What does emotional self-harm look like?

It’s natural to set high standards and hold yourself accountable, but when your inner voice is constantly harsh — blaming yourself for every mistake or tearing yourself down — it can take a serious toll. If you find yourself trapped in a cycle of self-criticism and shame, you may be experiencing emotional self-harm. 

Emotional self-harm happens when you hurt yourself by using negative self-talk, self-destructive behaviors, or patterns of self-punishment. This can lead to harmful behaviors like staying in toxic relationships, isolating yourself, or using substances to cope. Over time, it can lower your self-esteem and increase your risk of physical self-harm.*

Therapy can help you notice and challenge these harsh inner thoughts, replacing them with kinder, more balanced self-talk. With support, you can develop healthier coping skills and work toward growth without being overly self-critical.

*The 988 Suicide and Crisis Lifeline offers 24/7 confidential support through trained crisis counselors. If you or someone you care about is experiencing emotional distress, self-harm, or a suicidal crisis, please call or text 988. For life-threatening emergencies or immediate assistance, call 911.

Examples of emotional self-harm

Emotional self-harm can look different for everyone but may include:

• Self-destructive behaviors: These are actions that hurt your well-being, and they’re often linked to negative feelings or thoughts. Examples include:
  • Staying in harmful relationships even though they cause pain
  • Using substances to numb feelings of worthlessness
  • Isolating yourself (either to punish yourself or because you believe others don’t care)
  • Doing reckless things (like driving too fast or spending too much) to escape strong emotions
• Negative self-talk: Constantly putting yourself down, like calling yourself worthless or a failure, can be a form of emotional self-harm — especially when you use it to punish yourself for mistakes.
• Self-punishment: This can involve restricting basic needs, like denying yourself sleep when you’re tired or food when you’re hungry. You may do this until you meet a certain goal and/or as a way of punishing yourself.
• Cognitive distortions: These are harmful thinking patterns that affect how you see yourself, such as catastrophizing (always expecting the worst) and black-and-white thinking (viewing things as all good or all bad). 

Emotional self-harm causes pain through negative thoughts or behaviors, like self-criticism or withdrawing from others. On the other hand, physical self-harm — also known as nonsuicidal self-injury (NSSI) — involves intentionally hurting your body without the intent to end your life. 

Both types of self-harm can be used to cope with emotional distress. The main difference is that emotional self-harm affects your mental and emotional well-being, while physical self-harm directly impacts the health of your body. 

Regardless of which type of self-harm you’re engaging in, help is available. With the right support, it’s possible to heal and develop healthier ways to cope.

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Underlying causes of emotional self-harm

You may find yourself emotionally self-harming as a way to cope with deep feelings of guilt, shame, or low self-worth. Perhaps you feel like you deserve punishment for your mistakes and inadequacies. Or maybe you struggle with perfectionism, carry unresolved childhood trauma, or use self-criticism as a way to stay motivated.

Certain factors may make emotional self-harm more likely. If you’ve experienced trauma, low self-esteem, or high expectations for yourself, your risk of emotional self-harm may be higher. Having a mental health condition like depression, anxiety, or obsessive-compulsive disorder (OCD) can play a role as well. 

Other contributing factors might include a history of childhood abuse, relationship difficulties, or chronic stress. Lack of social support, feeling disconnected from others, and frequent feelings of rejection or criticism can also make emotional self-harm more likely.

Recognizing these risk factors is an important step in understanding your emotional well-being. With support, you can begin to heal and learn healthier ways to manage difficult emotions.

Long-term effects of emotional self-harming

Emotional self-harm can lead to negative effects on your well-being. Some possible consequences include:

• More shame and guilt: Constantly being hard on yourself can make you feel worse and add to feelings of not being good enough.
• Lower self-esteem: Over time, being critical of yourself can hurt your self-worth and make it harder to care for yourself.
• Problems in relationships: Withdrawing from others or acting in unhealthy ways can cause stress in your relationships with family, friends, or partners.
• Worsening mental health: Ongoing emotional pain may lead to increased anxiety, depression, or other mental health conditions.
• Increased risk of physical harm: Sometimes, emotional self-harm can lead to physical self-harm as a way to cope with the pain.

It’s important to know that you don’t have to face this alone. Help is available to support you in breaking these patterns and moving toward healing.

Support for people emotionally self-harming

Treatment for emotional self-harm often involves therapy and support to help people understand the root causes of their behaviors and develop healthier coping mechanisms. 

Some effective treatment options for emotional self-harm include:

• Professional support: Engaging in therapy is one of the most effective ways to address emotional self-harm. Your therapist may use approaches like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or trauma-informed therapy. These types of therapy can help you understand and change negative patterns, regulate your emotions, and heal from past wounds.
• Medication: Medication can be helpful for managing the symptoms of mental health conditions like depression, anxiety, or OCD, which often contribute to emotional self-harm. It’s important to work with a provider to determine if medication is right for your needs.
• Social support: Connecting with trusted friends, family, or support groups can provide a sense of community, which can help you feel less isolated and more resilient in overcoming emotional self-harm.
• Self-help strategies: In addition to professional support, self-help can play a crucial role in managing emotional self-harm. Practicing mindfulness — such as deep breathing or body scan techniques — can help you stay present and reduce emotional overwhelm. Journaling provides an outlet for expressing your feelings and tracking your emotional progress. Setting small, achievable goals can build confidence, while engaging in activities like exercise, hobbies, or spending time in nature promotes positive emotions and can reduce harmful behaviors.

With the right combination of self-care strategies and professional support, you can effectively manage emotional self-harm and work toward healing.

Find care with Rula

If you’re engaging in emotional self-harm, you might notice that you’re often hard on yourself. You may also feel guilty or regularly distance yourself from others. Over time, this can impact your mental health, relationships, and overall well-being. Therapy can help you explore the root causes of these behaviors, understand the patterns at play, and develop new strategies to manage your emotions. You’re not alone in this, and, with the right help, healing is possible.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 10,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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