Self-Harm: Revealing the Roots of Self-Injurious Behaviors

Thrive • March 1, 2022

By Thrive Reno Clinical Director and Therapist Kerstin Trachok, CPC 

WHAT IS SELF-HARM?

Individuals who self-harm or self-injure purposefully hurt themselves often as a means for dealing with painful memories, distressing emotions, or overwhelming situations. Rather than an attempt at ending one’s life , self-harm is generally a strategy for obtaining relief. Still, deliberately hurting oneself is dangerous and may shift to suicidal ideation. 

Self-injury afflicts a wide range of age groups. According to the American Psychological Association , 1.3% of youths ages 5 to 10, 17% of adolescents, and 15% of college students have intentionally hurt themselves. Older adults are also known to self-harm.

Sometimes mistakenly characterized as attention-seeking behavior, self-harm is typically performed in secrecy out of a sense of shame. As a means of coping with related feelings of guilt or remorse, individuals may continue engaging in self-injurious behaviors, which can create a vicious cycle. 

Risk factors for self-injury include having a co-occurring mental or behavioral health condition, such as:

  • Anxiety : Overwhelm or worry characteristic of anxiety can motivate self-injury.
  • Depression : Feelings of sadness, worthlessness, and numbness associated with depression can provoke individuals to intentionally hurt themselves.
  • Borderline personality disorder (BPD) : BPD can make emotions seem much more intense to affected individuals, driving them to seek relief in self-harm.
  • Eating disorders : Eating disorders, such as anorexia, bulimia, and binge eating disorder (BED), involve self-harming behaviors. Individuals struggling with eating disorders are also at risk for engaging in other self-injurious behaviors.
  • Substance use disorders: A form of self-harm in itself, substance abuse can evoke shame. Substances can also curb self-control, impair judgment, and lower inhibitions — all of which can lead to self-injury for someone who may be struggling. 
  • Post-traumatic stress disorder : Trauma and its concurrent painful emotions are closely linked to self-harm. 

Individuals who self-injure may be driven by the desire to:

  • Administer self-punishment
  • Process thoughts or feelings that are too uncomfortable to express in words
  • Express suicidal thoughts or feelings without the intention of taking their life 
  • Feel a release or sense of escape
  • Feel something physical other than numbness
  • Turn emotional pain into physical pain

Signs that a person is engaging in self-harm can include:

  • Avoiding situations that involve showing skin, such as swimming
  • Wearing clothes that cover the skin even when the weather is warm
  • Engaging in impulsive behaviors
  • Hiding sharp objects
  • Spending extended amounts of time alone 
  • Struggling to maintain healthy friendships, family relationships, or romantic relationships 
  • Bloodstains on clothes, towels, bedding, or tissues
  • Unexplained wounds that appear sporadically or in the same places, often on the wrists, arms, thighs, or torso

It’s important to note that these warning signs aren’t exclusive to self-harm and could also indicate that a person is facing another kind of physical, mental, or behavioral health condition.

STOP SELF-HARM

Self-harm requires treatment from a mental or behavioral health professional. If you suspect a loved one is harming themselves, you can express your concern for their well-being with compassion. Try to approach them without judgment, encourage them to seek clinical support, and offer to help them find care. 

Treatment for self-harm should address the underlying thoughts and feelings influencing self-injurious behaviors, while also integrating skills to process distressing emotions and experiences healthily. While treatment approaches for self-harm vary based on the individuals’ diagnosis, dialectical behavior therapy (DBT) can be an effective therapeutic method to teach individuals tangible skills for regulating emotions, implementing mindfulness, and creating a life where there is no space for self-harm.

CULTIVATE A HEALTHY SENSE OF SELF AT THRIVE

If you’re struggling to embrace your emotions constructively, Thrive’s specialists can help you discover what’s at the root of your suffering and guide you on a path to healing. Find out more about Thrive’s therapeutic services by reaching out

SUPPORT RESOURCES FOR INDIVIDUALS AFFECTED BY SELF-HARM

Individuals struggling with self-harm may also consider taking advantage of the following free national support resources.

