Article  Health

Understanding and helping those who self-harm

She sat in my office stiff and straight-backed, looking down at my desk as though something was keeping this 16-year-old girl’s rapt attention. She twirled her hair. She bit her lip. She looked at her shoes. She fussed with the sleeves of the sweater she was wearing, in August, in Florida. She was doing anything to avoid my eye gaze. She had no idea that I was as nervous as she was when I offered her a water bottle, a piece of chocolate, a Coke or anything that might build a bridge between the two of us.

I was one week into my new position in girls ministry; the walls in my new office were bare and still smelled of drying spackle and fresh paint. I desperately wanted to reach out to her, to crawl over my desk and scoop her up and hug her and tell her that Jesus sees her pain. But I waited, knowing that this needed to be in her timing. And I prayed for a breakthrough as we began to dig through the layers of conversation, attempting to lead her to the real reason we were gathered in my office. And then it happened. She said, “Miss Kim, I just hurt so much. That’s why a few years ago, I started cutting.”

In the first three weeks of being in girls ministry, I had nine different girls tell me about their issues with cutting. I remember thinking to myself, “I knew this was a thing, I just didn’t realize it was the thing.” But it was, and it’s still the issue that is growing in sickening popularity among our society today. It has grown to such proportions that as godly women engaged in our culture, we can no longer live uninformed. As much as I wish this wasn’t the case, cutting and other forms of self-harm have reached a critical status. We must be a part of the educated community so that we can meet the need that self-harm isn’t filling.

Understanding the scope

The National Center for Health Statistics (NCHS) states that each year, one in five females and one in seven males engage in self-injury. According to the statistics released by the NCHS, approximately two million cases of self-harm are reported annually in the United States. This number only reflects cases reported and documented by medical facilities.[1] That means there are more.

Most websites and medical journals report that the average age of self-harm begins around 12 to 14 and continues well in to their 20s.[2] I remember reading all of these statistics and being floored. I was tempted to compartmentalize it into those places of my brain that handle only raw numbers and figures, but I realized that these stats represented real lives, real faces. Some of these records represented my students, my friends’ daughters or, one day, my nieces. So, I kept reading.

The terms self-harm, self-injury or self-abuse refer to the act of purposefully harming oneself and is oftentimes called “cutting” or “blading.” There are also other forms of self-harm, such as skin burning, pinching, puncturing, anorexia, bulimia and even hair pulling. It is important to understand that most people who engage in self-harm are not suicidal, but rather they are attempting to self-soothe, express emotion or release pain or stress.[3]

Understanding the pain

For those who don’t have this impulse to self- harm, it seems impossible to understand. How could hurting yourself lead to feeling better? There actually is a physical reason that people return to behaviors like cutting. Aside from the destructive emotional coping mechanisms, physical pain does something for the body. When the body is in pain, it releases endorphins to counteract the physical effects of discomfort, giving the brain a naturally induced high. This feeling can become addictive, and before she knows it, the individual wants and needs this rush of opiates to feel normal.[4] But that doesn’t always explain the “why” behind engaging in self-harm. After all, a girl’s heart is the place we are so desperate to reach in the first place.

The comments I heard most often were, “I just wanted to be able to feel something. Even pain is better than being numb”; “It makes me feel better”; “It’s a way to relieve stress”; “No one understands”; or even, “I deserve it.” I remember meeting with a girl about cutting, and when she left, I went to my car and ugly cried until I thought my heart would burst. Listening to these beautiful precious souls talk about the emotional pain that they were experiencing and the lies that the enemy told them about who they are made me want to crawl into the throne room and just grieve.

Understanding the cycle

Each girl that I spoke with had a reason—a legitimate one, in her mind—for self-harm. The triggers usually began with stress and isolation. They usually did not see another way out or an alternative for coping with whatever was looming ahead. Most people engaged in self-harm express feeling very alone. They were reluctant to talk to people about the real reasons for their pain and would isolate to avoid doing so. These precious ones have also become masters of disguise and hiding in plain sight. But deep inside, there is pain and hurt or lies that are waiting to surface when stress is triggered.

