Can Self-Harm Be Emotional?

When talking about self-injury, often we are describing the act of causing oneself physical harm or pain. But can self-harm be emotional, too?

But I would argue that you don't need to physically self-harm in order to hurt yourself—nor are physical wounds the only kind that require healing.

Can Self-Harm Be Emotional as Well as Physical?

Self-harm can be an intensely emotional experience for many people. Often, people who self-injure, hurt themselves as a way to relieve themselves of a heavy, emotional burden—sorrow, perhaps, or one of its dark cousins like anger or guilt. Strong emotions may follow immediately after the act itself—a sense of peace, relief, or even elation.

Other emotions, like shame or fear of being found out, may follow soon after—or much later. Even people who hurt themselves as a way to break through a wall of numbness may feel something briefly—just enough to trigger cravings for more.

But can self-harm be purely emotional? That is, is self-harm "real" without the physical scars to prove it?

Can Self-Harm Be Emotional—Without a Physical Component?

Speaking on a purely technical level, no, self-harm can't be purely emotional. Nonsuicidal self-injury (NSSI), as a clinically diagnosed disorder, requires "deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned."¹ However, it is important to remember that clinical diagnoses are merely labels used to help medical professionals provide appropriate treatment and support, and to help patients give a name to the things they are experiencing.

Verbal abuse still "counts" as abuse in the world of domestic violence. Likewise, yes, self-harm can be an emotional, rather than a physical, experience. Words do hurt us, despite what certain aphorisms may tell us, and few people can wound you as deeply or destructively as you can wound yourself. After all, who knows your own fears and weaknesses—and how to use them against you better than you do?

Wounds don't have to break the skin to leave scars. Pain is pain, and regardless of how you may be hurting yourself, the fact remains that you are causing yourself harm. It is also true, however, that you don't have to keep doing so—there are other, better options for coping with the things you're thinking and feeling.

Healing from Emotional Self-Harm

As with physical acts of self-injury, healing from emotional self-harm can be a difficult and complicated process. It is all too easy to fall into the trap of blaming yourself for everything and giving yourself credit for nothing—and shaming yourself for feeling unable to do anything about it. I know, I've been there. In fact, I still find myself struggling sometimes not to fall into old thought patterns of never feeling "good enough" or "strong enough" to be the person I want to be. But the good news is that with help—and a lot of cognitive behavioral therapy—I'm getting a little better at it every day.

The even better news is this: you can, too.

Do you emotionally self-harm? Have you found any ways to stop these thoughts in their tracks, or replace them with more positive, less harmful alternatives? Let me know in the comments.

Source

1. Zetterqvist, M., "The 'DSM-5' Diagnosis of Nonsuicidal Self-iIjury: A Review of the Empirical Literature." Child and Adolescent Psychiatry and Mental Health, 2015.