Non-Suicidal Self-Injury

Non-suicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death.

Although the methods individuals use to hurt themselves, such as cutting their wrists with a razor blade, sometimes overlap with those of suicide attempts, non-suicidal self-injury is different because individuals do not intend the acts to cause death.

Often, individuals specifically state that they are not trying to kill themselves.

In other cases, medical professionals presume individuals are not actually trying to die when they repeatedly do something that clearly cannot cause death – for example, burning themselves with cigarettes.

However, the first time individuals hurt themselves, it may not be clear whether they actually intended to die. For example, individuals may think that they could kill themselves by taking an overdose of antibiotics or vitamins, take such dose, and then realise that such a dose is harmless.

Even when self-injury does not cause death, individuals who injure themselves are probably more likely over the long term to attempt or commit suicide. Thus, medical professionals and family members should not lightly dismiss non-suicidal self-injury.

The most common examples of non-suicidal self-injury include:

• Cutting or stabbing the skin with a sharp object, such as a knife, razor blade, or needle.
• Burning the skin, typically with a cigarette.

Non-suicidal self-injury tends to start during early adolescence.

It is more common among people who have other disorders, particularly borderline personality disorder, antisocial personality disorder, an eating disorder, or substance use disorders (including alcohol abuse), and autism.

Non-suicidal self-injury is only slightly more common among girls than boys, whereas suicidal behaviour is much more common among girls than boys. Most individuals stop hurting themselves when they get older.

Individuals often injure themselves repeatedly in a single session, creating several cuts or burns in the same location.

Usually, individuals choose an area that is at once accessible and easily hidden by clothing, such as the forearms or front of the thighs. Typically, individuals also hurt themselves repeatedly, resulting in extensive scars from previous episodes. Individuals are often preoccupied with thoughts about the injurious acts.

Why individuals injure themselves is unclear, but self-injury may be:

• A way to reduce tension or negative feelings.
• A way to resolve interpersonal difficulties.
• Self-punishment for perceived faults.
• A plea for help.

Some individuals do not think their self-injury is a problem and thus tend not to seek or accept counselling.