Thomas from Ontario, Canada shares his story of lived experience of self-injury and gender dysphoria, including how self-harm evolved for him over time as a transgender man. Season 4 | Episode 48 Podcast/ Season 4 | Episode 48 Lived Experience: Thomas' Story of Self-Injury & Gender Dysphoria Apr 26, 2024 Lived Experience: Thomas' Story of Self-Injury & Gender Dysphoria 00:00 / 01:04 Approximately 47% of transgender adults and 55.7% of transgender and non-binary youth report having engaged in nonsuicidal self-injury (NSSI) at some point in their life. In this episode, Thomas details his experience of self-harm beginning at age 12, how his self-injury evolved over time, and how it related to his gender dysphoria. He also discusses dissociation as a relatively constant function (i.e., reason) of his self-injury and what happened when he fully transitioned as a man. Previous Next

About Self-Injury What is Self-Injury? Resources / About Self-Injury / What is Self-Injury? "A distinct behaviour" Self-injury is a common yet poorly understand behaviour. Educating ourselves about self-injury starts with being specific about what we mean when we talk about it. There are several key elements to our definition: The harm is intentional or expected Risky behaviors that could result in harm, such as not wearing a seatbelt while driving, or behaviors that can result in accidental harm, such as playing extreme sports, are typically excluded under our definition. The injury results in immediate physical injury Behaviors that do not directly result in physical injury are typically excluded under our definition, even though they may be harmful or dangerous. For instance, food restriction is typically not considered a form of NSSI since the associated physical damage tends to build up over time, instead of happening as soon as the behavior occurs. Is not intended to cause death While suicidal thoughts may be present when someone self-injures, the self-injury itself is not intended to cause death. Some people may use self-injury to manage suicidal urges or intense distress related to suicidal thoughts. Self-injury enacted with suicidal intent is not classified as NSSI. Is not part of social or cultural practices Behaviors that might cause physical damage but are acceptable in our society, or part of a recognized cultural, spiritual or religious ritual, are not considered self-injury. Behaviors such as body modification, body piercing, tattooing, and religious self-flagellation are not usually considered forms of self-injury. A note on terminology The term "NSSI" is often used interchangeably with self-injury - we do so throughout this site; however, it is important to bear in mind that someone may use the term 'self-injury' and be referring to suicidal behaviour. Likewise, while we do not use the term self-harm on this site, many people, including researchers, clinicians, and individuals with lived experience, use this term to refer to NSSI. Regardless of the source, it is important to always ascertain whether the term is being used to refer to suicidal or non-suicidal behaviours. There are some other terms used throughout the field that may or may not refer to NSSI. Self-harm Often, when people think of 'self-harm', what comes to mind is NSSI. However, self-harm is an umbrella term that captures all self-directed injury regardless of intent. In some conceptualisations, self-harm includes indirect injury, such as that caused by reckless behaviours, or psychological injury, such as that caused by self-criticism. While NSSI falls under the self-harm umbrella, ISSS distinguishes NSSI from other behaviors due to the aetiological, functional, and predictive factors that are unique to NSSI. Deliberate self-harm Deliberate self-harm is a term usually used to refer to non-suicidal self-injury; however, it may also encompass any self-inflicted injury, regardless of intent. Determining what is meant when this term is used is important. Self-cutting NSSI is sometimes referred to by focusing on particular methods (e.g., self-cutting). While cutting is among the most widely recognized forms of self-injury, the behavior can take many other forms, including burning, hitting, or scratching. Furthermore, many people who self-injure report using more than method during their lives. Therefore, we recommend avoiding this term when referring to self-injury more broadly, as it dismisses the experiences of many people. Parasuicide, self-mutilation These terms are no longer used in contemporary research and practice, but are occasionally still seen in news media. The term 'parasuicide' links injury to suicide, creating an assumption that self-injury is a suicide attempt. As we know, this is not always that case. The term 'self-mutilation' is stigmatising and harmful, characterising an individual's injury as negative due to its appearance and conjuring judgement and fear (Hasking & Boyes, 2018; Hasking et al., 2019). References Hasking, P., & Boyes, M. (2018). Cutting words: A commentary on language and stigma in the context of nonsuicidal self-injury. Journal of Nervous and Mental Disease , 206 , 829-833. https://doi.org/10.1097/nmd.0000000000000899 Hasking, P., Lewis, S. P., & Boyes, M. E. (2019). When language is maladaptive: Recommendations for discussing self-injury. Journal of Public Mental Health , 18 , 148-152. https://doi.org/10.1108/JPMH-01-2019-0014 Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: What we know, and what we need to know. Canadian Journal of Psychiatry , 59 , 565-568. https://doi.org/10.1177%2F070674371405901101

