Are you struggling with self-harm in yourself or someone close to you? Find out when to seek help, what may be behind the problem, and how a psychologist can help you find a safer way forward.

Self-harm is the deliberate act of hurting one’s own body and is often a sign of severe psychological distress. It is often not about a wish to die, but about a way to bring temporary relief from unbearable emotions, inner tension, emptiness, anger, shame, or chaos. At the same time, it is important to remember that self-harm is not “just a bad habit,” and it can also be connected with a higher risk of suicidal behaviour, which is why it needs to be taken seriously.

What self-harm can mean

Self-harm can take different forms, but what is common is that a person turns to their own body at a moment when they no longer know how else to bear what is happening inside them. Sometimes it is an attempt to feel something, at other times an attempt to drown something out or get it under control. People who self-harm often describe that in that moment it is not a logical decision, but a desperate way of coping with psychological pain.

Why it happens

Self-harm is often driven by strong emotional pain, overload, anxiety, shame, feelings of failure, loneliness, or the need to regain at least some sense of control. For some people, it also appears as a reaction to trauma, inner emptiness, or intrusive thoughts. It is important to know that the reason may not always be clear at first sight, even to the person themselves.

How self-harm can show up

Sometimes people around the person notice the physical marks first. Other times, it is more about changes in behaviour. Common signs include becoming more withdrawn, feeling shame, hiding things, avoiding changing clothes in front of others, low mood, irritability, or strong self-criticism. For some people, isolation from loved ones, hopelessness, or major emotional swings also appear.

Why it can be so hard to stop

Self-harm can bring short-term relief, and that is exactly what makes it a dangerous coping mechanism. A person then experiences not only pain and shame, but also the fact that the body and mind begin to remember this route as a quick way of regulation. That is why the answer is usually not only the promise “I will not do it again,” but mainly the search for other ways to manage emotions and crisis.

When it is no longer only hidden suffering, but a condition that needs help

The situation deserves attention whenever self-harm is repeated, when the person is afraid they may not be able to stop themselves, or when thoughts of death, strong hopelessness, or loss of meaning are present as well. Help also makes sense even when the injuries seem “minor,” because they can still become infected and, above all, they show that the psychological burden is already exceeding ordinary coping.

When a psychologist or therapist can help

A psychologist or therapist can be very important when a person needs a safe space to talk at all about what they are going through and to gradually find other ways besides self-harm. Professional help is usually not focused only on the behaviour itself, but also on what is connected with it — for example anxiety, depression, trauma, strong self-criticism, or relationship and life difficulties. Assessment and treatment commonly rely on psychological and psychiatric evaluation followed by psychotherapy.

What usually helps

What helps most is not staying with it alone. It is very important to confide in someone safe, talk about what triggers the worst moments, and create a plan together for what to do in crisis moments instead of turning to self-harm. For some people, it also helps to notice what comes before the urge and to look for other ways of relief and emotional regulation.

When help is needed immediately

If the person is in immediate danger, has suicidal thoughts, feels unable to stay safe, or if the injuries are serious or need urgent treatment, it is important to act right away. In Czechia, in immediate danger, the appropriate emergency numbers are 155 or 112. For acute psychological help, the Line of First Psychological Aid is available for adults at 116 123, and the Safety Line for children and young people up to age 26 at 116 111; according to official Czech sources, these lines are available 24/7.

You are not alone in this

Self-harm does not mean that a person is “weak” or simply unable to cope. It usually means they are carrying something that has become too heavy in that moment. That is exactly why it makes sense to seek help as early as possible. A psychologist, therapist, or psychotherapy can be an important step so that pain, shame, and secrecy can gradually give way to greater safety, relief, and other ways of coping with what hurts.