Self-harm is often talked about as something teenagers do. But many adults self-harm too. Some started years ago and never stopped. Others began for the first time during a hard stretch of adult life. If this is you, you may feel alone, ashamed or worried about what people would think if they knew. This guide looks at self-harm in adults with care and without judgment: why it happens, why it can be so hard to stop and how therapy can help you find other ways to cope.
If you are thinking about suicide, or you have hurt yourself and may need medical care, please get help now. Call or text 9-8-8 any time, or call 911 in an emergency. More crisis numbers are listed near the end of this article.
What self-harm is
Self-harm means hurting yourself on purpose. It can take many forms, and it doesn't always leave visible marks. What the different forms have in common is that they are usually a way of coping with emotional pain that feels too big to handle any other way.
Self-harm is not the same as a suicide attempt. Many people describe it as a way to get through a moment, not to end their life. At the same time, self-harm is linked with a higher risk of suicide, so it always deserves to be taken seriously and met with care.
Common myths about adult self-harm
Myths make it harder for adults to reach out. Here are a few that are worth setting aside.
"It's a teenage phase." Self-harm can start or continue at any age. Adults of every background self-harm.
"It's for attention." Most people who self-harm work hard to hide it. When someone does share, it's usually a sign they need support, not a bid for attention.
"If it isn't serious, it doesn't matter." How visible or severe an injury is doesn't tell you how much someone is hurting inside.
"People who self-harm are dangerous to others." Self-harm is about coping with your own pain. It doesn't mean you are a danger to anyone else.
"You should just be able to stop." Self-harm often works in the short term, which is exactly what makes it hard to give up without other tools.
Why adults self-harm
There is no single reason, and the reasons can change over time. Many adults say self-harm helps them:
Release overwhelming feelings, like anger, sadness, anxiety or shame
Feel something when they feel numb, empty or cut off
Feel in control when life feels chaotic
Punish themselves when they feel guilty or worthless
Stop painful thoughts or memories for a while
Show on the outside pain that is hard to put into words
Often it comes from a build-up of stress. Adult life can bring plenty: relationship problems, loneliness, grief, money worries, work pressure, health problems or parenting stress.
Self-harm can also be linked with past or present trauma, abuse, depression, anxiety, eating problems, alcohol or drug use, or trouble managing intense emotions. Sometimes the reason isn't clear at all. You don't need to know why you do it to deserve help.
Why it can be so hard to stop
Self-harm often brings quick relief. The tension drops, the noise in your head quiets, or you feel present again. Your brain learns that this works, so the urge comes back the next time things feel unbearable.
Then the relief fades. Shame, secrecy and worry about being found out often follow. Those feelings add to the distress, and the cycle starts again.
Understanding this cycle matters. It means that stopping is not about willpower. It's about building other ways to get through the moments that feel impossible, and working on what's underneath.
How therapy helps with self-harm
Therapy gives you a private, non-judgmental space to talk about self-harm openly, sometimes for the first time. A good therapist won't be shocked, won't lecture you and won't ask you to promise to stop before you are ready.
In therapy, you and your therapist might work on:
Understanding your pattern. What tends to come before an urge, what the self-harm does for you and what happens after.
Handling intense emotions. Skills from approaches like dialectical behaviour therapy (DBT) can help you ride out a strong urge until it passes.
Changing harsh self-talk. Cognitive behavioural therapy (CBT) can help you notice and challenge thoughts like "I deserve this."
Living with hard feelings. Acceptance and commitment therapy (ACT) can help you make room for painful emotions without acting on them.
Making a safety plan. A written plan for hard moments: warning signs, things that help, people to contact and crisis numbers.
Healing what's underneath. Over time, you can work on trauma, grief, depression, relationships or whatever is driving the pain.
Progress is rarely a straight line. Many people have setbacks along the way. A slip doesn't erase your progress, and it's something you can talk about openly in therapy.
Coping with an urge in the moment
These ideas are not a replacement for professional support, but they can help you get through a hard moment.
Delay. Tell yourself you'll wait 15 minutes. Urges often rise, peak and fade.
Change your temperature. Splash cold water on your face or hold something cold. Strong physical sensations can calm your body quickly.
Move. Walk fast, do jumping jacks or put on music and dance. Getting energy out can lower the intensity.
Change where you are. Go to a room with other people, step outside or leave the space where you usually self-harm.
Reach out. Text a friend, call a crisis line or write down what you are feeling.
If you want to tell someone
Telling someone for the first time takes courage. Choose a person who is usually calm and caring. You don't have to share every detail. You might say, "I've been going through a hard time, and sometimes I hurt myself to cope. I'm telling you because I want support."
If you are a parent worried about a young person instead, our guide on self-harm in teens, what parents can say and do may help.
Getting support with us
Our therapists work with adults who self-harm, using approaches like CBT, DBT and ACT. You can read more about our therapy for self-harm. If an assessment would help, our psychologists can assess and diagnose, and our nurse practitioners can diagnose and prescribe medication when that's part of the plan.
We see clients in person in Waterloo, Kitchener, Cambridge and Ottawa, and online across Ontario. No referral is needed, and evening and weekend appointments are available.
Our clinic is not a crisis service. If you need help right now:
Call or text 9-8-8, the Suicide Crisis Helpline, any time
In Waterloo Region and Wellington, call Here 24/7 at 1-844-437-3247
In Ottawa, call the Mental Health Crisis Line at 613-722-6914 (adults), or the youth crisis line at 613-260-2360
If you are in danger or have a serious injury, call 911
Frequently asked questions
Do I have to stop self-harming before I start therapy?
No. You can start therapy wherever you are. Your therapist will work with you at your pace, and safety will be part of the conversation from the start.
Is what I say about self-harm kept private?
What you share in therapy is private. There are a few legal limits, such as when someone is at serious risk of harm. Your therapist will explain these at your first session so there are no surprises.
What if I've had therapy before and it didn't help?
That's common, and it isn't a failure on your part. A different therapist, a different approach or a different time in your life can make a real difference. In your free consultation, you can tell us what didn't work before so we can look for a better fit.
You deserve support, not shame
Self-harm is a sign of pain, not a character flaw. You can learn other ways to cope, and you don't have to do it alone. Book a free 15-minute consultation to talk with our team, privately and without pressure, about finding a therapist who fits.
Last reviewed: October 2026
Sources
Self-Harm, MedlinePlus, U.S. National Library of Medicine (NIH)