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The Psychology of Self-Injury: Exploring Self-Harm & Mental Health

The Psychology of Self-Injury: Exploring Self-Harm & Mental Health

By: Nicholas J. Westers Psy.D. ABPP
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Why do people self-injure? And what is the best way to respond when someone tells us they self-injure? Dr. Nicholas Westers, a clinical psychologist at Children's Health and Associate Professor at the University of Texas Southwestern Medical Center, collaborates with the International Society for the Study of Self-Injury (ISSS) to interview the leading experts in the field of self-injury and self-harm as well as individuals with lived experience of self-injury and parents and family members of those who have self-injured. This podcast is meant to be a resource for parents, professionals, and people with lived experience.2021 The Psychology of Self-Injury Hygiene & Healthy Living Psychology Psychology & Mental Health Relationships Science Social Sciences
Episodes
  • The Neurobiology of Self-Injury (in Layman's Terms) [Re-Release]
    Jun 26 2026

    What goes on at the neurobiological level that makes someone more vulnerable to self-injure or self-harm? What biological risk factors are at play? What roles do the vagus nerve, cortisol levels, and hypothalamic-pituitary-adrenal (HPA) axis have? We hope to discuss the psychology of self-injury pain in a future episode, but in this episode, Dr. Michael Kaess from the University of Bern in Switzerland explains the neurobiology of self-injury in simple terms, or what we hope can be considered simple layman's terms.

    Learn more about Dr. Kaess and his research team at the Universitäre Psychiatrische Dienste (UPD) in Bern here. To participate in Dr. Kaess' research study of an online intervention for self-injury (in German), visit the STAR (Self-injury Treatment Assessment Recovery) Project at https://star-projekt.de/.

    Below are links to some of the research referenced in this episode:

    1. Kaess, M., Hooley, J. M., Klimes-Dougan, B., Koenig, J., Plener, P. L., Reichl, C., Robinson, K., Schmahl, C., Sicorello, M., Schreiner, M. W., & Cullen, K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self-injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239.
    2. Reichl, C., Heyer, A., Brunner, R., Parzer, P., Völker, J. M., Resch, R., & Kaess, M. (2016). Hypothalamic-pituitary-adrenal axis, childhood adversity and adolescent nonsuicidal self-injury. Psychoneuroendocrinology, 74, 203-211.
    3. Plener, P. L., Bubalo, N., Fladung, A. K., Ludolph, A. G., & Lulé, D. (2012). Prone to excitement: Adolescent females with non-suicidal self-injury (NSSI) show altered cortical pattern to emotional and NSS-related material. Psychiatry Research, 203(2-3), 146-152.

    Follow Dr. Westers on Instagram @DocWesters. To join ISSS, visit itriples.org and follow ISSS on Facebook and X/Twitter (@ITripleS).

    The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

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    51 mins
  • The Psychology of Self-Injury Scarring (Re-Release)
    May 29 2026

    How are scars from nonsuicidal self-injury (NSSI) different than physical scars that are unintentional or result from non-self-inflicted wounds ? What psychological effects can result from daily reminders of one's own decision to self-harm? Is there an association between NSSI scars and suicidal thoughts and behaviors? In this episode, Dr. Burke discusses the mixed relationship that many people who self-injure have with the scars they bear from NSSI and how some may feel the need to hide their scars even from themselves.

    Learn more about Dr. Burke and her work by clicking here or visiting the Mood & Behavior Lab (MABL) at www.moodandbehaviorlab.org. Follow her on Twitter @TaylorABurkePhD.

    Below are some of her publications and papers referenced in this episode:

    1. Burke, T. A., Ammerman, B. A., Hamilton, J. L., Stange, J. P., & Piccirillo, M. (2020). Nonsuicidal self-injury scar concealment from the self and others. Journal of Psychiatric Research, 130, 313-320.
    2. Burke, T. A., Olino, T. M., & Alloy, L. B. (2017). Initial psychometric validation of the nonsuicidal self-injury scar cognition scale. Journal of Psychopathology and Behavioral Assessment, 39, 546–562.
    3. Burke, T. A., Hamilton, J. L., Cohen, J. N., Stange, J. P., & Alloy, L. B. (2016). Identifying a physical indicator of suicide risk: non-suicidal self-injury scars predict suicidal ideation and suicide attempts. Comprehensive Psychiatry, 65, 79–87.
    4. Bachtelle, S. E., & Pepper, C. M. (2015). The physical results of nonsuicidal self-injury: The meaning behind the scars. The Journal of Nervous and Mental Disease, 203(12), 927-933.

    Follow Dr. Westers on Instagram @DocWesters. To join ISSS, visit itriples.org and follow ISSS on Facebook and X/Twitter (@ITripleS).

    The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

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    43 mins
  • Eating Disorders & Self-Harm (Re-Release)
    Apr 28 2026

    The term "self-harm" is an umbrella term, encompassing a broad range of behaviors, under which is included substance abuse and misuse, suicide, nonsuicidal self-injury (NSSI), and even eating disorders. In this episode, Dr. Katie Gordon, a Licensed Clinical Psychologist in Fargo, North Dakota, discusses the prevalence of self-injury among individuals with eating disorders and the prevalence of eating disorders among those who self-injure. She explains the relationship between the two behaviors, including common risk factors.

    You can purchase Dr. Gordon's book The Suicidal Thoughts Workbook: CBT Skills to Reduce Emotional Pain, Increase Hope, and Prevent Suicide on Amazon here.

    Below are links to some of Dr. Gordon's research as well as resources referenced in this episode:

    1. Kiekens, G., & Claes, L. (2020). Non-suicidal self-injury and eating disordered behaviors: An update on what we do and do not know. Current Psychiatry Reports, 22(68).
    2. Fox, K. R., Wang, S. B., Boccagno, C., Haynos, A. F., Kleiman, E., & Hooley, J. M. (2019). Comparing self-harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed. International Journal of Eating Disorders, 52(5), 564-575.
    3. Smith, A. R., et al. (2013). Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating. Psychiatry Research, 206(2-3), 246-255.
    4. Gordon, K. H., Perez, M., & Joiner, T. E. (2002). The impact of racial stereotypes on eating disorder recognition. International Journal of Eating Disorders, 32(2), 219-224.

    Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

    The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

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    39 mins
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