Physical pain releases the endorphin dopamine within the brain. Once deliberate injury and relief have become associated, it can be difficult for those who self-harm to stop. Using the addiction model, self-harm function similarly to the negative reinforcement in that it masks emotional pain. 

Addiction Model of Self-Harm

Higher psychological and physical abuse during confinement due to COVID-19 isolation have resulted in increased self-harm and suicidal ideation in people in the UK. This study surveyed people in the UK (n=44775) and observed higher thoughts of suicide and self-harm in women, black, asian and minority ethnic groups, people experiencing socioeconomic disadvantages. 9% of participants in this study reported experiencing physical or psychological abuse, and 18% reported experiencing thoughts of self-harm or suicide.

Abuse, self-harm and suicidal ideation in
the UK during the COVID-19 pandemic

- Conditions that cause fluctuations in emotion, like depression and anxiety, can lead sufferers to search for release. 
- Those who self-harm have reported that while they do not want to do it, it is accessible and provides some measure of relief. 
- Shame, low self-esteem, and other sources of emotional pain can lead to the desire to inflict personal harm.
- Some may use self-harm to communicate the severity of their pain and express a need for help

Grand Valley State University

The act of purposely inflicting pain and damage to one’s body. Methods include cutting, burning, scratching, and other means of self-injury. Self-harm can also be emotional or internal, which may involve acts like deliberately triggering oneself or consuming toxic substances.

Self-Harm

Woodley, S., Hodge, S., Jones, K., & Holding, A. (2020). How Individuals Who Self-Harm Manage Their Own Risk—‘I Cope Because I Self-Harm, and I Can Cope with my Self-Harm’. Psychological Reports. https://doi.org/10.1177/0033294120945178

How individuals who self-harm manage their own risk—‘I cope because I self-harm, and I can cope with my self-harm’

Reasons and Causes for Self-Harm

- Younger adults
- Women
- Black, Asian, Minority Ethnic groups (BAME groups)
- People experiencing economic hardship
- People with disabilities, chronic physical illnesses and mental disorders

Higher risk groups for self-harm and suicidal ideation 

Contrary to popular belief, self-harm does not always indicate active suicidality. Instead, many who engage in self-harm cite it as a coping mechanism that helps them continue to live despite deep emotional pain and adversity. While some injuries could be lethal, those who self-harm often mitigate their own risk by planning their injuries, sterilizing the instruments they use, and practicing after-care. 

Non-Suicidal Self-Harm

Ultimately, it is the individual's response to the high risk situation that affects whether or not they will relapse. For example, a person who uses effective coping skills, such as leaving the situation or positive self talk, is less likely to relapse than someone who does not use effective coping skills. A person who has coped successfully with a high-risk situation will experience a greater sense of self-efficacy, thereby decreasing their chance of relapse in the future.

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