ISSS Rising Stars About /Awards / ISSS Rising Stars Recognizing Potential ISSS Rising Stars are dedicated early-career researchers, clinicians, or advocates whose work demonstrates potential and commitment to make a significant contribution to the field and to the lives of people with lived experience. 2023 Rising Star Read more Dr Kathryn Fox Dr Fox is an Assistant Professor in the clinical child psychology Ph.D. Program at the University of Denver, where she also directs the Fox Lab in the Department of Psychology. Rising Stars of ISSS 2026 Dr. Tinne Buelens Dr. Buelens is an Assistant Professor in Clinical Psychology at the University of Amsterdam (Netherlands). Her research focuses on self-injury and identity development in adolescents and young adults. Read more...

Kathryn Gardner, PhD, from the University of Central Lancashire in the United Kingdom discusses the significance of where on the body individuals choose to engage in self-cutting behavior and the psychology of self-injury and self-harm location. Season 2 | Episode 25 Podcast/ Season 2 | Episode 25 Self-Injury Location: Visible vs Concealed May 27, 2022 with Dr. Kathryn Gardner Self-Injury Location: Visible vs Concealed with Dr. Kathryn Gardner 00:00 / 01:04 Does it matter where on the body someone cuts, whether on typically more visible sites such as the forearm and wrist, or in typically more concealed areas, such as the upper arm and torso? Is there a relationship between where someone cuts on their body and their likelihood of continuing to engage in the behavior? In this episode, Dr. Gardner discusses her research on the psychology of self-injury location and where on the body one chooses to self-injure as well as intrapersonal (emotional) reasons and interpersonal (social) reasons for engaging in self-injury and self-harm. Learn more about Dr. Gardner and her work at https://www.uclan.ac.uk/academics/dr-kathryn-gardner , and follow her on Twitter @KathrynJGardner . Below are links to some of her research referenced in this episode: Gardner, K. J., Bickley, H., Turnbull, P., Kapur, N., Taylor, P., & Clements, C. (2020). The significance of site of cut in self-harm in young people . Journal of Affective Disorders, 266 , 603-609. Gardner, K. J., Paul, E., Selby, E. A., Klonsky, E. D., Mars, B. (2021). Intrapersonal and interpersonal functions as pathways to future self-harm repetition and suicide attempts . Frontiers in Psychology, 12 , 688472. 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 ." Previous Next

ISSS Rising Stars About /Awards / ISSS Rising Stars Recognizing Potential ISSS Rising Stars are dedicated early-career researchers, clinicians, or advocates whose work demonstrates potential and commitment to make a significant contribution to the field and to the lives of people with lived experience. 2023 Rising Star Read more Dr Kathryn Fox Dr Fox is an Assistant Professor in the clinical child psychology Ph.D. Program at the University of Denver, where she also directs the Fox Lab in the Department of Psychology. Rising Stars of ISSS 2024 Dr. Taylor Burke Dr. Burke is an Assistant Professor of Psychology in the Department of Psychiatry at Massachusetts General Hospital (United States). She also co-leads the Mood and Behavior Lab (MABL) at Harvard Medical School. Read more...

Spencer Ellison and Jennifer Muehlenkamp, PhD, from the University of Wisconsin-Eau Claire tell us what they learned when they asked therapists about their willingness to treat individuals who engage in nonsuicidal self-injury or self-harm. Season 5 | Episode 57 Podcast/ Season 5 | Episode 57 Are Therapists Willing to Treat Self-Injury? Jan 31, 2025 with Spencer Ellison & Dr. Jennifer Muehlenkamp Are Therapists Willing to Treat Self-Injury? with Spencer Ellison & Dr. Jennifer Muehlenkamp 00:00 / 01:04 In this episode, Spencer Ellison and Dr. Jennifer Muehlenkamp read a hypothetical case vignette of a client who engages in nonsuicidal self-injury (NSSI), has experienced suicidal thoughts or behaviors, or is experiencing significant depression. They then tell us how willing therapists are to treat each case (self-injury vs. suicide vs. depression), if therapists would accept them into their clinical practice, and if it depends on the therapists' (1) liability concerns, (2) comfort/skill confidence to treat self-harm, (3) attitude toward self-harm in general, and (4) attitude towards clients who self-harm. Learn more about Dr. Muehlenkamp at her University of Wisconsin-Eau Claire faculty page here , and see her growing list of peer-reviewed publications on Google Scholar here . Learn more about Trinity Equestrian Center at www.trinity-ec.com . Below are a couple research studies referenced in this episode: Levi-Belz, Y., Barzilay, S., Levy, D., & David, O. (2020). To treat or not to treat: The effect of hypothetical patients' suicidal severity on therapists' willingness to treat . Archives of Suicide Research, 24 (3), 355-366. Groth, T., & Boccio, D. E. (2019). Psychologists’ willingness to provide services to individuals at risk of suicide . Suicide and Life-Threatening Behavior, 49 (5), 1241-1254. Previous Next

