Article | March 2018


Self-injury, or self-mutilation, is the practice of hurting oneself. People who self-harm do it to deal with emotional pain. It's most common among teens and young adults, though it can happen at any age. Self-injury is a serious problem, but it can be treated.

How do people self-harm?

There are several types of self-abusive and mutilating behaviors. They include cutting, burning, wound interference, and picking.

  • Cutting: Using a razor blade, knife, broken mirror, or piece of glass to cut the skin.
  • Burning: Putting cigarettes, hot metal, lighters, or lit matches to the skin and causing a burn.
  • Wound interference: Creating a wound and stopping it from healing by tearing, picking, or pushing on it.
  • Picking: Picking at the skin until a bleeding wound is created.

It's important to note that not all self-inflicted injuries are self-harm. If the main purpose of the behavior is for sexual pleasure, body decoration (piercing or tattooing), spiritual enlightenment through ritual, or fitting in or “being cool,” the behavior isn't considered self-harm. Many teens go through phases of this type of behavior.

People who self-harm aren't always easy to spot. They often become very skilled at hiding their behavior. They also have excuses ready when someone asks about their scars.

Why do people self-harm?

People who self-harm do it to bring their emotions back to normal. When they feel a strong, uncomfortable emotion, they don’t know how to handle it. But they know that hurting themselves will quickly reduce the discomfort. People who self-harm often feel they can’t express themselves. These feelings of stress, pain, fear, or anxiety remain inside and build up. They eventually result in self-mutilating behavior.

Self-injurers come from all walks of life and all economic backgrounds. It's common among teenage girls, but boys, men, and women are affected too. Cutting usually begins during puberty and lasts five to 10 years. But it can go on much longer if left untreated. Self-injurers need to learn healthier ways of managing intense feelings. If they don't, the behaviors will return.

How can I help?

Do you suspect that someone you love may be self-harming? Some commons signs include:

  • Unexplained or frequent injuries
  • Wearing long pants or long sleeves, even in warm weather
  • Wanting to be isolated or alone
  • Blood stains inside clothing

You might feel scared, embarrassed, or helpless. You might hope that the behavior is a phase that will pass. Or you may worry that if you talk about the behaviors, your loved one might get worse. But remember that self-harm is a cry for help. It needs to be addressed.

When you talk to your loved one, do it without judgment. People who self-harm aren't crazy or seeking attention. They don't know how to handle their emotions. Their behaviors are a sign of emotional pain. And they need to feel accepted and not judged in order to heal.

How is it treated?

Self-harming behaviors can be treated. The first step is to talk to a doctor or psychiatrist. Therapy can help people learn new coping strategies. Medication can help with difficult emotions. And there are several organizations that can provide more resources.

Self-harming behaviors won't disappear if they're left untreated. A Band-Aid may hide the cut on the outside, but it won’t heal the hurt on the inside. Professional care and intervention is necessary.

For more information on self-injury, contact:

1 (800) DON’T-CUT (800-366-8288)

SAFE Alternatives Program:

Please note that Cigna is not associated with these resources, and does not endorse or guarantee references or sites listed.

Sad black woman seated alone on a bench

Source: National Alliance on Mental Illness (NAMI). Self-harm

This material is provided by Cigna for informational/educational purposes only. It is not medical/clinical advice. Only a health care provider can make a diagnosis or recommend a treatment plan. For more information about your behavioral health benefits, you can call the member services or behavioral health telephone number listed on your health care ID card.