Key Takeaways
- Cutting is a form of non-suicidal self-injury often used to cope with overwhelming emotional pain.
- Trauma, emotional regulation difficulties, and mental health conditions can increase the risk of cutting behaviors.
- Therapies such as dialectical behavior therapy (DBT) help people build safer coping skills and reduce self-harm urges
Important note: This article discusses self-harm and mental health. If you or someone you know is struggling or in crisis, call or text 988 or chat https://988lifeline.org/. You can also use these resources to find help.
When emotional pain feels overwhelming, some people may turn to cutting, intentionally breaking the skin, as a way to cope with inner distress. Many people who do it carry deep shame, but that shame gets in the way of the help that can actually make a difference.
Cutting is the most common form of nonsuicidal self-injury (NSSI), practiced by more than 70% of people who self-injure across multiple study samples, as per research published in Frontiers in Psychology. It typically begins between ages 12 and 14, though it can start earlier, affecting roughly 1 in 6 adolescents globally at some point in their lives.
Replacing shame with understanding is where real support begins.
What is Cutting and How Does it Differ From Other Forms of Self-Harm?
Cutting refers to intentional, self-inflicted damage to body tissue carried out without suicidal intent and not for purposes that are socially sanctioned. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-5-TR) recognizes NSSI as a clinically significant pattern that can appear alongside many different diagnoses, not just one.
While cutting and suicide ideation can coexist, they're clinically distinct: NSSI carries no intent to die. That said, the presence of self-injury is one of the strongest predictors of future suicide attempts, and it's sometimes an even stronger signal than a prior attempt. Early recognition genuinely matters.
Understanding self-harm in its many forms helps loved ones and individuals recognize when someone needs more support than they're currently getting.
Common methods of self-harm beyond cutting
Cutting is the most common form of nonsuicidal self-injury, but it is not the only one. Other forms to recognize include:
- Burning the skin
- Severe scratching or carving into the skin
- Hitting or banging parts of the body against objects
- Picking at wounds or scabs
- Biting the skin or pulling hair
A clinical study of NSSI patterns published in Frontiers in Psychology found that most people who self-injure use more than one method over time. Every form carries emotional weight, and each one deserves a compassionate, non-judgmental response.
Why Do People Cut Themselves?
The most common reason people cut themselves is emotional dysregulation. When feelings like anger, shame, panic, or sadness become overwhelming, physical pain may feel like it temporarily reduces emotional intensity.
A meta-analysis published in European Psychiatry confirmed that emotion dysregulation is strongly linked to NSSI, with an odds ratio of 3.03. The patterns most tied to self-harm included difficulty accepting emotions, trouble controlling impulses, and limited access to healthy coping strategies.
Emotion regulation isn't the only driver, though. Research identifies at least four distinct psychological functions:
For example, a teenager experiencing intense bullying might use cutting as a way to release anger or numb emotional pain. Another person may turn to self-harm during periods of overwhelming shame or self-criticism.
Trauma can also increase vulnerability. A systematic review in Lancet Psychiatry found strong associations between childhood maltreatment and nonsuicidal self-injury.
Mental health conditions such as depression, anxiety, eating disorders, post-traumatic stress disorder, and attention-deficit/hyperactivity disorder may also occur alongside self-harm behaviors.
Social influences may play a role as well. A study in JAACAP Open reported that adolescents who encountered self-harm content on social media experienced increased short-term risk for self-injury urges.
"Patients oftentimes report that cutting provides them a means by which to "feel something." It is not uncommon for people who self harm to note that they feel emotionally numb. The physical pain helps to move the needle on the numbness. Cutting is also sometimes a means by which people punish themselves when self loathing or personal judgement is significant. As far as prospective alternatives, the patient should be looking for something to distract, redirect negative feelings, and lean into positive coping mechanisms."
- Talkspace therapist, Henry Jay Swedlaw, LPC, LMHC
Patients oftentimes report that cutting provides them a means by which to "feel something." It is not uncommon for people who self harm to note that they feel emotionally numb. The physical pain helps to move the needle on the numbness. Cutting is also sometimes a means by which people punish themselves when self loathing or personal judgement is significant. As far as prospective alternatives, the patient should be looking for something to distract, redirect negative feelings, and lean into positive coping mechanisms.
