What Is Self-Harm
& How Can We Help?

When I penned the phrase, “a dashboard lighter primed for a brand” back in 2017 for Desiring God, I wasn’t imagining a creative way to illustrate self-harm urges for the sake of being dramatic. I was drawing upon personal experience–on an incident that really happened, a scar that really exists almost twenty years later.

While this sort of self-inflicted violence is taboo for many people, its skyrocketing allure, particularly among young people, should not be swept under the rug of Christian community. All around the country there are brothers and sisters in Christ who find themselves enslaved to the dirges that self-injury rituals strum. Spend any amount of time talking to someone who struggles in this way, and you’ll discover just how difficult it can be to lay the weapon down.

I would like to offer this article as a resource for those who are caring for someone who self-harms. This may mean a child who has taken up the behavior, or perhaps a spouse who dabbles in it from time to time when circumstances spin out of control. Whoever you may be ministering to–friend or family–I’d like to offer a high-level overview to shed some light on an increasingly prevalent mental health topic.
You’ve been here before, haven’t you? The swoon of an edge meant to flay? The pin in the wall, the staple in the gun, the dashboard lighter primed for a brand? When control escapes you and thoughts berate you, where else does the fury go but here? But nobody really understands.
What is Self-Harm?
Self-injury, self-harm, self-mutilation, self-abuse, and self-inflicted violence are some of the most common terms used to describe a person who intentionally injures their body. Most familiar in today’s culture is the term, “cutting,” in which someone uses a sharp object to slice into skin with the goal of finding temporary physical relief from overwhelming mental burdens. However, as I mentioned, self-injury can take other forms as well, such as picking at skin to the point of bleeding, banging body parts against walls, burning oneself, and punching one’s body. In fact, you can even place eating disorders and excessive drug/alcohol use under the umbrella of self-injury.
Why Do People Do It?
Self-injury is not a disease. It is a coping mechanism which quickly morphs into an addictive behavior pattern, where the struggler becomes reliant upon the physiological effects of bodily pain to manage the psychological demands of an emotional problem. This means that when someone self-injures, they come to expect that their body will release a chemical response to the pain that is inflicted. This chemical response temporarily offers a inner “release” of the emotional tension, and therefore makes the overwhelming wave of emotions more manageable. Imagine a balloon being inflated to the point of almost bursting: this is what the struggler's emotional pressure feels like leading up to the point of the injury. To release the pressure, they harm themselves, popping the balloon so that all of the air pressure is quickly lost.

On the topic, Ed Welch writes,
“These strategies substitute a lesser pain for a greater pain, a physical pain for a psychological pain. And if cutting and burning are a lesser pain, then the greater pain must be great indeed. One woman would hit herself in the face as a way to focus her mind so she would not be haunted by past shame.”
Someone may self-injure as a way of coping with internalized anger. At times, it can be a way of managing shame. Certain people will self-injure when they feel like they are not being listened to. Guilt from the past can motivate someone to punish themselves. Teenagers may sneak off to the school bathroom to cut as a response to feeling rejected by their peers. Those who have found their lives spinning out of control will self-injure as an attempt to regain control. These are just a few of the ways humans have turned to self-injury as a means of responding to emotional duress.

Self-injury is very much an addiction, which is why it takes so long to recover from. It's a behavior that must be unlearned over time and with practice–usually not without setbacks. In the battle against the urges of self-harm, the blood lust runs overwhelmingly rampant. It is not simply something people “quit doing.” Fighting for freedom from self-injury is a long, drawn-out journey, requiring the complete reprogramming of the way the struggler approaches emotional pain.
Yes, you know this dark passenger well — a hidden thorn in the flesh, buried deep in your loneliness. Locked away in your anger, he lies dormant until the ground starts to quake. In duress, the parasitic passenger rouses himself to destroy his suffering host. He stands tall to hiss wicked taunts. “But there’s no other way you can cope.” So, you pull out the sharp blade, or light up the coils, or glance at the smooth razor’s edge.
Is Self-Harm Suicidal?
Despite how it might appear, self-harm is not typically motivated by suicidal ideations. That’s not to say the person who struggles does not also have thoughts of suicide, but just that the driving factor to harm oneself is not to kill oneself in most instances. If you find yourself ministering to someone who is self-injuring, you might ask if they are also experiencing thoughts of taking their own life. I would not be surprised to hear an emphatic “No!” come as a result, but that isn’t to say everyone would respond like that. It is certainly prudent and compassionate to ask the struggler if they are having thoughts of suicide or hopelessness, if nothing more than to simply rule it out or to better diagnose what life circumstances may be contributing to their fragile emotional state. 
How Do We Respond to This Problem?
A common knee-jerk reaction is to tell people to just “stop it!” or “don’t do that!” It can be tempting to try and discipline it out of someone. However, like any other addictive behavior, legalistic or moralistic approaches will fall flat in offering a path towards meaningful recovery.

It is understandable that caregivers would feel helpless in approaching such a violent struggle, but I would argue that the obvious signs of self-harm (such as cuts on the forearm, for example) are only soured fruits of diseased roots. To properly address the problem, you need to pull up the rotting roots. When we see the effects that self-harm has taken on our loved ones, we need to train ourselves to look past the bodily wounds and pry into the hurt in their hearts. There is something bubbling under the surface that needs urgent attention. There is an issue that has become so entirely overwhelming that the struggler feels boxed into a corner, believing that mutilation is the only way to make it through the day.

