Self-harm is a way of coping with pain that has grown too big to hold — a private, often shame-filled attempt to get relief when emotions become overwhelming. If you are hurting yourself, or you love someone who is, it can feel frightening and isolating. It is also something people move through and recover from, with the right help.
Self-harm, sometimes called non-suicidal self-injury, means deliberately hurting your own body as a way to cope with emotional pain. For most people who do it, the aim is not to end their life but to find relief from feelings that have become too much to carry. That difference is why Suicidal Ideation is treated as its own separate concern — though the two can overlap, and self-harm does raise risk over time, so we never treat it as minor.
Self-harm is not random, and it is not about wanting to suffer. In the moment, it usually does something for the person, however much it costs them afterward. Common reasons include:
Getting relief from emotional pain that has built past what feels bearable
Feeling something real during stretches of numbness or disconnection
Regaining a sense of control when everything else feels unmanageable
Giving some outlet to shame or self-blame that has nowhere else to go
Underneath, there is almost always something more going on. Self-harm often travels with Depression, an anxiety disorder, PTSD, or Borderline Personality Disorder, and reaching that underlying pain is central to recovery.
Self-harm is often carefully hidden, but there are signs that someone may be struggling:
Frequent injuries explained as accidents that do not quite add up
Wearing clothing that keeps the arms or legs covered, even in warm weather
Spending long stretches alone, often withdrawing to a bathroom or bedroom
Pulling away from friends, activities, and people who used to be close
Signs of the deeper struggle underneath — hopelessness, sharp mood swings, or harsh self-criticism
If any of this feels familiar, for you or someone you love, our Online Assessment is a private, low-pressure place to start.
Because self-harm is a behavior rather than a diagnosis on its own, the first step is understanding what sits beneath it. A first meeting is a calm, judgment-free conversation that looks at:
what triggers it, what needs it is meeting, and what patterns keep it going
identifying conditions such as depression, trauma, anxiety, or other factors contributing to self-harm
evaluating risk to ensure you begin treatment at the appropriate level of care
You do not need to have stopped, or to have all the answers, before reaching out. Our Admissions Process page walks through what starting looks like, and if walking into an office feels like too much at first, we can begin over video.
There is no quick fix for self-harm, but it responds well to treatment that builds genuine skills for handling emotion and reaches the pain underneath. Medication can help when something like depression is part of the picture. What we draw on most:
The most established treatment for self-harm. DBT teaches concrete skills for riding out intense emotion, tolerating distress, and steadying relationships, so the urge to self-harm has somewhere else to go.
When self-harm is rooted in trauma, EMDR helps the brain reprocess the memories feeding the pain. As those experiences lose their charge, the pressure that drives self-harm often eases along with them.
A private, consistent one-to-one space to make sense of your own patterns, work at a pace that feels safe, and build trust with someone who will not flinch.
Self-harm rarely happens apart from the people around you. Family sessions help loved ones understand what is really happening and learn to respond in ways that steady you instead of adding pressure.
Most plans blend a few of these, often with medication for an underlying condition. The full list is on our Therapy Options page.
Most people work on self-harm through weekly outpatient therapy while living at home. When the behavior is escalating or safety becomes a real concern, more support is available. What each step provides:
For times when self-harm has become frequent or unsafe to manage at home, a short stay offers a protected, structured setting with support close at hand while things stabilize.
Well suited to times when self-harm needs more than weekly sessions but home is still a safe place to be. Several structured sessions a week focus on building skills and easing the pressure that drives the behavior.
The same structured program, held over secure video and available across the state. For people who feel more able to open up from home, or who live far from in-person care, it takes away a real barrier to getting help.
Recovery from self-harm is rarely a straight line, and urges can resurface under stress. Ongoing check-ins, plus an alumni community, make it easier to stay steady and to reach out early if the urges start to return.
If a crisis has led to a hospital stay, this gives you a supportive place to regain stability before stepping back into everyday life and ongoing care.
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Self-harm needs care that is both skilled and steady. Here is what makes ours different:
Dialectical behavior therapy is the most effective treatment for reducing self-harm, and our program is built around it. Because our clinicians specialize in DBT, you come away with concrete tools for managing overwhelming emotion rather than just an instruction to stop.
A lot of people hide self-harm because they fear being judged or panicked over the moment they open up. Our response is calm and proportional, matched to what is really happening, so you can tell us the truth without bracing for alarm. And the more openly you can talk about it, the better we are able to help.
Self-harm is almost always a way of coping with deeper pain, so stopping the behavior alone rarely holds. We treat what is driving it — depression, trauma, anxiety, emotional overwhelm — which is what makes recovery last. That way your plan is shaped around your own story, not a standard script for stopping a behavior.
Self-harm can intensify during a hard stretch, so we stay in close contact and can raise the level of support quickly when it is needed — without sending you elsewhere to start over, since the whole range of care is here. You never have to work out where to turn next on your own, because that step is already built into your care.
Self-harm affects the people who love you, and they often do not know how to help without making things worse. When it fits, we bring family into treatment so home becomes part of recovery rather than a source of added pressure. With everyone working from the same understanding, the support around you reinforces your treatment instead of working against it.
Around St. Louis, we work with adults from Shrewsbury, Rock Hill, Olivette, Sappington, and the surrounding communities. Because compassionate self-harm care is not easy to come by, our secure video sessions extend statewide as well, to places like Moberly, Mexico, and Carthage.
Our Meet the Team page shows who would be part of your care. And because loved ones so often want to help but do not know how, our Family Resources offer guidance for supporting someone through recovery.
Self-harm can convince you that you are alone in it and that nothing will change. Neither is true. Reaching out, even once, is a real step away from where you are — and you do not have to be sure it will work to take it.
Getting started is straightforward. We handle Insurance Verification at the outset, so the cost of care is clear from the beginning.
Reach St. Louis Mental Health at (314) 237-4435, or get in touch through the Contact Us page. The first conversation is private, unhurried, and entirely yours to lead.
And if you ever feel unsafe or find yourself thinking about suicide, help is available before your first appointment — call or text 988, or use our Crisis Hotlines page for support you can reach any time.
Is self-harm the same as trying to die?
No, though the two can overlap. Most self-harm is a way of coping with emotional pain rather than an attempt to end life, which is why it is sometimes called non-suicidal self-injury. Even so, self-harm does raise the risk of suicidal thoughts and attempts over time, so it is never something to brush aside. If suicide is on your mind, please reach the 988 Suicide and Crisis Lifeline by call or text.
Does self-harm mean someone is trying to get attention?
Most people who self-harm go to great lengths to hide it because they feel ashamed or fear being judged. Even when the behavior is visible, it usually reflects overwhelming emotional pain or difficulty expressing distress — not manipulation or a desire for attention. Dismissing self-harm as “attention-seeking” can prevent people from getting the understanding and treatment they need.
Will insurance cover self-harm treatment?
In most cases, yes. You do not need a standalone self-harm diagnosis for treatment to be covered — it is part of mental health care, which the large majority of plans include. We can confirm what your own plan covers through our Insurance Verification page ahead of your first visit.
What if I’m not ready to stop?
That is okay, and it is more common than you might expect. You do not have to promise to quit before getting help. Treatment can begin by understanding why self-harm has felt necessary for you and building other ways to cope, so that stopping becomes something you move toward rather than a condition for walking in the door.
Can people really stop self-harming?
Yes. With the right support, people learn to meet emotional pain in ways that do not hurt them, and the urges lose their grip over time. Recovery is not always a straight line, but it is very achievable. You can see the kind of results our clients reach on our Treatment Outcomes page.