# Helping Give Away Psychological Science/Resources/Non Suicidal Self Injury

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This page brings together information and resources for dealing with non suicidal self harm. For information regarding suicidal behavior, visit our second page. This page was curated by Helping Give Away Psychological Science, a non-profit focused on dissemination and connecting people to resources from which they could greatly benefit.

## What is Non Suicidal Self Injury?
### Self-Injurious Thoughts and Behaviors

* Suicidal self-injurious thoughts (suicidal ideation): thoughts about killing oneself and can include making suicide plans
* Suicidal self-injurious behaviors (suicidal attempts): behaviors that are harmful to oneself and can lead to injury, in which a child or teen wants to die
* Non-suicidal self-injury (NSSI): injuries caused by oneself but a child or adolescent has no wish to die. The most common forms are skin cutting, burning, scratching, and banging/hitting oneself. These NSSIs are often used to make oneself feel better or to stop the feelings of sadness, anger, and anxiety

### Non-Suicidal Self Injury (NSSI)

NSSI is deliberate but excludes suicidal intent. It does not matter how it’s done but matters more with the intention the individual has when doing it. NSSI can mirror a suicidal gesture, which can scare and confuse others especially when others do not know what it truly means. This makes it important to assess the why of the injuries and the what. Cutting is the most common and most documented form of how people harm themselves, but there are more forms of self-injury than what has been found in research.

### How is NSSI Related to Suicide?

* People who exhibit NSSI are at higher risk for a suicide attempt
* About 10% who injured themselves in the last 4 weeks made a suicide attempt in the last year, and 60% had suicidal thoughts
* Don’t assume people who self harm are suicidal, the only way to know is to ask them directly
For more information visit: https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf

## Why People Engage in NSSI

NSSI is used to cope with negative emotions and self-critical thoughts. People may self-harm to distract or process negative feelings, to feel something physical, gain self-control over their lives, express emotions they are uncomfortable sharing. Some common reasons for self-harm include:
* To manage painful feelings (57%)
* To punish oneself (25%)
* To communicate with others (6%)
* Other (58%)

## Recognizing NSSI
### Common Types of Self-Injury

* Self harm is anything that an individual does to intentionally hurt themselves
** Common types of self injury include:
*** Cutting (41%)
*** Scratching (40%)
*** Hitting body on hard surface (37%)
*** Burning (15%)
*** Hitting, punching or slapping oneself (34%)
*** Biting (15%)
*** Others include: picking at wounds, piercing skin with sharp objects, pulling out hair
** More more information visit: https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf

### Symptoms to Look Out For
#### Physical Warning Signs

* Scars
* Fresh cuts, burns or bruises

#### Behavioral Warning Signs

* wearing long sleeves/pants in hot weather
* having sharp objects on them or hiding sharp objects
* emotional/behavioral instability
* impulsiveness

## How to Help Someone Who is Self-Injuring
### What to Do When Someone Self Harms

* If you have noticed signs of self harm some steps you can take to help
** Ask them how they are doing and be a good listener
** Don’t be uncomfortable talking about it
** Explain that you want to be there for them and help
** Don’t dismiss emotions or make jokes
** Gently encourage treatment
* For more information visit: https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm

#### How to Talk to Someone Self-Harming
##### What to Say

* Express concern and listen
* Give support and reassurance
* Encourage them to seek help

##### What NOT to Say

* Don't minimize the person's feelings or problems
* Don't try to solve the persons problems for them
* Don't accuse them of attention seeking
* Don't make them feel guilty
* Don’t set goals or pacts to entice them to stop
For more information visit: https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf

## Coping with NSSI
### Breaking the Habit of Self-Harming

* Identify why you are harming yourself
* Find other ways of expressing the emotion/having the physical sensation
** Such as through forms of exercise or writing/journaling
* Identify the underlying emotions driving you to self-harm
* Talk to someone you trust for support
* Seek professional help

### Therapy Options

* Dialectical Behavior Therapy
** Evidence-based treatment originally developed for suicidal, multi-problem adolescents. It includes 5 functions: Weekly multi-family skills, weekly individual DBT therapy, inter-session coaching via telephone/text, family therapy/parenting sessions, therapist consultation team
* Cognitive Behavioral Therapy (CBT)
** These are usually short-term treatments that focus on teaching youth and/or their parents specific skills.
** There’s different types of CBT including:
*** CBT with Parents
*** Group CBT
*** Individual CBT
*** CBT with Medication
*** Trauma-focused CBT
*** CBT paired with Motivational Enhancement Therapy (MET)
*** CBT Paired with Motivational Enhancement Treatment and Family-based Behavioral Treatment
* Integrated Family Therapy
** This is a form of treatment that views psychological problems and their treatment in terms of the interactions among family member
* Interpersonal Psychotherapy
** This is a short-term treatment that is effective in treating depression in children. It’s based on the idea that depression occurs in the context of an individual’s relationships, regardless of its origins in biology or genetics.
** Typically a 12-16 week treatment