Non Suicidal Self Injury, Self Mutilation, Self Injury and Cutting – Part 2

This week’s guest blog is posted by Naghma Khan, a Clinical & Addictions Psychologist in India, she writes the blog:


The million dollar question you might ask is “Who am I & what am I doing writing this blog?” I am a clinical psychologist with a purpose. When I decided to study psychology, it was also due to the fact that my country has only two respected professions, Medicine or Engineering. In a way, my folks were disappointed by my choice. At that young age I didn’t care much about the opinions of others, I had a fire inside me and I believed I could change the world. I started studying psychology with zeal and had an amazing time learning the science of behavior. I completed my Masters in Clinical Psychology and then attained a certification from Rehabilitation Council of India for practicing Psychology. I finally became a psychologist but thought nobody was taking me seriously. I started with a special school where I was supposed to just “take care” of the clients. The frustrations started building up; I had to do something else. I found a job in a renowned hospital as a consulting psychologist. This was the job where I learned the basics of counseling. I then joined an addiction center and bingo; I found the field I have a passion for.


Lorraine emphasizes, “I work with young people (11-19) who self harm and I hear that young people say self harming helps alleviate the internal pressure that builds up around issues they struggle to deal with. My experience here in England is that young people do talk to peers but issues relating to family, peers or educational expectations can far exceed their ability to cope. Unfortunately this can and has led to suicide. Generally though self harming is used as a coping mechanism, I find that once we establish a non-judgmental, caring, safe and therapeutic environment young people can move forward.”


Some people develop NSSI through observational learning; they learn it from somebody else or through the media. The chances of most people actually seeing another person self-injure are very slim, but in places such as psychiatric hospitals and prisons the odds are much higher. Since self-injury has become a part of the vernacular, part of society’s everyday knowledge, the incidence of NSSI, especially amongst teens, has exploded. Once a self-injurer may have been alone in their social group, it is now common for teenagers to have friends who actively self-injure or have self-injured in the past.


Diane Sue, PhD. shares, “I have found that many of those who persistently self-injure have underlying conditions, especially depression, anxiety and sometimes PTSD. Often there are few adults in their lives they can turn to for support.”


My research and experience has made me realize one thing that NSSI is not limited to any age group or gender. The experience of NSSI varies in different individuals. Chris White, Ed.D. says, “Interestingly, I have observed a major change in who is engaging in this behavior over the past few years. For most of the 27 years I have been practicing, cutters were almost always women who had experienced fairly severe physical or sexual abuse as children and had begun cutting in their 20′s or 30′s. Now, I am seeing much younger girls, as well as some boys/young men, begin cutting in their early teens or even pre-adolescence, who do not have histories of trauma! Some even talk of having “cutter clubs” in their high schools where kids trade “tips” around this behavior.”


Basically the purpose is not killing or hurting oneself but it is due to lack of healthy strategies to deal with your pain. I researched and asked a lot of professionals from this field for help. From the studies and contributions from people working in this field I have compiled some strategies for people involved with NSSI:

  1. You need to find a healthy vent for your pain & problems. It is fine to find strength from within you, but it’s destructive to accumulate the pain you are going through internally. There is a critical difference here, which we need to understand; being a person who is not talkative is amazing if you are happy with it, but if you are going through a phase where you need help, you need to gather the courage to seek it.
  2. Young people need to understand the difference between positive & negative peer pressure. Just because someone we consider as our style icon is doing a certain thing, it is not necessary that we should follow them blindly. Sometimes it starts as a cool thing but stays with you forever, mutilating yourself becomes a habit which moves beyond your control. The origin of self-injury is often difficult to determine or understand. Many people are unable to remember where they first got the idea of hurting themselves, when they actually began to self-injure.
  3. If you know someone or are a caretaker of a person going through this syndrome, you need to establish a non judgmental & caring atmosphere.  You need to be very vigilant for the early signs of injury. Ask questions and seek answers. People who self-injure usually begin by cutting themselves with a knife, razor blade, or other sharp object. From there the person tries other forms of self-injury, such as burning, hitting, etc., until they find their preferred method. Bring in a person, a counselor, doctor or therapist that can help. The best way you can help a person going through NSSI is connecting him to a therapist. You need an expert here because often there is a lot of underlying reason behind the NSSI behavior.
  4. Allow and teach the expression of emotions in a healthy way. Don’t bottle emotions up inside. Often it is fear or the disturbing emotions around expressing the fear which leads to the self damaging path. Sometimes you also learn unhealthy ways of showing your emotions, through drugs, alcohol, sexually acting out, kleptomania, or anorexia. Seek proper care if you are involved in any addiction, by joining a support group.
  5. Don’t be scared of changes in your life. Change is growth, though it is feared by most, as it is“the unknown”. Most cases of NSSI are reported or observed in people aged 11-25. It could be due the fact that in this phase of your life you go through a lot of changes.The best way to deal with it to be aware and ready for the new.
  6. Feel the pain: Running away from your pain is never the solution.  NSSI is a short lived relief. You need to live your feelings. There is a therapeutic catchphrase on pain: Feel the pain, live the pain and relieve the pain.Repeating this mantra could help you with this step.


Do accept that there is no shame in what you are doing. It is quite understandable that until now NSSI was the only coping skill you had, but now you realize that it is not a healthy one. Deal with your feeling of shame and seek help.

For a primary self check, examine your thoughts by asking yourself direct questions like:


“What did you intend to accomplish through ___________?”

“What was the point to __________?”

“How did you expect people to react?”

“What did you expect to happen if you didn’t do it?”.

I would like to compare NSSI to an addiction to a depressant. You start with a feeling of euphoria, which fades away leaving you more depressed. You chase the “first time high”, sadly that is unattainable.


In the end I want to say that there are more ways of coping, you just need to look for it!

Related articles:

    Feel the Pain (

    Pain: Your Take (

    March 1st is International Self Injury Awareness Day (

Written by Naghma Khan, a Clinical & Addictions Psychologist in India, she owns and writes the blog:

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One Response to Non Suicidal Self Injury, Self Mutilation, Self Injury and Cutting – Part 2

  1. Barbara Reidhaar Mc Carthy says:

    Unfortunately, I recognized myself as a self-mutilator while reading these articles…I pick at scabs, so I guess that qualifies me . I’m bi-polar, with PTSD, diagnosed in 1995. Thanks for the article; it gives me another topic for discussion the next time I see the shrink! if you ever get some time, give me a call … I’d love to hear from you! Thanks – Barb

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