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Start therapyWarning Signs and Risk Factors to Watch for in People Who Cut Themselves
Recognizing the signs of cutting early opens the door to compassionate conversation and timely care. Physical marks are often hidden deliberately, but behavioral and emotional signals are visible if you know what to look for.
Physical signs
- Unexplained cuts, scratches, or burns, often on arms, thighs, or the stomach
- Fresh cuts from self-harm in various stages of healing alongside older scars
- Wearing long sleeves or layered clothing to cover skin in warm weather
Behavioral and emotional signs
- Withdrawal from friends, family, or previously enjoyed activities
- Keeping sharp objects nearby without a clear reason
- Expressing intense shame, worthlessness, or self-directed blame
- Flinching when touched or pulling away from physical contact
Certain experiences can increase risk. Peer victimization and bullying have been linked to higher rates of self-injury among adolescents. Some groups also experience elevated risk due to stigma or stress. Research in JAMA Pediatrics found higher rates of self-injury among transgender and gender-diverse youth compared with cisgender peers.
Noticing these signs isn't about assuming the worst or confronting someone harshly. Curiosity, warmth, and a genuine willingness to listen are the most powerful first responses available.
How Can You Cope Safely When the Urge to Cut Arises?
Urges to self-injure don't arrive quietly, and when they do, they tend to escalate quickly. The goal of safe coping isn't to eliminate the feeling but to create enough space between the urge and the action for a different choice to become possible.
Two categories of skills make that possible: in-the-moment strategies and longer-term therapeutic work.
Immediate grounding techniques to ride out an urge
Urge-surfing is a distress tolerance skill drawn from dialectical behavior therapy (DBT): rather than acting on a self-harm urge, you observe it rise, peak, and fall, like a wave, but without letting it carry you under. With practice, this breaks the automatic link between distress and action.
Sensory substitution gives the body something else to focus on. DBT techniques explicitly teach these strategies in distress tolerance modules:
- Hold ice cubes until the sensation peaks and passes.
- Snap a rubber band on your wrist at the moment of peak urge.
- Do 10 minutes of intense movement, whether it's running in place, jumping jacks, or a brisk walk.
- Use the 5-4-3-2-1 grounding exercise: name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, and 1 you taste.
None of these replaces professional support, but each can create a moment of pause that changes the outcome.
Long-term professional and peer support options
Sustained recovery requires more than in-the-moment strategies. Online therapy with a licensed therapist builds the emotion-regulation capacity that makes urges less frequent and less overwhelming over time.
Evidence points toward several approaches:
Treatment for self-harm often focuses on:
- Developing emotion-regulation skills
- Understanding causes and patterns
- Building supportive relationships
- Addressing underlying mental health conditions
Between-session tools like diary cards tracking urges, what activates your self-harm urges, and coping mechanisms extend therapeutic work into daily life. Support groups and a primary care provider can serve as valuable additional layers of care alongside formal therapy.
When Should You Seek Emergency Help or Call a Crisis Line?
Some situations require immediate action. If a wound won't stop bleeding, is deeper than a surface-level scrape, or if thoughts of suicide accompany the urge to self-harm, that's an emergency, not something to manage alone.
Use this reference table to match the situation to the right response:
Crisis services are confidential. Reaching out does not automatically mean hospitalization, and trained counselors can help people navigate moments of crisis safely.
Cuts from self-harm that are escalating in frequency or severity are a signal that current coping strategies aren't enough, and that's exactly the kind of pattern a licensed therapist can address before a crisis point arrives.
Therapy Support for Self-Harm Recovery
Cutting does not mean someone is beyond help. It often signals emotional pain that needs care and support. Talkspace connects members with licensed therapists through message-based therapy and live video sessions, making it easier to reach professional support when difficult moments arise.
Members can message their therapist during the week, which can be especially helpful when self-harm urges appear unexpectedly. For teens, adults, or anyone supporting a loved one who self-harms, Talkspace accepts many insurance plans, making professional mental health care more accessible than many people assume.
