Exploring the urge to hit yourself — and how to stop

When a person purposefully and repeatedly hits themselves, it can be a form of self-harm* or nonsuicidal self-injury (NSSI). The effects of this form of NSSI can range in severity. But left untreated, it can lead to significant physical harm. 

We don’t know exactly how many people engage in hitting as a form of self-harm. But research shows that NSSI, in its many forms, seems to be most prevalent among young people and people receiving psychiatric care. One study found approximately up to 20% of adolescents will engage in NSSI at some point in their lives, and it typically occurs when someone is around age 13 or 14. NSSI appears to be less common among adults, affecting approximately 6% of the adult population. 

If you don’t have prior experience with self-harm, it can be difficult to understand. You might wonder why someone would purposefully hit or injure themselves. Taking the time to understand the underlying causes of self-harm can help you recognize the signs and offer meaningful support — to yourself or someone else. Therapy can provide support and strategies to help manage self-harm and build healthier coping skills.

*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.

Does hitting yourself count as self-harm?

We all accidentally injure ourselves once in a while. We might mistakenly grab a hot pan from the oven, stub a toe on a hard surface, or trip and fall. But these behaviors, while potentially painful, aren’t the same thing as self-harm. The difference is that these behaviors are accidental and not intended to relieve emotional distress. 

Self-harm occurs when you intentionally harm yourself as a way to cope with difficult feelings, emotions, or situations. Here are some examples of how hitting might manifest as self-harm:

• You keep making errors at work, so you hit yourself as a form of punishment, believing you deserve it for making “stupid” mistakes.
• When you’re in crowded, noisy spaces, you get extremely overwhelmed. You use hitting as a way to cope with sensory overwhelm because it’s something you feel like you can control.
• As a child, your parents modeled that it wasn’t safe to express your feelings. So when uncomfortable emotions bubble to the surface, you hit yourself as a way to release them.
• You often feel nervous in new social situations, worried that you’ll do or say the wrong thing. After a recent interaction in which you thought you accidentally insulted someone, you hit yourself as a way to express your embarrassment.
• You struggle to regulate your emotions — especially anger. When you sense that your temper is about to flare, you hit yourself to avoid hitting someone else or damaging property.

Recognizing these patterns is an important first step toward change. With the right support, healthier coping strategies can replace self-harm, helping you manage emotions in a way that fosters healing and self-compassion.

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Is self-harm like hitting a mental health condition?

On its own, self-harm isn’t a mental health concern. But it’s associated with conditions like:

• Depression
• Post-traumatic stress disorder (PTSD)
• Eating disorders
• Personality disorders

Self-harm behaviors like hitting may also be more common among people who:

• Experienced childhood trauma such as abuse or neglect
• Have low self-esteem
• Have friends who self-harm
• Misuse substances 

Harmful effects of hitting yourself

It’s important to remember that hitting yourself isn’t a sign of a personal weakness or a character flaw. It’s typically an attempt to cope with stress, self-soothe, or regulate emotions. 

However, hitting yourself can have many harmful consequences. In some cases, it may lead to significant physical harm and even be life-threatening. But even milder forms of hitting can affect relationships, work, and overall well-being. Additionally, self-hitting can contribute to emotional distress, such as feelings of guilt, shame, or hopelessness, which can further complicate your mental health.

Dig deeper:

• Can you get addicted to self-harm?

Strategies to prevent hitting yourself

While not a replacement for professional help, here are some strategies you can use to prevent hitting yourself. 

• Distract yourself: We might think of distraction as a bad thing. But in the case of self-harm, it can help you focus on something else when you’re tempted to hit yourself. For example, you could try going for a brisk walk, listening to some music, or calling a friend when you feel the urge to hit yourself.
• Stop and wait: Sometimes, delaying self-harm can help to curb the behavior. So rather than trying to eliminate it all at once, see if you can wait a few minutes. Then slowly increase the time you wait (for example, start with five minutes and then go to seven minutes). 
• Understand your triggers: Try to reflect on the feelings that arise right before you’re tempted to hit yourself. Consider what you’re trying to achieve by engaging in self-harm. For example, do you hit yourself to relieve anxiety? Express shame? Unleash anger? Knowing your triggers can help you identify when you might need support to choose a safer behavior.
• Practice self-compassion: When you feel like you want to hit yourself, stop to think about how you might treat a friend in this situation. You’d likely offer support and compassion, not judgment or criticism. See if you can start to treat yourself in the same way.

Getting support for self-injury and hitting

Although it’s not a mental health condition, self-harm can be treated. With the right support, people can reduce the urge to hit themselves and manage the underlying emotions that might be driving the behavior. 

Some of the most common treatments for self-injury include:

• Cognitive behavioral therapy (CBT): CBT can help you recognize and interrupt unhelpful thought and behavior patterns and learn new coping skills. 
• Dialectical behavioral therapy (DBT): DBT can help you regulate overwhelming emotions, increase distress tolerance, and increase self-compassion.
• Psychodynamic therapy: This form of therapy can help you understand how past experiences might be shaping your thoughts, feelings, and behaviors in the present. These insights can help you make positive changes and reduce self-harm.

Currently, there’s no FDA-approved medication to treat self-harm on its own. However, medication may be prescribed to treat related mental health concerns like anxiety or depression. It’s important to work with your provider to determine if medication is right for you.

Find care with Rula

When a person hits themselves as a form of self-harm, it’s often an attempt to manage emotional pain or reduce stress. Although this behavior might be confusing to other people, it’s important to know that it’s often a sign of a mental health condition and not a conscious choice. Left untreated, self-harm can seriously impact a person’s health, safety, and overall well-being. So if you or someone you care about is hitting themselves, don’t hesitate to seek professional help. With the right support, people can overcome the urge to self-harm and learn healthier ways to manage uncomfortable emotions.

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 15,000 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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