Nonsuicidal self-injury is a severe mental health problem that usually affects teenagers. NSSI is mostly associated with different psychiatric diagnoses. Like many disorders, NSSI can take on many forms. From literally cutting one’s skin with a knife or scissor to rubbing an area of the skin so vigorously as to cause actual physical damage and pain. Each person suffering from NSSI has their “preference” and “rituals” for self-mutilation, similar to an alcoholic who may have their drink of choice. However, the physical outcome manifests, the underlying emotional cause of this disorder is the real culprit.


“I go to the boxing gym to release steam when I’m mad or angry.”

“Nothing clears my mind like a nice long run when I find myself frustrated.”

“Mediation is the only way I can manage my anxiety.”

“I carry a small razor in my purse and cut myself to cope with stress.”

One of these coping strategies is different from others.

woman crying

What Is NonSuicidal Self-Injury (NSSI) 

As shocking as that last statement may sound, the act of hurting oneself to cope with stress, anxiety, or frustration has a name, nonsuicidal self-injury (NSSI) and it affects 17% of adolescents, 15% of college students, and about 5% of adults.

NSSI, often simply called self-injury, is the act of deliberately harming the surface of one’s body, such as cutting or burning yourself. It’s typically not meant as a suicide attempt. Rather, this type of self-injury is an unhealthy way to cope with emotional pain, intense anger, and frustration.

Most people who use NSSI are not suicidal; however, the repeated act of self-mutilation and the emotions that cause them can become more severe over time if not swiftly and adequately treated. Depressive and anxiety disorders are common. Many feel emotionally dysregulated due to a variety of factors including, but not limited to, a history of trauma or abuse, bullying, shame, family dysfunction, school or other daily pressures, low self-esteem/worth, loneliness, depression, etc.

A cutting (or any other form of NSSI) sometimes releases endorphins, similar to a strenuous workout (or even sex), killing the pain momentarily and raising one’s mood. On the opposite end, a person who has trouble feeling any emotions at all may use NSSI as a way to feel something, anything “real” to replace the emotional numbness. Typically, after the initial “high” wears off, hurting themselves will cause feelings of guilt and shame, causing them to harm themselves again, suppressing their feelings further. Thus the dangerous cycle is perpetuated and can be extremely hard to find a way out.

man asking help for non-suicidal self-injury

What to Look for in NonSuicidal Self-Injury?

Aside from the most common form of NSSI, which is the physical cutting of the skin, it’s important to note that any of the below rituals may also be considered as NSSI:

  • Scratching
  • Burning (with lit matches, cigarettes or hot, sharp objects like knives)
  • Carving words or symbols on the skin
  • Hitting or punching
  • Piercing the skin with sharp objects
  • Pulling out hair
  • Persistently picking at or interfering with wound healing.

Recognizing that someone is using NSSI to cope with their emotions isn’t always easy. The best thing you can do to help is to ensure they start to learn proper and less harmful ways to cope with the emotional pain that is causing the act of self-harm.

woman in the woods

How to stop NonSuicidal Self-Injury Behavior?

Begin some form of a healthy mind-body outlet such as yoga, Pilates, running, Zumba class, kickboxing, etc. to begin to integrate your physical and emotional selves.

Use Your Senses

Being mindful of what you see, hear, taste, smell, and feel are powerful tools to engage more in the here-and-now. For example, go to the freezer and grab on to ice instead of cutting or rub your hands on a fuzzy blanket for calm-down stimulation.

Get Support

Talk to someone you trust BEFORE you self-harm. Have an emergency plan with a list of names and numbers with you at all times. When you are in the emotional realm, and the desire to cut is strong, it can be difficult to “think” about what to do. Create this crisis worksheet when things are calm.

Wait Before You Self-Harm

If you automatically use self-harm to cope with strong emotions, wait one more minute. See if you can add a minute every day or every week. Try to gain some control over the behavior.

Draw the Word STOP

If you find yourself wanting to self-harm, draw an X or the word STOP on the part of your skin where you typically injure as a visual reminder not to harm.

Distract Yourself

Do something that you enjoy and keep your mind busy with something else – play music, dance, scream, hit a pillow, or even sleep.

Get Rid of Sharp Objects

Dispose of all sharp objects in your home or office that you might use. Not having them accessible may provide time to think before acting.

Get Professional Help

Individual and group therapies are incredibly useful as medications or holistic remedies. Seek professional help. This is treatable once new coping strategies are gain and practiced.

Final Thoughts

The most effective treatment for NonSuicidal Self-Injury is cognitive behavior therapy, specifically dialectical behavioral therapy (DBT), which helps to provide clients with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. When searching for a health care provider, be sure to find a therapist who has training in CBT and DBT.