What Is Emotional Self-Harm and What Does It Look Like?

Self-harm is a term used to describe behaviors that cause intentional self-injury. It includes suicide attempts, nonsuicidal self-injury (NSSI) like scratching or cutting, and physiological self-injury.

Emotional self-harm occurs when you use your thoughts and behaviors to cause an emotional distress response.

What’s the difference between emotional self-harm and physical self-harm?

Emotional self-harm involves intentional emotional distress. It can occur in the form of physical actions, like substance abuse, but it isn’t the same as physical self-harm.

Physical self-harm, also known as NSSI, is any deliberate physical injury to yourself that doesn’t involve the intention of dying. It’s often used as a form of external release for psychological distress.

Research suggests emotional self-harm often precedes NSSI, and you can experience both simultaneously.

Emotional self-harm can mean something different for everyone. In general, it includes:

Self-destructive behaviors

Ann Robinson, a licensed clinical social worker and trauma specialist from Fort Collins, Colorado, explains, “This is when we repeatedly engage in behaviors that we anticipate will be hurtful.”

Examples of self-destructive behaviors include:

• staying in abusive situations
• substance misuse
• social withdrawal
• unprotected sexual behaviors
• dangerous driving
• illegal activities
• fighting

“These experiences impact the way that we see our self-worth, our self-talk, and our self-esteem,” Robinson says.

Negative self-talk

Negative self-talk as emotional self-harm is more than just a passing internal comment when you’ve made an error. Negative self-talk becomes emotional self-harm when it’s used to discipline yourself for perceived flaws or mistakes.

Katherine Chan, a licensed marriage and family therapist from Los Angeles, says it includes “yelling at yourself in anger, calling yourself names (like loser or worthless), and regular ridiculing.”

Self-restriction

Self-punishment doesn’t have to come only in the form of negative talk. It can also include restricting your personal needs, like not allowing yourself sleep or food until a certain condition is met.

Cognitive distortions

Cognitive distortions, also known as cognitive errors, are thought patterns that create a distorted reality about how you see yourself and how you believe others see you.

Many types of cognitive distortions exist, including:

• jumping to conclusions
• catastrophizing
• comparison
• black-and-white thinking
• disqualifying the positive
• emotional reasoning
• externalizing self-worth
• making assumptions
• labeling
• magnification
• mind reading
• minimization
• overgeneralization
• perfectionism
• selective abstraction
• “should” statements

In emotional self-harm, for example, Rachel Montoni, a psychologist from New York City explains catastrophizing means always assuming or believe the worst-case scenario will happen.

Another example is in black-and-white thinking, which can lead to negative-thought extremes, she says, such as “I always fail” or “I’m never going to win” statements.

There’s no singular reason why you might engage in emotional self-harm.

Chan explains it can come from skewed perspectives on self-worth and also from the absence of positive skills for processing emotions.

Factors that may contribute include:

• trauma
• childhood neglect or abuse
• bullying
• low self-esteem
• witnessing emotional self-harm in a caregiver
• insecure attachment style
• mental health disorders

Emotional self-harm and depression

Cognitive distortions are prominent features in certain mental health disorders, like depression.

Rebecca Capps, a licensed marriage and family therapist from Santa Barbara, California, explains, “Emotional self-harm and depression are often closely linked, as emotional self-harm can be both a symptom and a cause of depression.”

She adds that when you engage in emotional self-harm, you’re reinforcing negative thoughts patterns that can contribute to depression. On the flip side, living with depression can make you more likely to experience those negative feelings.

Feelings of worthlessness and inappropriate guilt are core diagnostic features of major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition, text revision (DSM-5-TR).

You don’t have to live with emotional self-harm. Small steps can help you change your inner dialogue.

Practicing self-compassion

Self-compassion is the opposite of emotional self-harm. It’s the practice of self-forgiveness and acceptance, and showing yourself the same compassion you would a loved one.

Chan says, “When you feel badly about yourself, take a moment to think about how you would feel toward a friend if they were in your shoes. Would you berate them for being stupid and worthless? Probably not.”

Encouraging accomplishment

Spending time doing things you’re good at can help you feel valuable and effective, says Robinson. This can mean anything from hobbies, like drawing, to mundane everyday tasks like organization.

You can also achieve the same sense of accomplishment by participating in meaningful activities like volunteer work.

Being aware of emotional self-harm

Chan says changing emotional self-harm starts by being able to recognize it. She recommends using a mindfulness practice called “RAIN:”

• Recognize you’re feeling something.
• Allow yourself to experience it.
• Investigate where the feeling is in your body.
• Nurture yourself in some way, like pressing your hand over your heart.

Treating emotional self-harm depends on the underlying causes.

“A combination of evidence-based psychotherapy treatment such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), or dialectical behavior therapy (DBT), as well as considering options for psychotropic medication are considered best practice,” says Montoni.

These therapies can help you identify emotional self-harm, restructuring those feelings into beneficial thought patterns.

When emotional self-harm stems from a lack of connection or repression of feelings, Chan says internal family systems therapy, somatic experiencing, and eye movement desensitization and reprocessing (EMDR) therapy may help.

In some cases, antidepressants or anti-anxiety medications can help relieve mood symptoms accompanying emotional self-harm.

Causing yourself intentional emotional distress is emotional self-harm. It can come in the form of harmful behaviors, self-criticism, and skewed self-perception.

However, you can change emotional self-harm behaviors. Psychotherapy can help identify underlying causes. It can teach you to recognize unhelpful thought patterns and how to shift them to beneficial ones.