Ask a therapist: Understanding self-harm

12th June, 2025    |    By  Reach Out    |     8

Clinical Psychologist Nasalifya Namwinga answers common questions about self-harm, including why people self-harm is, how to help a friend, strategies to manage urges, and how to seek support.

Please note: this video discusses self-harm. It is intended for informational purposes only and not as a crisis support resource. If you feel like you or someone you know is at risk of serious harm, call 000 if you live in Australia. You can also call crisis support services such as Lifeline (13 11 14), Kids Helpline (1800 55 1800), and 13YARN (12 92 76) for Aboriginal and Torres Strait Islander people.


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Video Transcription

Understanding Self-Harm: Common Questions Answered

Hi, all. I am Nasalifya, a clinical psychologist, and today I’m going to be answering some commonly asked questions about self-harm.

I know it can be a tough topic to hear about, so please take a break if you need to and look after yourself while watching. Let’s get started.

What is self-harm?

Self-harm is when someone intentionally physically hurts themselves but without wanting to end their life. It can take many different forms, like cutting, scratching, or burning. For most young people who self-harm, it’s a way to cope with painful feelings and emotions.

Why do people self-harm?

People self-harm for a range of reasons, and it’s important to know that not everyone is the same. Often, it’s about trying to cope with or express really intense feelings and emotions like anger, guilt, and even self-hatred. It can also be a way of communicating a need for support or providing a sense of immediate relief, even if that relief is only temporary. Sometimes, it’s about trying to regain a sense of control when everything just feels overwhelming.

I want to add that it can be hard to make sense of why someone self-harms, but even if we’re not able to fully wrap our heads around it, we can still take steps to understand it and offer support.

Is self-harm attention seeking?

A common misconception is that people who self-harm do so only for attention. Rather than being for attention, self-harm is often a deeply private way of trying to cope, and many people go to great lengths to keep it hidden. Even if someone hopes that others will notice, it’s usually a sign that they’re in distress and need support.

So instead of assuming it’s attention seeking, we can respond with empathy and help them get the right support.

How can I tell if someone is self-harming?

Recognising the signs of self-harm can be tricky as they’re not always visible. The following signs could be a cue that someone is going through a tough time and may need support.

  • Physical signs: unexplained cuts, burns, or bruises; often feeling sick or unwell.
  • Emotional signs: feeling sad, angry, or irritable; seeming depressed or anxious.
  • Behavioural signs: wearing long sleeves or pants even when it’s hot; avoiding social situations; withdrawing from friends and family; taking unnecessary risks.

So the truth is, whether you see these signs or you don’t, if your gut tells you that someone you know might be struggling, have a chat with them, check in, and offer support.

How can I help a friend who might be self-harming?

Seeing a friend who might be intentionally physically hurting themselves can be really tough, and it’s normal to feel worried about their wellbeing. Here’s some advice on helping a friend who might be self-harming:

  • Approach the topic with sensitivity and without judgment.
  • Let them know that you’re here to listen and offer support. You might say something like, “Hey, I’ve noticed you seem really down lately, and I just want to check in. How are you going?”
  • Remember, you can’t make someone stop self-harming. That’s a decision they need to make for themselves.
  • If they do open up to you, gently encourage them to seek professional help. You might say something like, “It might be helpful to chat with someone who knows a bit more about this,” or, “What do you think about checking in with a doctor or counsellor?”
  • Take care of yourself too. Keep up with your hobbies, exercise, or other activities that recharge you so you’re in a good place to offer support.
  • It’s okay to not have all the answers or to be your friend’s only support system. If you are really worried or need support yourself, talk to a trusted adult or professional.
  • It might feel like you’re betraying your friend’s trust, but gently let them know you’re doing it because you care and want to help keep them safe.

What are some ways to seek help and get support?

Reaching out can be really hard, but there are many ways you can find support. A great place to start is by chatting with someone you trust, like a friend, teacher, or community member. There are also amazing online communities where you can connect with others about your experiences.

You can try peer support services like ReachOut PeerChat, where you can connect with peers who have lived experience and are trained to support you. I’m also a big advocate for talking to a GP or a mental health professional. They can work with you to help uncover what might be driving these feelings and build healthy ways to manage the urges and strong emotions.

If you want to talk to someone immediately, you can use online and phone services like Kids Helpline and Lifeline. The great thing about these services is that they’re free, confidential, and staffed by trained people ready to listen and help.

What are some strategies to manage self-harm urges?

Besides getting support from a professional, there are simple strategies you can try on your own. One great idea is to make a distraction box. This is something you can turn to in moments when you’re feeling strong urges. You can fill it with things that help you feel calm and safe, like a colouring book, stress ball, soothing scents, or photos of people that make you smile.

You could also have a list of go-to activities that you enjoy, like gaming, watching funny videos, putting on your favourite music, or even having a chat with a friend. Activities like these can help shift your focus during tough moments and help those feelings pass.

I also suggest taking time to reflect on what might be triggering your urges. Are there certain people, environments, or situations that tend to bring up those feelings? Understanding these might help you avoid those situations that increase your urges. Or if you can’t avoid them altogether, it can help you feel more prepared to manage those urges when they come up.

Remember, progress is not a straight line. Setbacks happen, but they’re not a sign of failure. Learning new ways to manage self-harm can take time, but even small steps really matter. With the right support, it is possible to reduce the intensity of urges and build healthier ways to cope.