Self-Harming Behavior (SH)

Trigger Warning

This page deals with self-harming behavior. The following content may be distressing. Please take care of yourself and your limits. If you are in an acute crisis, please immediately contact the crisis helpline or emergency services.

What Is Self-Harming Behavior?

Self-damaging or self-harming behavior (SH) can take many forms, particularly in the borderline personality. The behaviors often become particularly pronounced after sexual abuse or rape. SH actions frequently have a self-punishing character.

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Forms of Self-Harming Behavior

Risk-Taking Behavior

• Reckless driving with cars, motorcycles, mopeds
• Deliberately putting oneself in dangerous situations
• Provoking others with the knowledge of getting into “trouble”
• Provoking arguments or relationship breakups within the relationship
• Getting involved in abusive relationships

Direct Self-Harm

Note

The following list serves exclusively for information and understanding. It is not intended as instructions.

Common forms include:

• Pulling out nails (inner pressure release)
• Pulling out or cutting hair
• Banging head against walls or hard objects
• Scratching until the skin bleeds, cutting or slashing
• Burning with cigarettes
• Lying in ice-cold or scalding water
• Alcohol, medication, drug abuse

Functions of Self-Harming Behavior

SH serves various functions for affected persons:

Function	Explanation
Pressure release	Release of inner, unbearable pressure
Self-punishment	As punishment for perceived wrongdoing
Feeling oneself	Return to the “here and now” during dissociation
Pain substitute	Physical pain substitutes for emotional pain

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Neurobiological Explanation

The Pain Center in the Brain

A specific area in the anterior, upper third of the limbic system in direct connection with the cerebral cortex registers every physical and emotional pain. This “pain center” is activated with every pain - regardless of whether it is of somatic (physical) or emotional origin.

Scientific Findings

Studies show that any rejection of one’s own person - or even just the feeling of rejection - activates precisely this pain center. In people with borderline, the neurons in the pain area often fire many times more intensely than in other people.

Why SH “Works”

People with borderline disorder suffer enormous inner (emotional) pain that cannot be absorbed by the fragmented ego. A physical pain at another location can temporarily “overlay” the original pain.

SH creates a counterbalance to emotional pain - energy is diverted from the neuronal firing in the pain center and the brain is given a “definition” of the pain.

Addiction Potential

Important

Self-harming behavior can become an addiction. Endogenous substances such as endorphins act on the reward system, causing increased release of dopamine and norepinephrine. Through this synaptic learning process, more and more must be done - as with any addiction - to achieve the same result.

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Suicidal Behavior

Suicidal behavior is a constant companion of borderline disorder. Approximately 75% of affected persons have one or more suicide attempts behind them.

Important Distinction

The smallest proportion of affected persons makes a suicide attempt with the intention of actually ending their life. As a rule, it is a cry for help or - in the relationship - an emotional blackmail instrument. In some cases, however, this attempt ends fatally “unintentionally.”

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For Relatives and Partners

For partners, self-harming behavior is often difficult to understand. Important to know:

• You cannot prevent it as long as the affected person is not in therapy
• In such moments, the affected person cannot see their environment and does not want to see it either
• This has nothing to do with their “love” for you, but with splitting
• It is difficult to distinguish whether it is manipulation or genuine desperation

Effects on Partners

Partners who experience suicide attempts or find the affected person often suffer severe consequences themselves: depression, post-traumatic stress disorder, anxiety, substance abuse. The guilt feelings are enormous - some break under them.

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An Appeal to Those Affected

Think of the People Who Love You

Try in such moments to think of the people who love you - and who might break under your suicide.

By taking away your own pain, you inflict it on others. Fight for a life. Death is not your deliverance, but life is. Take the difficult path and you will prevail. At the end of the road, the sun will shine for you too.

Only wanting and doing it is something YOU must do.

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Support Services - Immediately Available

Telefonseelsorge Germany

Protestant: 0800 111 0 111 Catholic: 0800 111 0 222 Free and anonymous, available 24/7

Emergency

112 In case of acute danger to life

Telefonseelsorge Switzerland

Die Dargebotene Hand: 143 Free and anonymous, available 24/7

Telefonseelsorge Austria

Telefonseelsorge: 142 Free and anonymous, available 24/7

Further Support Services

Service	Contact	For Whom
Nummer gegen Kummer	116 111	Children and adolescents (DE)
Elterntelefon (Parent Helpline)	0800 111 0 550	Parents (DE)
Online Counseling	online.telefonseelsorge.de	Everyone
Psychiatric Emergency Service	Via 112 or local number	Acute crises

You Are Not Alone

There are people who want to and can help you. The first step is to seek help. That is not a sign of weakness, but of strength.