cut?”: Non-suicidal self-injury and imagined communities of practice on Tumblr. Social Science & Medicine, 296. https://doi.org/10.1016/j.socscimed.2022.114760
[8] Sukhija, V. J. (2023). Slang and Self-Harm: A Qualitative Exploration of the Usage of Slang on Reddit Self-Harm Communities [Master’s thesis]. https://thesis.unipd.it/handle/20.500.12608/48647
Exploring self-harm 