Making Sense of Self-Harm vs. Self-Mutilation

Some of the wording in the mental health community is frequently confusing to the point where the meaning of certain terms and phrases are lost. I have found that the phrases self-harm and self-mutilation are some of the most confusing phrases in the mental health community, and it has gotten to the point where I am even confused as to what the meanings of these phrases are in connection to symptoms of depression, suicidal ideation, anxiety and so many other mental health concerns. However, I have been working with my therapist to further understand self-harm and self-mutilation in regard to my own mental health concerns – and it has made me think more about the intent behind these behaviors, as the intent is what ultimately separates their meanings.

Self-harm is often an umbrella term used to describe all forms of harmful actions taken against one’s body, but its official meaning refers to actions that are used to harm oneself, not just one’s body. Self-harm doesn’t refer only to physical injuries. It can also refer to actions that are detrimental to an individual, such as gambling, overspending to purposefully harm one’s wellbeing, using eating disorder behaviors as punishments, substance abuse, and so much more. For something to be defined as self-harm it has to be an action taken to purposefully harm one’s own body or self (MedlinePlus, 2021). While self-harm is often used interchangeably with self-mutilation, they are both completely different terms. Whereas self-harm refers to actions taken to purposefully harm one’s self, self-mutilation refers to actions taken against one’s self out of an intent to disfigure one’s own body without suicidal intention (Simpson, 2001). Self-mutilation is often linked with personality disorders, such as borderline personality disorder, and can refer to behaviors such as using substances or eating disorder behaviors out of an intent to damage one’s body.

Whereas self-harm can be linked to suicidal behavior, self-mutilation is not borne out of intended suicidal ideation. This is possibly the biggest difference between self-harm and self-mutilation.

While it is often found that both self-harm and self-mutilation are used interchangeably, it is important that we do not label an individual’s behavior as either self-harm or self-mutilation until we know more about the intent behind their actions. The intent is what separates these terms and will tell us more about an individual’s mental state. When labeling your own behaviors, you have the right to choose the term that best defines your actions as you understand them. But it is also OK to not be sure what your intent is behavior your self-injuring behavior. It has taken me getting professional help to better understand the intent behind my own actions by looking at my thoughts and behavior patterns with how they relate to my mental illnesses.

It is also important to understand that self-mutilating behavior is often linked to an individual’s past abuse. Frequently, a history of sexual, emotional and/or physical abuse will lead to new self-mutilating behaviors to try and relieve the pain that one feels from their abusive past. But these behaviors can also be used out of an intent to further harm oneself out of feelings of unworthiness.

In my personal experience, I have used both self-harming and self-mutilating behaviors which have frequently been tied to past abuse, including sexual and emotional abuse. While suicidal ideation was tied to certain instances of my self-harming behaviors, there were other times where my self-mutilation was intended to disfigure my body but was not linked to any suicidal ideation. Understanding the intents behind my behaviors has helped me to interrupt these behaviors before they begin. While I am not always successful, I do feel as though I have more control over my actions, and I am better able to process what I am experiencing in a healthy way.

However you decide to define your actions is your choice, but please do not assume that another’s behaviors are self-harm or self-mutilation without knowing more about their inner experience. It is a person’s inner experience alone that helps to define whether an action is self-harm or self-mutilation.