Self-injury involves behavior intended to cause harm to one’s own body. Methods of self-injury include cutting or burning the skin, head-banging, hair-pulling (trichotillomania), ingesting poison and even breaking bones.

Although self-injurers can cause serious physical harm to their bodies, they often are not trying to kill themselves. Self-injury differs from suicide or suicidal ideation because the self-injurer does not wish to die. Instead, self-injury is performed in order to relieve emotional distress. For self-injurers, hurting themselves may become a method of coping with stress – an effort to turn internal emotional pain into an external sensation.

About 2 million people deliberately injure themselves each year in the United States, according to the National Mental Health Association (NMHA). However, this number may be even greater because many self-injurers do not seek help for their condition. Most are teenagers and young adults, and women self-injure more often than men. Although self-injury affects people of all races and backgrounds, it appears to be more common in individuals in the middle to upper class who are of average to high intelligence and who have low self-esteem. Most have difficulty expressing negative emotions, such as anger or sadness. Self-injury can easily turn into a self-destructive pattern, since those who have injured themselves in the past are more likely to do so again.

Self-injury can occur anywhere on the body, depending on the method used. For example, cutting and burning are usually done on the front of the torso, arms and legs. Punching usually involves injury to the head and thighs, and head-banging involves the skull. Biting can occur on the lips, nails or elsewhere. Drinking harmful fluids such as detergent or bleach can affect a number of internal organs.

Although not intended to cause death, self-injury can sometimes result in fatality. An inability to stop the behavior can lead self-injurers to make actual suicide attempts. Also, self-injurers may accidentally kill themselves due to medical complications as a result of the behavior or if they are unable to control the extent of the injury.