Self-Harm as Agency

In February 2025 I invited ‘unanswered questions’ about self-harm and throughout March 2025 and beyond I will be responding to these questions in a series of blogs. In these blogs I draw on my personal and professional experience, as well as survivor and academic literature. The purpose of these blogs is to bring together a range of perspectives and pose ideas and questions for further reflection. I welcome feedback and questions – thanks for reading!

The Unanswered Question(s): How do people feel after they self-harm?

Training role play: I love it, some hate it. You really can’t learn to do supportive listening work without it. The most fun I have had with it was when I was the client, and I was ANGRY. Not because of what the listener was doing or even saying, but because we couldn’t agree on language.

On the Tip of My Tongue

We were practicing summarising both, what people were saying to us, and the emotion that was coming across, and my partner was trying valiantly to give me the right word to sum up how I felt. But he was being timid, and I, in character, wanted strong words that summed up big feelings and I wanted the exact specific word. No, I’m not cross or sad or deflated. I need a much more powerful and nuanced word. No, I don’t know what word that is, but I will when you say it!

We were a room full of very well-meaning, polite people there to learn helping skills, so anger and frustration hadn’t featured much in our conversation and listening practices so far. I think I may have had a little too much fun with the process, as my partner looked slightly shell-shocked at the end.

I still vividly remember that training session, even a decade later, which makes me think it must have resonated with my internal experience a lot more than I thought it did in the actual moment. I know I have spent a lot of time since reflecting on language, how we use it and how it shapes our shared understanding of the world.

One of the trickiest things about language, is that we all assume we have a shared frame of reference for meaning. But you only have to use British English in the US, or indeed, Scottish turns of phrase outside Scotland, to realise that is most definitely not the case.

Language is incredibly powerful, in more ways than we often realise in our day to day lives. The information we get from it is far more than the meaning of the words we use; our tone, volume, accent and use of dialects or slang all impact how others hear and understand us. Language has cultural, political and social dimensions that are so deep-rooted they are almost invisible. And yet there are also areas of our lives where language is not always enough.

A World Divided by a Common Language

Despite decades of research and whole professions dedicated to untangling and reflecting on our innermost thoughts, conveying your own emotional state to another human being is still, in my experience anyway, one of the most challenging aspects of any relationship.

First of all, you must recognise or know yourself how you feel, which is not often as straightforward as it sounds. Secondly, despite there being an estimated one million words in English, it can be hard to find language that is the right fit for your internal experience. So many descriptions can be almost right, but not quite, and add the free association of another human being into the mix and you can find your experience being framed and understood in a completely different way to how you intended.

Many parents can relate to the sometimes frustrating, often hilarious language development stage of small children when they clearly and directly ask you for something that is obviously very important, and you have no idea what they are saying. Inevitably, that one thing that you cannot understand will become the most important thing in your toddler’s world, and you the parent who is supposed to know and provide all things, are completely useless. And as most people know, toddlers are no strangers to frustration, and they ensure everyone around them knows all about it.

I sometimes wonder if the frustration, and in all honesty, rage, I can feel when I can’t communicate my internal emotional state has its roots in that feeling of impotence experienced at such an early stage in life. When you know exactly what you want to say, but the language you have available to you is just not enough.

The reason I’m saying all of this, is because, although I can do my utmost to describe and explain the experience of self-harm, drawing on my own and hundreds of other experiences I have witnessed, I know on some level, I will not be able to do it justice. But here is my best attempt.

Unlocking Agency

I’ve picked this question of how someone feels after self-harm and am reflecting on it separately to what people get out of self-harm, as although there is some overlap, the answer is not always the same.

In 2005, the brilliant Lifesigns, a user-led, self injury support charity, developed a deceptively simple diagram focused on what they called ‘Precursors to Self Injury’ and the feelings that subsequently followed self-injury. This was based on the shared experiences of the charity founders and people using their support. I first came across it in a training course, and I have used it ever since. I say it’s deceptively simple, because although it uses only thirty-two words, it manages to encapsulate a wide range of experiences and how they are connected.

They use the word ‘hyper-stress’ to cover the breadth of intense and potentially unbearable feelings and experiences that can lead up to self-harm. This captures far more than a focus purely on emotional intensity or ‘dysregulation’ and could include experiences such as intense intrusive thoughts, hearing voices or being stuck in abusive relationship. They also show how the flip side of this hyper-stress can be the disconnection of dissociation.

The most important thing though for me is that the diagram shows what changes, and I think that’s the fundamental thing about how it feels after self-harm; it feels different and different in a way that’s more manageable.

Looking at the words at the bottom of the diagram, the common theme that jumps out at me is that these are all words and feelings with a sense of agency and autonomy: in control, functional, calm, able to act. Incredibly intense experiences and feelings can be paralysing and taking action, in the form of self-harm, can unlock that sense of agency.

Process or Person

There is a range of research exploring emotion regulation models of self-harm, including research that reports young people describing a change in ‘affective state’ before and after self-harm. There is a cognitive-emotional model, an affect-regulation model and four function model focusing on automatic and social positive and negative reinforcement, to name a few. This research is interesting to read, but the focus is on the process rather than the person going through that process.

To me the value in knowing how someone feels afterwards is in is in connecting with where the person is now, and what do they need in this moment. Further value is in understanding what need is being met, and whether self-harm is the best way to meet that need. And for some people, some of the time it will be, and for others they might be looking to find out what would work better for them.

In 2011 I was involved in making a short film, Submerged, which at the start was about people’s experiences of the symptoms that can come with the label of borderline personality disorder, but quickly came to be focused on the impact of dissociation and self-harm on the participant’s lives.

At one point, one person says, “Sometimes it feels like if I self-harm, I can then go around my day quite normally.”

I think this sums it up; there’s a shift that makes things more possible, and self-harm makes that happen. It’s not for me to say how or why that happens, or what that shift is for any individual, but paying attention to that shift, and acknowledging it and hearing about it, can help start a constructive conversation. It’s OK if you don’t know the exact, specific word needed, but you have to be willing to search for it.