Don't let the blood or the bruises or the lumps of self-harm distract you. Something else is going on in the struggler’s heart, an issue which must be gracefully invited into the light. If we find ourselves stuck trying to regulate injuries while completely ignoring the spiritual lacerations of the heart, we will fail to guide our loved ones to God's transforming grace for change.

So, we respond with thoughtful concern over what has been done to the body. We see the harm as an external expression of an internal pain. We take a moment and pray to God to give us a tender heart for the broken person we are about the care for. Assume they are emotionally unstable. Assume they already know they should not have done what they did. Assume that they already have a voice of self-condemnation chipping away at their identity in Christ. Assume this person is a leaf driven to and fro (Job 13:25), needing someone to love them anyways.

Assume that position. Then come ready to listen, to ask good questions gently, and to offer a helping hand. 
Jesus invites you to put down your weapons of self-inflicted vandalism. He sees the scars on your skin and the darkness in your heart, and still he calls you by name. The love you crave in the carve, he lavishes freely. The acceptance you desire through the cut, he gives without cost. In Christ, you’re not weighed and found wanting, but loved and made righteous by a blood that is not your own.
What Can We Do to Help?
There are a variety of good things you can do to begin walking a struggler through recovery. First, I’d like to offer you a free download of my “Jump Start Checklist.” Though it is oriented towards depression recovery, the main points (and even the recommended reading/audios) still apply. You may discover your loved one has been walking through a season of depression and only now is it coming to the light. This checklist will offer some clarity either way, so please do take advantage of it.

Besides the items I outline in the checklist, be prepared to play an active and prolonged role in the struggler’s recovery. This will mean long conversations and an abundance of ministry opportunities. This struggle may even be an opportunity for evangelism, when the timing is right. It's extremely important to communicate to strugglers these sinful temptations are common to man (1 Corinthians 10:13). They are not walking through something abnormal. Violent and bizarre? Yes. Uncommon to man? No.

As we help our loved ones explore the underlying issues fueling their unhealthy coping mechanisms, we need to remind ourselves that we are ambassadors of Christ preaching the message of the gospel of reconciliation (2 Corinthians 5:20). I demonstrate how one could approach encouraging a struggler through the Scriptures in my Desiring God article, Lay Your Weapon Down: An Invitation to Cutters. Consider taking the Scripture references from this article and using them as a bible study, carefully going over each of the verses, helping the struggler to apply it to their own lives. The key here: Jesus invites them to experience a greater, more permanent relief; a greater, more sufficient spilled blood; a greater, more satisfying desire; a greater, more intoxicating love. 

Beware of contributing to the strugglers sense of guilt. Ed Welch makes the following observations:
Every experienced counselor, secular or Christian, knows that change will not take place under a load of guilt and condemnation…Guilt and change cannot exist. Guilt will stifle any attempt at self-reformation.
He goes on to describe the importance of adopting a “grace-based” model to addiction recovery: “Its emphasis is not so much on our sin as it is on the grace that comes from God through faith. (Eph. 2:8) Our knowledge of our own sin is intended to point us to the redemptive grace we can receive through Jesus Christ.”

I have linked to some Christ-centered resources on the topic of self-harm below. While this article is simply an overview of the issue, the links provided refer you to additional places to turn to for reliable equipping.

Though the command to not make cuts on our bodies is only referenced a few times in the Bible (Leviticus 19:28, Deuteronomy 14:1), the Scriptures speak volumes to the common underlying issues that strugglers need help addressing, such as fear, anger, shame, guilt, loneliness, isolation, broken relationships, injustice/abuse, idolatry, repentance, spiritual amnesia, etc. Remember, pay mind to the roots of the problem, not just the visible fruits of it. A "you shouldn't do that, the Bible says so," approach, while not untrue, is not the way God instructs us to help people in their weakness (Galatians 6:1):

"Don't you see how wonderfully kind, tolerant, and patient God is with you? Does this mean nothing to you? Can't you see that his kindness is intended to turn you from your sin?" (Romans 2:4 NLV)

Kindness. The kindness of God. The kindness of God's patience. The kindness of God's patience, that while we were still sinners, Christ died for us (Romans 5:8). The kindness of God's patience, that while we were still sinners, Christ died for us, and we have been justified by his blood, not our own (Romans 5:9). And this kindness is intended to motivate us to turn from our sin. The road to recovery from self-harm must travel through Calvary, where a true and better blood was spilled for our peace.

It will also take a village of Christian community to help sort through the struggler’s needs: from accountability, to counseling, to preaching, to others-oriented service opportunities. We must recognize this process will take time. On occasion, the struggler may relapse. But there is freedom to be experienced from this dreadful bloody battle–the faded scars on my hand and the gaping holes of His hands are proof.
You will never find healing in wounds you inflict upon yourself. They promise remedy, but instead bleed the life from your veins. The devil’s bloodlust will forever demand more and deeper from you. The tender hands of Jesus pull us toward himself, that we would lay down our weapon of choice and find ourselves satisfied by belonging to him.

Peace through the blood of his wounds, not yours.
Christine M. Chappell
Christine Chappell is the author of Clean Home, Messy Heart, and is a guest contributor at Desiring God. She writes frequently about mental health topics at her blog, has completed biblical counseling certificates with the Institute for Biblical Counseling & Discipleship, and is currently pursuing certification with the Association of Certified Biblical Counselors.
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