Dr. Edward Welch, who serves as the director of the School of Biblical Counseling and professor of practical theology, says, “Anything that arouses unwanted emotions can trigger the cycle of self-abuse.”[5] And so the cycle begins with an emotional trigger, a stress that causes the impulse to seek distance and relief from these feelings. If the person has previously engaged in self-harm, there will most likely be a built-in desire to return to that behavior. Without appropriate coping mechanisms, the desire for self-harm grows, and self-injury becomes the response simply because it works. There’s temporary relief from the unwanted emotions, followed quickly by shame and guilt over the behavior of hurting oneself.

The greatest challenge is that the circumstances that drove the individual to self-injure usually haven’t changed, and the feelings have only been abated for the short term. There has not been any real healing. This is where you, as a believer, come in. If the Lord has placed you in a unique opportunity to minister to girls or women who engage in self-harm, you know the secret of freedom found in Jesus Christ alone.

Understanding the call to minister

So now that you are informed, the most natural questions are, “What do I do? Where do I go from here?” I’d like to encourage you with a few things:

  1. The Word of God is the first place to start. The girl or woman you are ministering to who may be dealing with self-harm needs help, but please remind her (or yourself, if you are engaged in self harm) that she is not beyond the power and scope of God’s great grace and healing. We all need to be reminded of the promises of God. Psalm 4:1; Psalm 107: 1-9; Psalm 94:14, 17-19; Romans 5:20 and 1 John 1:9 are some of my favorite places to start. Let’s go to our Source for the ultimate encouragement!
  2. It’s okay to admit that you don’t have all of the help that they need. Guiding them to understand their need for a supportive community is key in beginning the process of healing.
  3. If you have personal experience with self-harm, don’t hide it in shame. Tell your story and use it to express the glory of redemption and healing that can be found in Jesus Christ. Often times, a girl will feel more comfortable sharing with someone who she can make a personal connection with.
  4. Be aware of the prevalence of the idea of self-harm. If you work with students or have teenagers in your home, they have been exposed to it. The next generation is already engaging with this topic.
  5. Telling someone to “just stop” isn’t helpful. It usually doesn’t make sense to them and can come across as belittling and cold. In their mind, it doesn’t work like that; there is a reason for their behavior. Offer to walk with them in the journey and desperately pray for them as they fight the lies of the world.
  6. If the person is a minor, you must involve their parents. Unless the parents pose an imminent danger to the student, it is their right and God-given responsibility to know and love their child through these moments.
  7. If you are the parent, please seek to be as understanding as you possibly can. This is not your fault. You are not to blame. You haven’t failed. There may be areas of growth in your relationship with your son or daughter that the Lord will have an opportunity to improve through this journey. Love them. Pray with or for them and bring both of your hearts to Jesus so that the Great Physician can do his work.

Self-harm is a problem, but it is not the ultimate problem. There are root issues associated with all of our behaviors. This is true for all of humanity. We are each in desperate need of our Savior, who graciously wrapped himself in flesh and died to set us free. We must be brave women who dare to look these things in the eye and reach for our sisters in Christ who may be in crisis. We doesn’t need to be afraid—not of this issue or any others that we face in our cultures today. Scripture reminds us that we are more than conquerors through Christ Jesus (Rom. 8:37). We must be willing to reach across the divide, stick our hands in the broken places and speak hope into the life of another.


  1. ^ Claassen, Cindy and Kashner, Michael. Self Harm in the United States: What we can learn from National and State-level Medical Datasets. National Center for Health Statistics 2012 Data Conference.
  2. ^ Kerr, P. L., Muehlenkamp, J. J., & Turner, J. M. (2010). Nonsuicidal self-injury: A review of current research for family medicine and primary care physicians. Journal of the American Board of Family Medicine 23(2), 240-259.
  3. ^ Welch, Edward. “Self-Injury: When Pain Feels Good.” The Journal of Biblical Counseling. Winter 2004. 34-41
  4. ^ Stanley, Barbara. Sher, Leo. Wilson, Scott, Ekman, Rolf, Huang, Yung-yu, Mann, John. “Nonsuicidal Self-Injurous Behavior, Endogenous Opioids and Monoamine Neutransmitters.” J of Affect Disord. 2010 Jul; 124(1-2): 134-140.
  5. ^ “Self-Injury: When Pain Feels Good,” 32

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