Self-harm or nonsuicidal self-injury isn’t a mental disorder, but rather refers to deliberate actions a person takes to harm themselves, such as cutting, burning, or other self-injurious behavior. It is most common during adolescence and young adulthood and appears to occur at elevated rates in LGBTQ youth. According to The Trevor Project's National Survey on LGBTQ Youth Mental Health 2020, 48% of LGBTQ youth (ages 13–24) in the US reported engaging in self-harm in the past 12 months, including over 60% of transgender and nonbinary youth.

There is no single reason why people intentionally hurt themselves. The current version of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5—a reference commonly used by mental health professionals in the US—lists nonsuicidal self-injury as a condition in need of further study.

Still, there are some identified risk factors, including:

While self-injury is not necessarily a predictor of suicide or suicidal behavior, it is a concerning expression of emotional distress that should be taken seriously and engaged in treatment by mental health professionals.

If you have injured yourself severely or in a life-threatening manner, call 911 or your local emergency number immediately.

If you are in crisis or having suicidal thoughts, call the National Suicide Prevention Lifeline at 800.273.8255 for 24/7 free, confidential emotional support, or use their webchat.

At the Austen Riggs Center, we have successfully helped many patients find alternatives to self-harm and self-injury. In fact, we are known as the place “where treatment-resistant patients become people taking charge of their lives.”

Self-harm and self-injury symptoms, like many mental illnesses, arise from a complex and highly personal interplay of biology, social stress, and psychological factors. At Riggs, the whole person is the focus of the treatment, not simply discrete symptoms. We work with you as a person with your own unique life story and your own problems and strengths. With self-harm and self-injury symptoms, we work with you to translate what the behavior means to you and what you may be communicating through your actions into words that bring to life and better communicate feelings and thoughts that you may not have been aware of, but that you may have been communicating through these actions.

Our treatment approach centers on intensive psychodynamic psychotherapy four times a week with a doctoral-level therapist, exploring your lived experiences to identify patterns and the potential impact of losses or other adverse experiences that may be outside your awareness but that influence your decision making. Through this deeper self-understanding, you can be freer to make better choices.

To augment regular psychotherapy sessions, medication usually is part of your treatment at Riggs. We have been trailblazers in developing what we call psychodynamic psychopharmacology, a way of using medications for their biochemical benefit, while also carefully attending to the impact of their meanings to the patient and to the doctor.

Family is often part of the social context in which self-harm and self-injury, or other symptoms, may emerge. So an important part of every treatment at Riggs is family evaluation—with family treatment offered when indicated.

In addition to therapy and medications, our open setting with its Therapeutic Community Program mobilizes the powerful potential impact of social learning from interactions with peers—a profound opportunity to learn about things we do that we cannot see but that others can help us see and address.

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