  • Crisis Text Line : A 24/7 crisis line offering mental health support and crisis intervention. Individuals can text “HOME” to 741-741 to connect with a counselor.
  • The Trevor Project : A resource dedicated to ending suicide among LGBTQ people. Individuals can text “START” to 678-678 or call 1 (866) 488-7386 to connect with a counselor.
  • CHADS Coalition : An organization dedicated to advancing awareness and prevention of suicide. Individuals can call or text CHADS’ Family Support Warm Line at (314) 952-8274
  • National Suicide Prevention Lifeline : A national network of local crisis centers that provides support to those facing a suicidal crisis or emotional distress. Individuals can connect with the lifeline by calling 1 (800) 273-TALK (8255).

About the Author

Thrive Reno Clinical Director and Therapist Kerstin Trachok, CPC

Kerstin received her master’s degrees in clinical mental health counseling and school counseling from the University of Nevada, Reno. Kerstin has six years of experience in the counseling field working in different settings and a wide array of mental health issues. Kerstin has experience working in schools with children of all ages, clients with psychosis in a hospital setting, adults and teens in private practice, and working at an agency providing counseling to children and families. Kerstin is a fully licensed clinical professional counselor in the state of Nevada and received her certification in Complex Trauma Levels I and II. Kerstin has experience working with children, teens, adults and families with trauma, anxiety, grief, depression, ADHD, autism spectrum, suicidal ideation, and behavioral issues. Kerstin is passionate about fostering client’s growth and autonomy while providing a safe and secure space to process emotions. Kerstin uses creative interventions and other tools to allow clients to voice their internal experiences beyond traditional talk therapy. Kerstin’s theoretical approach is Acceptance and Commitment Therapy. She uses mindfulness tools and techniques to help clients be present moment oriented, and reduce stress so they may move towards psychological flexibility. Kerstin believes all individuals have the right to live a fulfilling and vital life.

