Self Harm: Definitions and Distinctions
By Caroline Harroe (Harmless CEO)
Self harm, a complex and often misunderstood behaviour, refers to the act of deliberately causing harm to oneself physically. More often than not, this is associated with emotional or psychological distress. What it is not, however, is an attention-seeking behaviour or an attempt to manipulate others – a misconception often held in society.
When comparing the definitions used in the UK and the United States, the differences often lie in the extent and type of behaviour that is classified as self harm. In the UK, self harm is typically defined as any act of self-poisoning or self-injury, irrespective of the intent behind the action. In the US, the definition is narrower, often referring to non-suicidal self-injury (NSSI), which implies a clear distinction from suicide attempts.
These two perspectives significantly shape the understanding and treatment of self harm in the respective regions. The UK approach covers a broader range of behaviours, potentially leading to more comprehensive psychological assessments and interventions. On the other hand, the US approach focuses on non-suicidal self harm, emphasising treatment for the emotional distress rather than categorising the behaviour as a failed suicide attempt.
These categorisations impact societal attitudes, individual self-perceptions and therapeutic approaches. Acknowledging cultural and definitional variations is vital for an effective, empathetic approach to understanding and mitigating self harm. Through clarity of definition and public awareness, we can work toward destigmatising self harming behaviour and facilitating support for affected individuals.
Understanding the intent behind acts of self harm is an essential aspect of treatment. In the UK, where self harm is considered any act of self-poisoning or injury irrespective of motivational intent, this can pose challenges. The potential conflation of suicide attempts and non-suicidal self-injury (NSSI) — where intentions can vary greatly — can lead to inaccurate conclusions or treatments.
NSSI often serves coping functions, helping individuals to manage emotional distress or to feel something when numb. Such actions, while harmful and needing intervention, don’t necessarily signal a desire to end life. When the intent is to stay alive through self-management strategies, albeit harmful ones, treatment solutions ought to focus on healthier coping mechanisms, resilience building and emotional regulation.
In contrast, when self harm includes suicidal intentions, interventions may need more immediate crisis management and comprehensive mental health treatment, including suicide prevention strategies. Here, the focus lies on addressing the root causes leading to a desire to end one’s life.
Hence, an understanding of motivation behind self harm is crucial for distinguishing between NSSI and suicide attempts for prevention and intervention approaches. It’s also important for empathetic understanding, reducing stigmatisation, and improving policy-making.
For further reading, consider:
– Klonsky, E.D. (2009). The functions of self-injury in young adults who cut themselves: Clarifying the evidence for affect-regulation.
– O’Connor, R.C., Nock, M.K. (2014). The Psychology of suicidal behaviour.
– National Institute for Health and Care Excellence. (2011). Self-harm in over 8s: Long-term management.
