Self-harm, clinically known as non-suicidal self-injury, is becoming more and more common, especially among young people. There’s no single reason why some people self-harm, but childhood trauma is one major risk factor.
If you self-harm, there is no reason to feel ashamed. But it’s also important to understand why you’ve started to cope this way so that you can start to break the cycle. We’re here for you.
Let’s talk about the complex relationship between childhood trauma and self-harm.
If you’ve seriously injured yourself or may hurt yourself soon, call 911 or go to the nearest emergency department. If you’re in crisis, call or text 988 to reach the Suicide & Crisis Lifeline. If you’re a teen, tell someone you trust and ask them to stay with you while you get help.
Childhood trauma can be a risk factor for self-harm
Although we’re still learning, researchers have found that there is a link between trauma, especially childhood trauma, and self-harming behaviors. More severe childhood trauma experiences, and childhood sexual abuse in particular, are associated with a higher likelihood of self-harming.
This doesn’t mean that experiencing childhood trauma directly causes you to self-harm. People engage in self-harm for many different reasons, not just trauma, and not everyone who goes through trauma ends up self-harming.
But going through trauma alters your brain and nervous system. And these changes can indirectly make you more vulnerable to turning to self-harm to cope.
Here are some of the ways that childhood trauma can increase your risk of self-harm:
Emotion regulation
Children who experience abuse, neglect, or other types of trauma tend to have a harder time with emotion regulation, or being able to manage their own emotions (especially intense or painful ones). This has to do with the way trauma can literally change your brain.
Challenges with emotion regulation are linked to a higher risk of self-harm. If you tend to experience your emotions more intensely and have a harder time calming yourself, then you may be more likely to self-harm as a way to cope with or escape from these emotions.
Dissociation
Dissociation may also play a role. This is when you feel disconnected from yourself, reality, or the world around you. Trauma can directly or indirectly lead to dissociation; it’s a way your brain can try to protect you from the frightening reality. You may dissociate as an adult as well, even if the traumatic events of childhood have passed. The more likely you are to dissociate, the more likely you may be to self-harm.
Shame and guilt
A few different studies have found that the shame and guilt that trauma survivors often feel can increase the risk of self-harm. Many people who’ve been through trauma end up blaming themselves, consciously or subconsciously. You may know logically that it isn’t your fault, but the shame may still live in the background until you release trauma stored in your body.
Some people self-harm as a result of these feelings of shame. You might feel subconsciously like you need to punish yourself. Or self-harm could feel like the only thing that allows you to cope with these painful feelings.
Hyperarousal
Post-traumatic stress disorder (PTSD) can cause a group of symptoms called “hyperarousal.” This is when your nervous system never feels calm. Your stress response helps protect you from potential threats. But if you went through trauma, especially long-term trauma during childhood (also called complex trauma), your nervous system can interpret things as threatening even when you’re safe.
This can look like always scanning your environment, feeling anxiety and fear for no obvious reason, feeling unsafe in relationships, etc. Some research has found that if you have more of these hyperarousal symptoms due to trauma, you could be more likely to self-harm.
Borderline personality disorder
Some studies have shown that borderline personality disorder (BPD) is a mediating factor in the relationship between self-harm and trauma. It’s well-established that childhood trauma is a risk factor for BPD. People with BPD are also more likely to self-harm.
Can self-harm cause trauma?
Some people wonder if the reverse is true, whether self-harming behaviors can lead to trauma (for the person hurting themselves). Self-harm isn’t typically considered a risk factor for trauma. They show up together, but trauma usually comes first, not the other way around.
But self-harming can be traumatic, especially if you:
- Hurt yourself more than you meant to
- Needed to go to the hospital or emergency services
- Were treated poorly by medical staff
- Have been bullied because of your scars
- Were dissociated while you self-harmed, and find the memory of it disturbing
- Feel like you can’t keep yourself safe
Why else do people self-harm?
Trauma can be a risk factor for self-harm, but it’s not the only one. And the relationship is usually more complicated than “I self-harm because I went through trauma.” People who self-harm do so for many different reasons.
Some of these reasons and risk factors include:
- Overwhelming emotional distress; wanting to substitute emotional pain with physical pain
- Not knowing other ways to cope with intense feelings
- Feeling detached from yourself or your body
- To block upsetting memories when they come up
- Living with other mental health conditions like depression
- As a way to express a need for help
- To try to feel more in control
- Being a victim of bullying
How therapy can help
You may not be sure why you self-harm, or you may feel like you’ve tried everything and still can’t stop. But there’s hope, and evidence-based interventions have helped many people find healthier ways to cope with painful emotions.
A therapist can help you understand what tends to happen before, during, and after an urge, and work with you to find safer ways to manage the feelings or situations involved.
Treatment for self-harm usually focuses both on reducing self-harm as well as building other skills for managing intense emotions. It can also address trauma, depression, dissociation, or other underlying mental health concerns when they are part of your experience.
Trauma-focused therapy is essential if trauma has been a part of your journey and how/why you started self-harming.
Healing doesn’t mean that you need to quit self-harming overnight. Slowly, with support, you can make progress.
Trauma-informed therapy for self-harm in Houston, TX
At Jones Wellness Center, we know it’s possible to recover from both trauma and self-harming because we’ve been fortunate enough to have walked beside people as they do it. If you or your teen is struggling with self-harm, please don’t give up hope. With support, people can find other ways to cope and move toward a life without self-harm.
An intensive outpatient program (IOP) offers more frequent, structured care than weekly therapy while allowing you to continue living at home. Many of these intensive programs offer specialized support for self-harm and suicidal behaviors.
Jones Wellness Center provides mental health IOPs for teens and adults (separate programs) in Houston, TX. Reach out to learn whether the program may be the right fit for you.