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November 11, 2025
Are you looking for a meaningful way to give back this holiday season? Thrive Wellness is excited to continue our 6th Annual Giving Tree Program in collaboration with Perenn Bakery this winter. This year, Thrive Wellness Reno and Perenn Bakery are proud to partner with Ronald McDonald House Charities® of Northern Nevada. The organization supports families with children receiving treatment at area hospitals, providing comfort, hope, and a home-away-from-home during challenging times. Ronald McDonald House Charities offers essential services, removes barriers, strengthens families, and promotes healing when children need healthcare the most. How It Works Simply take one (or a few) tags from the Giving Tree, each listing an item you can purchase and donate for residents of the Ronald McDonald House. Then, drop off your item(s) at one of our designated donation locations by Friday, December 19. Items Needed: Restaurant gift cards Walmart or Target gift cards Games, puzzles, and coloring books Toys (Barbie, Hot Wheels, Lego sets, craft sets, magnet blocks, baby dolls, action figures, journals, infant toys, etc.) Children's books (picture, chapter, and graphic novels) Toiletry sets (for adults) Lotion/self-care gift sets (for adults) Sweatshirts/hoodies (adults, XS-XXL) Scarves, gloves, fuzzy socks, pajamas (all sizes) Infant diapers, onesies, and baby bottles Bulk individually wrapped snacks (granola bars, chips, etc.) Please ensure all donations are new, in original packaging, and unwrapped. Donation Drop-Off Locations Please deliver donations by Friday, December 19, to one of the following sites: Thrive Wellness 491 Court St., Reno, NV 89501 201 W Liberty St., Suite 201, Reno, NV 89501 Perenn Grocery 7600 Rancharrah Pkwy, Suite 130, Reno, NV 89511 Perenn Rancharrah 7750 Rancharrah Pkwy, Suite 110, Reno, NV 89511 Perenn Midtown 20 St. Lawrence Ave, Reno, NV 89509 Claio Rotisserie 3886 Mayberry Dr., Suite D, Reno, NV 89519 Why We Give Back Through our Giving Tree program, we’re honoring one of our core values at Thrive Wellness: staying rooted in community. This annual tradition allows us to give back to those who need support most during the holiday season. We invite you to join us by taking a tag at any Thrive or Perenn location and helping spread kindness throughout our community. There’s no better way to embrace the holiday spirit than by supporting local families with thoughtful, heartfelt donations. We are deeply grateful for your generosity and continued support. Thank you for helping us make a difference!
September 22, 2025
Eating disorders are one of the most serious mental health concerns facing today’s adolescents. They can affect every aspect of a young person’s life, including their physical health, school performance, relationships, self-esteem, and more. According to the National Institute of Mental Health, about 2.7% of adolescents in the U.S. will experience an eating disorder in their lifetime, and many more engage in disordered eating behaviors that may not meet full diagnostic criteria. The good news is that providers are in an influential position to notice early warning signs, open conversations, and connect families to support before these patterns of behavior become too engrained. Why Early Intervention Matters The earlier an eating disorder is identified and treated, the better the treatment outcomes. Research shows that getting support quickly after the disorder’s onset is linked to faster recovery, lower relapse rates, and healthier long-term development (Treasure & Russell, 2011). Waiting too long to seek help can mean medical complications, deeply ingrained behaviors, and a more difficult path to healing. For many adolescents, a caring provider who notices the signs and advocates for treatment can make all the difference in recovery and can even save lives. Recognizing Early Warning Signs Adolescents may not always disclose their struggles directly, so providers should keep an eye out for a range of indicators: Physical signs: noticeable weight changes, menstrual irregularities, digestive issues, dizziness, or fatigue. Behavioral patterns: skipping meals, restrictive eating, excessive exercise, frequent dieting, eating in secret, or leaving for the bathroom after meals. Emotional and cognitive signs: preoccupation with weight or body shape, food rituals, heightened anxiety around eating, or perfectionistic tendencies. It’s important to remember that eating disorders don’t always “look” a certain way. Teens can be distressed about food and body image even if their weight appears to be within a “normal” range. Screening Tools and Assessments Using free screening tools available online can be an effective way to gauge a patient’s needs and gain further insight on treatment options for a possible eating disorder. Here are 4 free screening resources we recommend you use before making a referral for a higher level of care. EDE-Q (Eating Disorder Examination Questionnaire) : helps assess eating attitudes and behaviors. Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS) : helps to assess the signs of ARFID in children. Eat 26 Screening Tool : a screening measure to help you determine attitudes towards food and eating. BEDS-7 (Binge Eating Disorder Screener) : for situations where binge eating is suspected. When possible, gathering input from parents, teachers, or coaches can also help, as teens may minimize their experiences out of fear or shame. The Role of Primary Care and Pediatric Providers Routine checkups are often where eating disorders first come to light. Providers treating children, teen, and adolescents can: Incorporate simple questions about eating habits and body image into wellness visits. Track growth charts and weight trends while pairing them with questions about mood, anxiety, and behavior. Foster trust by creating a safe, nonjudgmental space where adolescents feel comfortable sharing sensitive information and know there will be no weight stigma. Coordinating Multidisciplinary Care Supporting a young person with an eating disorder works best when care is collaborative . In order to treat the whole person, there are usually multiple members of a treatment team needed, including: Medical support: monitoring vital signs, lab work, and physical health. Therapeutic care: evidence-based approaches such as family-based therapy (FBT) and cognitive-behavioral therapy (CBT) help address thoughts and behaviors. Nutritional guidance: dietitians provide education, meal support, and reassurance. Family involvement: engaging caregivers empowers them to support recovery in everyday life. Addressing Barriers and Stigma Many families face challenges in seeking help, whether due to stigma, lack of awareness, or limited access to specialists. To help, providers can: Normalize conversations about body image and mental health as part of overall well-being. Use culturally sensitive approaches that honor diverse experiences with food, body, and health. Connect families to community organizations, online resources, or telehealth when in-person specialty care is limited. Eating disorders in adolescents are serious, but with early recognition and timely support, recovery is possible. Providers are often the first to notice changes and can play a vital role in opening doors to crucial support. By blending professional expertise with empathy and collaboration, providers can guide adolescents and their families toward lasting recovery and a healthier future. References National Institute of Mental Health. (2023). Eating Disorders . Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. The British journal of psychiatry : the journal of mental science, 199(1) , 5–7.
By Julia Actis, LCSW September 11, 2025
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