Trauma & Self-Harm: Why They Coincide

September Trent, MS, LPC

Trauma & Self-Harm: Why They Coincide

Trauma and self-harm behaviors are not always present together.  Yet, it is helpful to understand why self-harm behaviors are present with so many individuals who identify with experiencing a traumatic event.

In This Article

  1. Self-Harm As A Coping Mechanism
  2. References

About the Author

This article is based on scientific evidence and clinical experience, written by a licensed professional and fact-checked by experts.

September Trent MS, LPC is a licensed professional counselor specializing in eating disorders, self-harm, anxiety, and depression treatment. You can schedule an appointment with September for online counseling or in-person at our Springfield, Missouri counseling center.

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Trauma & Self-Harm: Why They Coincide

Often after a person experiences a traumatic event such as abuse or threatened death, self destructive behaviors or self-harm develops as well.  It is important to note this is not always the case.  Trauma and self-harm behaviors are not always present together.  Yet, it is helpful to understand why self-harm behaviors are present with so many individuals who identify with experiencing a traumatic event.

First, it is important to understand and define what is meant by traumatic event.  Diane Langberg, who has over 30 years experience working with survivors of sexual abuse, defines a traumatic event as “involved actual or threatened death or injury, during which you experience pain, horror, and helplessness” (1999, p. 52).    It is also interesting to note that trauma comes from the Greek word for wound (Langberg, 1999, p. 53).  Self-harm behaviors are often used to cope with the wound of trauma.

Self-Harm As A Coping Mechanism

One way those with trauma try to cope with their trauma is through self-harm behaviors.  For those who are reading this and have never known someone or experienced self-harm, the previous statement may not make sense.  Stay with me, and I will explain it further.   “A traumatic event overwhelms a person’s coping systems and makes them useless” (Langberg, 1999, p 53).   Therefore, healthy coping mechanisms the person used in the past may not help after experiencing a trauma.  Those who engage in self -harm behaviors describe its purpose in a number of ways.  It can be a way for the individual to manage emotions through the distraction of self-harm behaviors.  A person who has experienced trauma believes the emotions tied to the trauma are too overwhelming and the self-harm provides a distraction.

Another way self-harm behaviors serve as coping mechanisms are to numb the experience of intense emotion from trauma.  Self-harm behaviors have also been used to interrupt or “short-circuit” negative thoughts and emotions (Ferentz, 2015, “Toward A New Understanding,” para 12).  Control is a common theme for those individuals who have experienced trauma.  Most often in trauma you do not have control.  Therefore, some trauma survivors will use self-harm behaviors to feel in control of their body.  In order to escape the feelings or memories of trauma, self-harm behaviors are used to either ground oneself or dissociate (Ferentz, 2015, “Toward A New Understanding,” para 12).  To ground oneself is to keep in the present moment, while to dissociate is to take oneself to another location mentally.   These purposes of self-harm behaviors are a stark difference to the out dated and unhelpful view of self-harm being a form of attention seeking.

While behaviors of self-harm are dangerous and harmful to the person engaging in them, it can also be helpful to see them as a “life-sustaining act” (Ferentz, 2015, “Toward A New Understanding,”  para 24).  “Self-injury a life-sustaining act: a behavior designed to help clients cope while alleviating distress” (Ferentz, 2015, “Toward A New Understanding,”  para 24).   Most individuals who engage in self-harm behaviors are trying to cope with painful and difficult symptoms without ending their lives.

That being said, it is always the right decision to seek professional help when you learn your child or someone you love has engaged in self-harm behaviors.  Also, if you are ever fearful of your loved one is a danger to herself contact emergency services immediately.  It is is helpful to see self-harm behaviors as coping mechanisms, yet it is more important that the person be in treatment for the self-harm behaviors.  While it is a coping mechanism, it is not healthy or the most effective coping mechanism a person can use to cope with trauma.

Self-Harm As Nonverbal Communication

Self-harm behaviors being a form of communication may be a foreign concept for some reading this article.  For others, it may provide a context for understanding or feeling understood.   As a form of nonverbal communication, self-harm behaviors tell the story of the internal pain for which a person with unresolved trauma is struggling (Ferentz, 2015).  As a clinician, one of the first questions for those that self-harm is what are the cuts, scars, burns, or marks trying to say?  At first, a trauma survivor may not have the answer.  Through working the a trained trauma clinician, the survivor can put words to her pain.

“Unresolved traumatic pasts often create cognitive distortions, pervasive negative affect, and profoundly compromised self-esteem” (Ferentz, 2015, “Working With Trauma Survivors,” para 2).  A cognitive distortion is something our mind persuades us is true, but is actually false.  An example of this would be a statement such as “No one could ever truly love me if they know what has happened to me.”  The difficulty or inability to show or experience positive emotions is the definition of pervasive negative affect.  Compromised self-esteem is when one cannot see herself with value despite all the evidence she has to support it.  “Trauma survivors believe they are inherently flawed, bad, and incompetent.  They hold themselves solely responsible for the way they are in the world, believing they have problems because there is something intrinsically wrong with them” (Ferentz, 2015, “Working With Trauma Survivors,” para 3).   “It is ironic that so many trauma survivors do not consciously attribute their poor self-esteem to their trauma” (Ferentz, 2015, “Working With Trauma Survivors,” para 2).  Instead, she would believe there is something wrong or bad with her.

Unfortunately, the cognitive distortions created by the trauma may never be talked about.  The distortions may even be reinforced by unhealthy attachments.  In these situations, it can be very difficult for the trauma survivor to hear or be witness to the love she should be treated with.  Instead, due to the aloneness and self-hatred “the impulse to get rid of the damaged part of oneself is manifest through self-harm behaviors.  If one sees oneself as damaged, it resonates to hurt the body” (Ferentz, 2015, “Working With Trauma Survivors,” para 11).  Therefore, through her self-harm behaviors she is saying she is damaged, hurt, defective, unlovable, alone, and many others.

In no way am I condoning self-harm behaviors through writing this article.  Rather, I believe understanding and compassion for those who engage in self-harm behaviors is the helpful approach.   It cannot be said enough that if you or someone you love is struggling with self-harm behaviors the best choice you can make is to get help.  There is hope, compassion, and connection.  You do not nor should you work through trauma and self-harm behaviors alone.  If you are a loved one of someone who has trauma and engages in self-harm behaviors, let her know you care and you will be with her through the pain.  Even better, offer to help her find treatment or support her as she walks the road of healing.


Ferenz, L. (2015). Treating self-destructive behaviors in trauma survivors: A clinician’s guide.  (2nd ed.).  New York: Routledge. (Electronic version).

Langberg, D. (1999).  On the threshold of hope: Opening the door to healing for survivors of sexual abuse.  Carol Stream, Illinois: Tyndale Momentum. 

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