Woman hiding bandaged wrist while struggling with compulsive self-harm

Understanding Compulsive Self-Mutilation

Skin picking, nail-biting, hair-pulling—it’s not uncommon to occasionally fuss with your hair or pick at an annoying scab. For some people, however, that fussing turns into a compulsive behavior that is both destructive and embarrassing. From constantly biting one’s nails to cutting one’s skin when strong emotions hit, these repetitive behaviors often have a serious physical and emotional impact, especially when obsessive-compulsive disorder (OCD) is also involved. 

Understanding compulsive self-mutilation and the possible causes behind it can help you address your own behaviors or support someone you know who may be struggling. Call Promises Behavioral Health at 844.875.5609 to learn how our OCD treatment center can help.

Understanding Compulsive Self-Mutilation

Compulsive self-mutilation is a mental health condition that involves an individual engaging in the intentional destruction or alteration of their own body tissue. It is sometimes referred to as body-focused repetitive behavior, and it can include behaviors such as cutting, burning, picking at skin, and biting. Compulsive self-mutilation often co-occurs with other mental health issues such as depression, anxiety, and substance use.

The exact cause of compulsive self-mutilation is not clear. Still, it may be linked to various factors such as emotional distress or trauma, low self-esteem or feelings of powerlessness, difficult family dynamics, and difficulty managing emotions. People who engage in compulsive self-mutilation often report feeling a sense of relief or distraction from pain or distress after engaging in the behavior.

Compulsive self-mutilation can be a severe and complex condition, but with the right help and support, it is possible to manage the symptoms and find relief from distress. It’s important for people struggling with compulsive self-mutilation to know that they are not alone and there are resources available to help them. If you or someone you know is struggling with compulsive self-mutilation, reach out for professional help. With the right treatment, individuals can find relief and learn healthier ways of managing their emotions.

Types of Self-Mutilation

Some types of self-mutilation are quite obvious, but others are more covert and harder to notice. Some examples of what to look for are outlined below.


Although alarming to others, individuals who engage in this type of compulsive self-mutilation don’t do it with the intent to kill themselves. Rather, they almost always use it as a way to cope with intense negative feelings. The impulsive act of cutting gives the person a sense of control over their emotional pain. For many who engage in this type of behavior, self-harm actually releases endorphins that provide a sense of pleasure.

The arms and wrists are the most commonly cut areas. Sadly, cutting often leaves permanent, unsightly scars. Cutting occurs most frequently in adolescents, but for some individuals, particularly many diagnosed with borderline personality disorder, it can continue into adulthood.

Hair Pulling

Also known as trichotillomania, individuals with this impulse-control disorder have the uncontrollable urge to pull out hair from their heads, eyebrows, eyelashes, or arms. Feelings of anxiety often trigger the urge. The hair-pulling behavior relieves the tensions and provides a feeling of satisfaction—at least temporarily. It’s common for those with trichotillomania to also compulsively twirl their hair, inspect their hair’s roots, and chew on it. Unfortunately, the behavior often results in visible patches and bald spots.

Nail Biting (Onychophagia)

This is a common habit affecting many young children. Most people, however, stop biting their nails on their own by around the age of 30. Chronic and severe nail biting can lead to scarring and infections. It can also create feelings of shame. For example, a nail-biter might become too embarrassed to shake hands. If their condition is severe, they may wear gloves to hide the self-inflicted damage.

Skin Picking (Dermatillomania)

This condition is marked by repetitive skin picking that results in tissue damage. Picking can occur on any part of the body, but common target areas include:

  • The face
  • Arms
  • Lips
  • Gums
  • Scalp
  • Chest
  • Fingers

Many individuals with dermatillomania pick with their fingers; however, some use tools like fingernail clippers or tweezers. Skin picking can cause infections, interferes with the healing of wounds, and often leave visible scars.

OCD and Self-Harm

OCD and self-harm often go hand-in-hand, as individuals can feel compelled to engage in behavior that is ultimately harmful to them. In some cases, people may have intrusive thoughts which lead them to perform a certain action repeatedly, or they may experience intense anxiety that leads them to self-harm as a coping mechanism. Self-harming behaviors can range from minor to severe and may include cutting, burning, scratching, picking at skin or scabs, or other forms of physical injury. It is important to understand that these behaviors are not intentional attempts to hurt oneself but instead are a way of managing distress and anxiety. People who self-harm due to OCD are often ashamed and feel a sense of guilt or failure, so it is essential to create a safe space for them to talk openly about their experiences. 

It is important to remember that self-harm due to OCD is not a sign of weakness, and it does not mean that an individual lacks willpower. Rather, it is a sign of how powerful the urge to engage in compulsive behavior can be and how challenging it can be for people to manage these urges without help. It is also important to remember that self-harm due to OCD is treatable, and with the right support and treatment, individuals can learn to better manage their symptoms and lead healthy, meaningful lives. If you or someone you know is struggling with OCD or self-harm related to OCD, reach out for help today.

Treating Compulsive Self-Mutilation

Self-help strategies are essential tools for managing and eliminating self-mutilating behaviors. These include:

  • Managing stress – Making time for a relaxing hobby or volunteer work will also provide the physical and emotional relief needed to resist cutting, skin picking, and other behaviors.
  • Expressing emotions – Conveying your emotions through activities like writing, singing, painting, or dancing. Talking with friends or a support group will also give you an outlet for negative feelings.
  • Keeping hands busy – A fidget toy can be any object you can fiddle around with, like a small squeeze ball or stress ball. Small craft projects, like knitting or crocheting, can also keep your hands busy during long periods of inactivity, such as watching television or riding in the car.

However, compulsive self-mutilation should be taken very seriously, and the person harming themself should receive professional help. One of the most effective types of treatment for compulsive self-mutilation disorders is cognitive-behavioral therapy (CBT). The goal of CBT is to help the individual identify unhealthy and irrational thought patterns and re-wire their thinking. By doing so, they can learn to replace self-harming behavior with healthy ways to cope with anxiety, emotional pain, and other triggers. Researchers have found that CBT is far more effective than a medication-only approach.

Since people who struggle with compulsive self-mutilation often suffer from other psychiatric disorders, such as PTSD or major depression, a successful treatment plan will also integrate therapies to address those conditions as well. One of the challenges with compulsive self-mutilation is that the damage may also generate physical injury that requires medical treatment. Cutting, hair pulling, and skin picking can lead to infection and scarring that requires treatment by a dermatologist or other type of physician.

Begin to Heal at Promises Behavioral Health

Self-mutilation, from nail biting to skin picking, is more than an inconvenient habit. If your behavior is causing embarrassment, shame, or physical problems, seek help. A skilled mental health professional will give you the resources to reverse these conditions so you can live the healthy, happy life you deserve.

Promises offers comprehensive mental health programs to help you overcome compulsive self-mutilation and other disorders. Reach out to Promises today by calling 844.875.5609 or filling out our online contact form to get started.

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