What self-harm actually does

When eighteen studies were pooled and people were asked what it was for, one answer came first: to quieten an unbearable feeling. Second was to punish themselves. “So someone would notice” came far below, and was chosen rarely.

There is a sharper study: 51 women, two weeks, several surveys a day, three and a half thousand measurements. It found that this almost always begins with something between people — an argument, a refusal, silence in reply.

And the important part: relationships afterwards were neither better nor worse. So other people set it off, but other people do not reward it. The folk theory that it is attention-seeking has the direction backwards.

None of that makes it safe or makes it right. But it explains why shame fixes nothing here: what is happening is about an unbearable feeling, not about an audience.