Many people think of self-harm as someone cutting themselves. Whilst this is the most common form of self-harming, it's by no means the only method used in order to release pent-up emotions. Any behaviour that causes you physical damage is a form of self-harming, from cutting, burning, pulling out hair to drinking or eating to excess to taking risks like driving too fast or putting yourself in danger.
When emotional pain is so intense that it is frightening or impossible to express verbally, hurting ourselves can become an immediate outlet. If you have low self-worth, then not taking care of yourself and keeping yourself safe seems natural and acceptable.
When working with self-harming, it's important to explore ways that those utilising this coping mechanism can keep themselves safe. Identifying and exploring which emotions or fears aren't being expressed naturally and healthily, and building confidence, self-esteem and self-worth, is also crucial.
For many who self-harm, anger and the fear of expressing it, can be at the root of the issue. Having a safe place to acknowledge and express such a powerful and often scary emotion is part of the process of finding a way toward recovery and healing.