Deliberate Self Harm (DSH)

What is self-harm?

Deliberate self-harm is when someone deliberately hurts or injuries themselves.

OR:

‘Intentional self-poisoning or injury, irrespective of the apparent purpose of the act’ (NICE Guidelines, 2022)

This issue is subject to much misrepresentation, with deliberate self-harm sometimes referred to as attempted suicide, para-suicide, self-mutilation and self-injury.

A small minority of people who self-harm will die by suicide, but in most instances, this will not have been their intention. Self-harm can actually be viewed as the opposite of suicide, because in the majority of cases the person is seeking a coping mechanism for their life, rather than electing to end it. There is evidence however, that the risk of suicide in people who self-injure, is significantly greater than in the general population (HSE, 2025).

How do people self-harm?

Individuals can deliberately self-harm through one or a combination of these means:

Why do young people self-harm?

It is important to note that some of the factors listed above may be a symptom rather than a cause of self-harm. Self-harm is used as a safety valve to release high levels of emotional pressure. Young people often feel that the pain accessed during this process enables them to feel more alive than the ‘numbness’ or ‘dead inside’ feelings of everyday life. These acts can also constitute a way of self-punishment when feeling overwhelmed by emotions of guilt or shame, or for some it is a vehicle to communicate their unhappiness, and desire for help. Elsewhere, for others it simply allows them to feel a sense of control over one aspect of their lives, when experiencing feelings of helplessness and hopelessness about all remaining facets of their existence.

Self-harm occurs across all cohorts, but it is most prevalent amongst young people and adolescents. Many of these young people establish a pattern of self-harm over a long period of time, in response to unwanted circumstances or emotions. Conversely, other individuals cease to employ these behaviours as a temporary coping mechanism, once they perceive that a specific problem has been resolved, or a particular phase of their life has elapsed. The most common personal setbacks and negative encounters overlap closely with many young peoples’ triggers to self-harm.

How can psychological support help?

People who regularly self-harm may not perceive that they have problem-solving or problem-minimising options available, and as such their coping strategies are limited. Failure to identify and harness internal and external resources will inevitably inhibit long-term growth and development of natural levels of resilience. Ultimately, this reinforces a person’s urge to maintain self-harm as their default coping mechanism. Nevertheless, the purpose, practice, and outcomes of virtually all defence or coping mechanisms are unhealthy.

Waterford Counselling Centre offers non-judgemental professional support to individuals who self-harm. Working together we can look at your motivations to self-harm and explore other proven and constructive structures for expressing or coping with your feelings. Regardless of your age, sex, neurotype, cultural, or religious background, our goal through this approach, is to help you to address the issue of your own self-worth. This work may be quite difficult but understanding why you self-harm is crucial in helping you to stop.

Seeking support is a strength and not a weakness!

”…people who harm themselves as a way of relieving distress (through cutting, for example) might be compelled to this as a coping and suicide prevention strategy. They are likely to continue to need to do this until they receive appropriate and sufficient psychotherapeutic interventions and support.”
(NICE Self Harm Guidelines, 2004)

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