Coping With Self-Harm Scars and Self-Injury

Learn how to heal from the physical and emotional effects of self-harm scars.

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Self-harm, or nonsuicidal self-injury, is when a person intentionally hurts themself, often as a way to cope with difficult emotions, memories, and situations. There are different forms of self-harm, but experts say some of the most common include cutting with a sharp object, hitting or banging your head, and burning.

“People self-harm for different reasons. Sometimes, when individuals are incredibly overwhelmed or upset, it can feel like they have no way to get the immense emotions out any other way, so they lash out toward themselves,” explains Alysson Thewes, MSW, LCSW, a Charlie Health Primary Therapist. “Sometimes, it can be to punish themselves, other times it can be because the pain feels good, and other times it is their way to let others know they need help,” says Thewes. Below, we discuss how to treat the physical and emotional effects of self-harm, as well as healthier ways to manage your feelings and emotions. 

Do all forms of self-harm leave scars?

Many forms of self-harm have the potential to leave a physical mark or visible scar. These behaviors include:

• Skin cutting, using a knife, razor blade, or other sharp object
• Putting objects into body openings
• Scratching your skin so hard that you draw blood
• Intentionally breaking your bones
• Punching yourself or objects
• Burning yourself 
• Pulling out your hair

There are also self-harm behaviors that are less obvious or easy to recognize or don’t leave a wound or raised scar. For example, reckless driving, binge drinking, and substance use can all be considered types of self-harm. There’s also something called digital self-harm, which is when someone anonymously posts hurtful content about themself online. For example, someone might create a fake Instagram account to leave insulting comments on their own posts.

In addition to physical scars, self-harm can also leave lasting mental and emotional wounds. For many people, it’s common to experience shame and guilt for intentionally harming themself. They may also be concerned about other people judging their behaviors, contributing to anxiety, depression, and feelings of worthlessness. 

Treatment options for self-harm & self-harm scars

Treating self-harm scars fundamentally includes treating the underlying causes of self-injury. But it can also be a chance to practice acceptance and coping skills. “Therapy can absolutely help people accept their self-harm scars,” says Thewes. “A therapist can be a huge help with talking through one’s challenges in the past, including understanding why the self-harm started. And, there can be peace found in this as well as just in telling one’s own story overall.” A few treatment options that are used to treat self-harm include: 

• Cognitive behavioral therapy (CBT) can help people understand the thoughts, emotions, and situations that trigger their self-harm behaviors and focus on more empowering alternatives.  
• Dialectical behavior therapy (DBT) shows people how to accept their past behaviors, as well as how to manage emotional pain and be more mindful of their self-harm urges moving forward.
• Group therapy is a chance to share your thoughts, emotions, and self-harm scars with others who face similar challenges and experiences. 

How to handle physical self-harm scars

Self-injury scars can be a difficult reminder of painful periods in your life. If you’re struggling with physical reminders of self-harm, like a visible scar, Thewes has some advice to help you navigate those feelings. 

To start, she encourages people to remind themselves how strong they are as individuals. “Self-harm is a coping mechanism, and it takes courage to move through it and develop healthier coping mechanisms. The scars don’t have to define who they are, but they can remind them of what they have been strong enough to move through,” she says.

Next, Thewes suggests people try “to be more comfortable with their scars at home, such as by not covering them up at home, allowing them to start to normalize seeing their own scars on a regular basis.”

From there, “I encourage individuals to come up with a small script that can be a go-to when the scars are exposed around family or in public,” says Thewes. “This script can be just two or three sentences that an individual is comfortable with saying that helps explain what their scars are when people noticeably look or ask about them.” Here are two example scripts:

• These marks are a part of my story, and I’m doing better now. It’s personal, but I appreciate your concern.
• You may have noticed my scars, so I want to be honest with you. There was a time when I was struggling with intense emotions and didn’t know how to cope. I’m now working hard to heal and process things in a healthier way.

How to cope with self-harm urges

It’s not always easy to end the cycle of self-harm. What starts off as a temporary solution for managing distressing situations and emotions can actually contribute to feelings of shame and guilt — which can continue the self-harm cycle. Next time you feel the urge to self-harm, consider an alternative coping method instead. 

1. The ice cube method

Hold two ice cubes in each hand and squeeze the ice cubes simultaneously for 5-7 seconds. Drop the ice cubes in a sink, wait for 10 seconds, then repeat. “Doing this for just a few rounds is often enough to provide that stinging feeling which can be the antidote to the urge to self-harm,” says Thewes. “By holding the ice cubes for only 5-7 seconds, we are not injuring our skin or causing a wound.”

2. The rubber band method

Put a rubber band on your wrist in the morning and wear it during your waking hours. Whenever you feel the urge to self-harm, snap the rubber band once, twice, or three times to ease the urge. 

Other coping strategies include:

• Physical activity, such as jogging, yoga, or dancing
• Positive affirmations, such as “I am strong enough to overcome this”
• Connecting with trusted family and friends for guidance and perspective 
• Journaling about your emotions, triggers, and personal growth goals

3. Create a self-harm safety plan

People with a history of self-harm may also benefit from creating a self-harm safety plan. This is a personalized resource that you can refer to when you’re struggling with difficult emotions or feel the urge to self-harm. An effective self-harm safety plan includes:

• Triggers and warning signs, meaning specific situations, sensations, and emotions that cause the urge to self-harm.
• Distraction techniques to help you resist the urge to self-harm. For example, exercise if you’re feeling angry or a hot bath if you’re feeling sad.
• Coping strategies for dealing with distressing emotions and situations in a healthy way.
• A list of people in your support network who you can lean on during tough moments.
• Emergency support resources, include the National Alliance on Mental Illness Helpline (Call 1-800-950-6264 or text “HelpLine” to 62640) and SAMHSA’s National Helpline (Call 1-800-662-4357).

Online therapy with Charlie Health

Self-harm isn’t a diagnosable mental health condition, but it is associated with underlying mental health conditions such as anxiety, trauma, and depression. If you or someone you know is showing signs of self-harm or emotional pain, consider professional support. 
At Charlie Health, our virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people dealing with serious mental illness, including self-harm and thoughts of suicide. Our expert clinicians incorporate a variety of evidence-based therapies into individual, group, and family sessions so that you can treat your emotional scars. Fill out the form below or give us a call to start healing today.