Understanding Self-harm: A Humanistic Counsellor's Perspective

Self-harm, or self-abuse, is a deeply painful and complex behaviour. As a humanistic counsellor, I believe in understanding the whole person their feelings, their stories, their unmet needs rather than labelling or pathologising them. In this blog, I want to explore what self-harm really means, how it affects not just the individual but those around them, and how healing can be supported in a compassionate, collaborative way.

What We Mean by Self-Harm

Self-harm refers to intentional injury to one’s own body, typically as a way to manage or express emotional pain. This can include cutting, burning, self-poisoning, or other forms of self-injury. Importantly, self-harm doesn’t always come from a desire to die it might be a coping mechanism, a way to relieve overwhelming feelings, or a way to feel something when numbness has taken over.

In the 2023/24 Adult Psychiatric Morbidity Survey in England, 10.3% of 16- to 74-year-olds reported having self-harmed at some point in their lives. Among younger adults, the prevalence is even higher: for 16- to 24-year-olds, 31.7% of women and 15.4% of men said they had ever self-harmed. These are not small numbers they represent millions of people, each with a unique story.

Why People Self-Harm: A Humanistic View

From a humanistic counselling lens, self-harm is often understood as a signal a cry for help, a way to make internal pain visible, or to regain a sense of control when life feels chaotic. Some common drivers include:

Relieving intense emotions: Many people report self-harming to relieve anger, anxiety, tension, or deep sadness.

Expressing distress: When words fail, the body sometimes speaks.

Connecting to feelings: For some, harm feels like a way to feel something real even if it’s pain when emotional numbness is overwhelming.

Self-punishment: Shame, guilt, and self-criticism can drive someone to harm themselves as a form of punishment.

Trying to communicate: It may feel like no one hears their suffering, so self-harm becomes a way to show how bad things are inside.

A humanistic counsellor doesn’t judge these behaviours instead, I try to understand the person’s experience, validate their pain, and help them find healthier, more life-affirming ways to cope.

The Ripple Effect: How Self-Harm Impacts Others

Self-harm doesn’t exist in a vacuum. The emotional wounds that lead someone to harm themselves often affect their family, friends, and community.

1. Family and Loved Ones

Worry and Helplessness: Loved ones may feel terrified, not knowing how to help or how serious things are.

Guilt and Self-blame: Parents or siblings might blame themselves, thinking they “should have seen it coming” or “done more.”

Communication Breakdown: Silence, withdrawal, or defensiveness may grow, as people don’t know how to talk about self-harm without making things worse.

2. Friends and Peers

Emotional Burden: Friends might feel anxious, fearful, or drained, especially if self-harm is recurring.

Confusion or Misunderstanding: Without understanding self-harm, friends may misinterpret it as attention-seeking which can cause further isolation.

3. Community and Social Impact

Stigma: Self-harm is often misunderstood or stigmatised, which can discourage people from opening up and seeking help.

Service Pressure: Increased rates of self-harm also put pressure on mental health services, impacting availability of care for all.

By acknowledging these ripple effects, humanistic counselling helps not only the individual but also supports those affected around them offering guidance, communication tools, and a space for healing for everyone involved.

The Types of Help Available in the UK

Helping someone who self-harms (or helping someone to stop self-harming) usually involves a mix of professional, community, and relational support. From a humanistic stance, I work with you not on you to build a trusting, non-judgmental relationship, empowering you to find your own path to healing. Here are the main forms of help available in the UK:

1. Primary Care (GP)

The GP is often the first port of call. They can listen, assess risk, prescribe medications if needed, and refer you to appropriate services.

2. Mental Health Services / NHS Support

NHS Talking Therapies (formerly IAPT) offer psychological therapies, such as cognitive behavioural therapy (CBT).

Specialist mental health services: For more complex or recurrent self-harm, Community Mental Health Teams (CMHTs) or specialist clinics may be involved.

Crisis support: If you’re in immediate danger or emotional crisis, there are urgent help options. The NHS recommends turning to your GP, local crisis team, or calling for urgent support.

3. Voluntary & Helpline Services

Samaritans: Call 116 123 to talk any time, day or night.

Shout: UK’s 24/7 crisis text line text “SHOUT” to 85258.

Other support organisations provide non-judgmental listening, peer support, and signposting.

4. Counselling & Psychotherapy

As a humanistic counsellor, I aim to create a safe, empathetic space: we talk about what’s behind self-harm, explore your values, your hopes, your pain, and work together to build non-harmful coping strategies.

Depending on your preference and resources, counselling might be weekly or less frequent, face-to-face or online.

5. Groups and Peer Support

Support groups (online or in-person) can be very powerful: they allow you to hear others’ stories, know you’re not alone, and learn coping tools.

Peer-led programmes often give people a sense of belonging, and reduce isolation.

6. Self-Help & Skills-Based Work

Developing alternative coping skills: mindfulness, distress tolerance, grounding techniques, journaling, creative expression.

Emotion regulation work: learning to identify, name, tolerate, and express emotions in healthier ways.

Why “I Work With You, Not On You”

One of the core principles of a humanistic approach is collaboration. Here’s what that means in practice:

Respect for your agency: You are the expert in your own life. My role is to support you, not to fix you.

Empathy and unconditional positive regard: I strive to offer a space where you feel seen, heard, and accepted — without judgment.

Holistic view: We explore not just self-harm itself, but the feelings, beliefs, relationships, and life experiences that underlie it.

Growth mindset: Healing is not about eliminating all pain; it's about finding more life-affirming, sustainable ways to navigate pain, connect with others, and build meaning.

The Broader Picture: Mental Health & Self-Harm in the UK

To frame this issue in context:

According to NHS Confederation reporting, the proportion of 16–64 year-olds with a common mental health condition has risen from 18.9% in 2014 to 22.6% in 2023/24, and non-suicidal self-harm in 16–74-year-olds has increased from 6.4% in 2014 to 10.3% in 2023/24.

Self-harm is more common in women than men: for example, in the 16–24 age group, 31.7% of women and 15.4% of men report having ever self-harmed.

Regarding suicidal behaviour: the same survey found that past-year suicidal thoughts increased, from 3.8% in 2000 to 6.7% in 2023/24, and suicide attempts (past year) rose from 0.5% to 1.0%.

On suicide rates more broadly, in 2024 the age-standardised suicide rate in England was around 11.1 deaths per 100,000 people.

These statistics highlight how self-harm is not an isolated or niche issue it affects a significant minority of people and is deeply linked to the broader mental health crisis.

Final Reflections: Hope, Compassion, and Healing

Self-harm can feel very lonely, overwhelming, and shame-laden but help is possible, and healing is possible. From a humanistic counselling perspective, you don’t have to go on this journey alone. I work with you to build trust, to understand your pain, and to co-create a safer, more compassionate way of relating to yourself and your emotional world.

If you or someone you care about is self-harming, I encourage you to reach out — to a GP, a counsellor, a trusted friend, or a helpline. Sharing what you’re going through is a powerful first step towards change.