When Pain Turns Inward: Understanding Non-Suicidal Self-Injury (NSSI)
Written by Crisis Coordinator Amber Johnston MA, LPC
Nov 7, 2025
Content Warning: This article discusses self-injury. If you are in crisis, please call 988 in the U.S. or text HOME to 741741 to connect with a trained crisis counselor.
“I hurt myself today. To see if I still feel. I focus on the pain.
The only thing that's real.
The needle tears a hole. The old familiar sting.
Try to kill it all away. But I remember everything….”
— excerpt from “Hurt” by Nine Inch Nails
Understanding and Supporting Ourselves
College can be exciting, exhausting, and, at times, overwhelming. Between academics, relationships, work, and personal growth, it can feel like there’s a lot to manage. For some students, everyday stressors pile on top of deeper struggles such as past or current trauma, abuse, or learned patterns of maladaptive coping with painful emotions.
Sometimes, during periods of intense distress or overwhelming emotion, individuals may cope by harming themselves. This is called non-suicidal self-injury (NSSI). It is intentional harm to one’s own body without the intent to die. It is important to note that while NSSI it is a maladaptive coping strategy, it is still a coping strategy. Let’s explore why some people self-injure, help reduce stigma and feelings of isolation, discuss harm-reduction strategies, and remind readers that there are steps toward healing.
Why Do People Self-Harm?
Research shows NSSI is most often about managing emotions, not about seeking attention or manipulation (a harmful myth). Some common reasons include:
- Regulating intense emotions: Physical pain may feel easier to manage than emotional pain.
- Expressing feelings: Self-injury can become a way of “saying” what feels unspeakable.
- Feeling something when numb: It may create a sense of being alive or real.
- Managing guilt or shame: For some, self-injury can feel like a way to cope with these difficult feelings.
- Self-punishment: Guilt or shame can drive self-harm as a form of punishment.
- Regaining control: When life feels chaotic, self-injury can create an illusion of control.
Self-injury is not the same as a suicide attempt, though it can still result in serious harm and reflects deep emotional pain that deserves care and attention.
How People May Self-Harm
Self-injury often happens in private, on parts of the body that are easier to hide. It is more common than many realize, studies suggest that about 17% of adolescents and 15% of college-aged adults have engaged in self-harm at some point.
NSSI doesn’t always look the same. Common forms include:
- Cutting, scratching, or burning the skin
- Hitting or punching oneself or objects
- Interfering with wound healing
- Hair pulling
- Ingesting small amounts of toxic or illicit substances (not intended to be lethal)
- It has even been reported that some individuals use sexual behaviors as a form of emotional regulation or coping (for example, through excessive masturbation)
Dispelling Common Misconceptions
(Adapted from the Cornell Research Program on Self-Injury & Recovery)
- Myth: Only females self-injure.
- Truth: All genders can engage in NSSI.
- Myth: Self-injury is a suicide attempt.
- Truth: Most studies find self-injury is often used to avoid suicide.
- Myth: Only teenagers self-injure.
- Truth: People of all ages may engage in NSSI; about 15% of college students have done so.
- Myth: Talking about my NSSI means I’ll be hospitalized.
- Truth: Self-injury alone does not mean you meet criteria for hospitalization.
- Myth: It’s just attention-seeking.
- Truth: Most people go to great lengths to hide scars or burns. Hidden or not, self-injury is a sign of distress.
- Myth: NSSI is untreatable.
- Truth: Therapies such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are effective. Some people also recover on their own.
- Myth: People who self-injure enjoy the pain.
- Truth: It usually hurts. Sometimes feeling pain is the point, to reconnect with the body or just to feel something.
- Myth: I can’t help someone who self-injures.
- Truth: Listening without judgment and offering support can make a difference.
Harm Reduction: Meeting Yourself Where You Are
If you’re struggling with NSSI, it may feel impossible to just “stop.” Expecting yourself to quit immediately can add pressure and shame. Harm reduction strategies focus on safety and gradual change. Some examples can include:
- Delay and distract: Wait 10–15 minutes before acting. Try listening to music, humming, squeezing ice, or drawing on your skin with a washable marker.
- Substitute safer sensations: Snap a rubber band, hold something cold, or engage in vigorous physical activity like running, dancing, jumping, or stretching
- Create a safe environment: Reduce access to objects you typically use to self-harm.
- Plan for aftercare: If harm does occur, tending to wounds safely is not only important but is an act of self-compassion.
- Talk back to shame: Self-injury doesn’t define you. Treat yourself with the care you’d give a friend.
The Role of Belonging
College is a time of identity, independence, and connection. Students who feel disconnected, unseen, or excluded may be more vulnerable to self-injury. In this way, NSSI isn’t just about managing inner pain; it can also reflect an absence of connection.
Feeling “I matter here” can reduce the urge to self-harm. Research suggests a strong sense of belonging- to peers, cultural communities, or campus groups- can be protective. Building community may not replace therapy, but it is a powerful part of healing.
Finding Support
On Campus (CU Denver):
- Student & Community Counseling Center: Free intake + 10 sessions/year
- Tivoli Student Union, Room 454
- 303-315‑7270
- Drop‑in crisis services: Monday through Thursday from noon to 4:00 PM
- Health Center at Auraria: Minor injury treatment and wound care
- 303-615‑9999
- After Hours Crisis Line: 303-615‑9911
- Auraria Mental Health 24/7 Line
- 303-615‑9911
- Office of Case Management, Phoenix Center, Office of Disability Resources: Support for students navigating crises, assault, or mental health conditions
Off Campus / 24/7 Resources:
- 988 Suicide & Crisis Lifeline: Call or text 988 anytime
- Crisis Text Line: Text HOME to 741741
- Colorado Crisis Services: coloradocrisisservices.org or 844‑493‑8255
- Safe2Tell Colorado: 1‑877‑542‑7233
- Self‑Injury Outreach & Support (SIOS): sioutreach.org
- The Trevor Project (LGBTQ+ Youth): thetrevorproject.org
If you’re worried about immediate safety, call 911 or go to your nearest emergency room.
Apps to Help Manage Self-Harm Urges
- Calm Harm: Developed by stem4, Calm Harm offers activities categorized into Comfort, Distract, Express Yourself, Release, and Random. It provides evidence-based techniques to help manage self-harm urges.
- HarmLess: This app includes features like mood tracking, journaling, breathing exercises, and guided meditation. It also offers courses on coping strategies and provides access to professional mental health therapists at a discounted rate.
- Calm Urge: Calm Urge helps you track your emotions and provides calming activities like breathing exercises, Tibetan bowls, musical instruments, and drawing tools. It also allows you to create a private password to keep your information secure.
- Distract: This app offers information about self-harm, self-help tips, and links to support resources. It includes a "Calm Zone" with art, books, music, and other resources to help you feel better when struggling
Final Thoughts
If you’ve ever self-injured, please know this: you are not broken, AND you are not alone. Self-harm signals that you’re carrying pain too heavy to hold, not that you’re unworthy. Healing is possible, beginning with small steps, reaching out for help, trying harm reduction strategies, or simply talking about what you’re going through.