Self-harm is a signal, not a sentence, and understanding why people cut themselves is only the first step. The next step is finding support that helps change the pattern. If you're struggling with self-harm urges, a licensed therapist at Talkspace can help you find safer ways to cope and move toward recovery.
Frequently Asked Questions (FAQs)
Is cutting the same as a suicide attempt?
No, cutting is usually categorized as nonsuicidal self-injury, meaning the person is not trying to end their life. However, self-harm can increase the risk of future suicide attempts, so professional support is important.
Can cutting become an addiction?
Cutting can become a compulsive coping pattern because it temporarily reduces emotional distress. Therapy helps people replace that cycle with safer emotion-regulation skills.
How do I talk to a friend who cuts themselves?
Choose a private, calm moment and express concern without judgment. Encourage them to seek professional support and offer to help them take the first step.
Will scars from cutting ever go away?
Cuts from self-harm can leave scars, although their appearance often fades with time. A dermatologist can help with scar management while therapy addresses the underlying emotional distress.
Sources:
- Zetterqvist M, et al. Nonsuicidal self-injury: a systematic review. Frontiers in Psychology. https://pmc.ncbi.nlm.nih.gov/articles/PMC5682335/. 2017;8:1946. Accessed March 5, 2026.
- Zinchuk M, Kustov G, Mishin I, et al. Clinical and psychological profiles of patients with different patterns of nonsuicidal self-injury. Front Psychiatry. 2025;16:1570880. Published 2025 Jun 19. doi:10.3389/fpsyt.2025.1570880. https://pmc.ncbi.nlm.nih.gov/articles/PMC12225643/. Accessed March 5, 2026.
- Wolff JC, Thompson E, Thomas SA, et al. Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis. Eur Psychiatry. 2019;59:25-36. doi:10.1016/j.eurpsy.2019.03.004. https://pubmed.ncbi.nlm.nih.gov/30986729/. Accessed March 5, 2026.
- Liu RT, Scopelliti KM, Pittman SK, Zamora AS. Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry. 2018;5(1):51-64. doi:10.1016/S2215-0366(17)30469-8. https://pubmed.ncbi.nlm.nih.gov/29196062/. Accessed March 5, 2026.
- Hamilton JL, Untawale S, Dalack MN, Thai AB, Kleiman EM, Yao A. Self-Harm Content on Social Media and Proximal Risk for Self-Injurious Thoughts and Behaviors Among Adolescents. JAACAP Open. 2025;3(3):431-438. Published 2025 Feb 5. doi:10.1016/j.jaacop.2024.11.008. https://pubmed.ncbi.nlm.nih.gov/40922781/. Accessed March 5, 2026.
- McArthur BA, Pesigan KL, Berg L, Sin G, Singh S, McClurg C. Suicidality and Nonsuicidal Self-Injury in Transgender and Gender Diverse Youth: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2026;180(2):144–151. doi:10.1001/jamapediatrics.2025.5274. https://jamanetwork.com/journals/jamapediatrics/article-abstract/2842556. Accessed March 5, 2026.
- Cook NE, Gorraiz M. Dialectical behavior therapy for nonsuicidal self-injury and depression among adolescents: preliminary meta-analytic evidence. Child Adolesc Ment Health. 2016;21(2):81-89. doi:10.1111/camh.12112. https://pubmed.ncbi.nlm.nih.gov/32680373/. Accessed March 5, 2026.
- Harris LM, Huang X, Funsch KM, Fox KR, Ribeiro JD. Efficacy of interventions for suicide and self-injury in children and adolescents: a meta-analysis. Sci Rep. 2022;12(1):12313. Published 2022 Jul 19. doi:10.1038/s41598-022-16567-8. https://pubmed.ncbi.nlm.nih.gov/35853962/. Accessed March 5, 2026.
- Bjureberg J, Ojala O, Hesser H, et al. Effect of Internet-Delivered Emotion Regulation Individual Therapy for Adolescents With Nonsuicidal Self-Injury Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(7):e2322069. doi:10.1001/jamanetworkopen.2023.22069. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807193. Accessed March 5, 2026.
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