[Health in the 100-Year Life Era] Self-Harm Is a Call for Help... Listen with an Open Heart and Provide Support

“Even though I’m happy, I often cry alone. I also cut my arms to suppress my anger.” This is a song sung by a teenage rapper on a TV program. As mentioned in the lyrics, actions that cause harm to oneself or inflict wounds on oneself are called ‘self-harm.’

Self-harm usually begins in adolescence, especially around ages 12 to 14. Although self-harm is not a newly emerging phenomenon, it has recently shown a clear increasing trend. As a result, clinicians frequently encounter adolescents who have self-harmed or are currently self-harming. However, when talking with them, the meaning of self-harm varies from person to person. Trying to understand the behavior under the single term ‘self-harm’ can easily lead to misunderstandings.

Self-harm is already surrounded by many misconceptions. One common misconception is that people self-harm to seek attention. While there are cases where self-harm is done to attract attention, reports indicate that this accounts for less than 4% of all self-harm cases, so it is not the main reason. Most people who self-harm do not want those around them to know about it. There is also talk that peer pressure causes self-harm. Although the influence of peers or SNS cannot be denied, in many cases, individuals self-harm because they themselves are struggling and meet friends who are similar to them or who understand them.

So why do people self-harm? It seems like a simple question, but many who self-harm answer “I don’t know.” Sometimes this answer is given because they do not want to talk about it, but more often it is because they truly do not understand. Even though they performed the act themselves, at that moment they may feel confused, everything is a mess, and it is difficult to express it in words. One reason for self-harm is to convert mental pain into physical pain to find comfort for the mind. Sometimes it is done to punish oneself out of self-hatred. It can also be done to feel alive when everything feels empty. Paradoxically, self-harm is sometimes used to calm the desire to die.

If someone around you is self-harming, it can be difficult and frustrating to know how to respond. Especially if it is a family member, people often react strongly out of shock. You might see reactions like asking why they hurt their precious body, telling them to stop immediately, or crying and getting angry. In some cases, people try to prevent self-harm by accommodating everything or giving in. Rather than sudden words and actions like these, it is important to listen to the other person with an empathetic attitude. Even if you cannot empathize, try to keep an open mind without criticism. The person may not say anything, so instead of interrogating, it is better to let them know you are ready to listen and wait. Above all, help the person who self-harmed to seek professional help. Many who self-harm do not seek help on their own.

As a doctor who treats the mind, I want to say to those who are thinking about or currently self-harming that you have endured a lot. In a way, self-harm is an attempt to overcome difficult situations. However, since self-harm is not a good way to solve problems, I hope you seek help from professionals and those around you and find better methods.

Professor Tae-Yeop Lee, Department of Child and Adolescent Psychiatry, Seoul Asan Medical Center

This content was produced with the assistance of AI translation services.