Help for the Hurting: Non-suicidal self-injury (NSSI)
Self-injury is difficult to talk about.
- It’s difficult for the person who engages in self-injury, who may want to keep the behavior a secret, admitting it to only a select and small group of people.
- It’s difficult for the loved ones who are distressed and confused when discovering that their child or friend deliberately hurts themselves.
Non-suicidal self-injury (NSSI) has a clinical definition that highlights a very important distinction: NSSI involves injury that inflicts pain but not injury intended to end life.
The American Psychological Association uses the following definition:
“The individual has… engaged in intentional self-inflicted damage to his/her body … likely to induce bleeding, bruising, or pain, with the expectation that the injury will only lead to minor or moderate physical harm (with no suicidal intent)” (APA, 2022).
NSSI behaviors may include cutting, scratching, burning, biting, carving, hitting, punching, and head banging
Teens as young as 13 years of age engage in NSSI. The actual prevalence of NSSI has not been established. Preliminary data suggests females and members of the LGBTQ population may be a higher risk for NSSI.
While clinical definitions may offer the reassurance that the person may not want to die, the alarming discovery of NSSI actions leaves parents, friends, teachers, and siblings in a position of not knowing what to do to be helpful.
Helping the Hurting: What to do if a loved one is self-injuring
Self-harming behaviors are serious and require the help of a professional, but there are things loved ones can do to support someone who is self-harming.
Open Communication: Remain calm. Don’t ask “why”.
Suggest Alternatives when the urge hits: Taking a run, working out, taking a bath or shower.
Use STOP: Stop what you’re doing. Take a deep breath. Observe what it felt like to take that deep breath (focus on breathing). Proceed to what you wanted to do.
Breathing: Breathe with your loved one for up to 10 minutes.
Get Help
NSSI Urge: Drive to the ER. If the urge reduces while sitting and waiting, go home. If not, register to be seen by a med provider.
NSSI Injury: If you see blood – go to the nearest urgent care. NSSI can escalate and become life-threatening. Home management may not be enough.
Adapted from Preventing Self-Harm: What You Should Know if You Want to Offer Help | MSW@USC
Learn More
- The Cornell Research Program on Self-Injury and Recovery
- The Cornell Research Program – Reaching Out for Help: Talking About Ongoing Self-Injury
- Beigel, G. & Cooper, S. (2020). Mindfulness Workbook for Teens: Self-harm.
- Cipriano, A., Cella, S., & Cotrufo, P. (2017). Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 8, 1946. https://doi: 10.3389/fpsyg.2017.01946.
- The Cornell Research Program – Recovering from Self-Injury
- Calm Harm App Home – Calm Harm App