Sylvanna Mirichlis, PhD, and Stephen Lewis, PhD, talk all things Self-Injury Awareness Day (SIAD). We also share some of our favorite clips from past episodes for those new to the topic of self-harm. Season 5 | Episode 58 Podcast/ Season 5 | Episode 58 Self-Injury Awareness Day (March 1) Feb 28, 2025 with Drs. Sylvanna Mirichlis & Stephen Lewis Self-Injury Awareness Day (March 1) with Drs. Sylvanna Mirichlis & Stephen Lewis 00:00 / 01:04 In this episode, Dr. Sylvanna Mirichlis from Curtin University in Perth, Australia, and ISSS Past President Dr. Stephen Lewis from the University of Guelph in Ontario, Canada share about the origins of the annual March 1st Self-Injury Awareness Day (SIAD), what people around the world are doing as part of this day, and what our ISSS Stigma, Recovery, and Lived Experience Special Interest Group is doing to boost awareness of self-injury. We also share some of our favorite clips from past episodes. Self-Injury Resources: International Society for the Study of Self-Injury (ISSS) ( https://itriples.org/ Self-injury Outreach & Support (SiOS) ( http://sioutreach.org/ ) Cornell's Self-Injury & Recovery Resources (SIRR) ( www.selfinjury.bctr.cornell.edu ) Shedding Light on Self-Injury ( https://www.self-injury.org.au/ ) Lewis, S. P., & Hasking, P. A. (2023). Understanding self-injury: A person-centered approach . Oxford University Press. To watch Dr. Lewis' TEDx talk about his own lived experience of self-injury on YouTube, visit https://youtu.be/G17iMOw0ar8 . Timestamps for clips from past episodes: 37:37 - Lived experience: Kirsty's story of self-injury & advocacy (Season 2, Episode 30) 43:41 - Psychologists with lived experience of self-injury, with Dr. Sarah Victor (Season 1, Episode 9) 45:25 - Self-injury stigma and language, with Dr. Penelope Hasking (Season 1, Episode 4) 48:26 - Lived experience: Thomas' story of self-injury & gender dysphoria (Season 4, Episode 48) 52:48 - Self-harm across cultures, with Dr. Marc Wilson (Season 2, Episode 24) 56:39 - The psychology of self-injury scarring, with Dr. Taylor Burke (Season 2, Episode 31) 1:01:52 - A dad & daughter discuss her lived experience of self-harm (Season 3, Episode 37) 1:15:15 - Parenting youth who self-injure, with Dr. Janis Whitlock (Season 1, Episode 3) 1:23:49 - Supporting siblings of individuals who self-harm, with Dr. Amy Lucas (Season 4, Episode 46) Previous Next

Home / Awards / Invited Fellow / Dr. Penelope A. Hasking Dr. Penelope A. Hasking Previous Dr. Penelope A. Hasking is an Associate Professor of Psychology at Curtin University (Australia). Her research focuses on the emotional, cognitive, and social factors that contribute to NSSI and related behaviors. She has played a central role in advancing emotion regulation models of self-injury and in developing prevention and intervention programs that are both evidence-based and sensitive to the needs of young people. Dr. Hasking’s work also highlights the importance of understanding social connectedness, self-compassion, and help-seeking behavior. She is known for her thoughtful mentorship, scientific rigor, and her dedication to making psychological research meaningful and applicable in everyday life. Her work stands out for its clarity, empathy, and commitment to real-world impact. Next ISSS Fellow | 2025

About Self-Injury Talking About Self-Injury Resources / About Self-Injury / Talking About Self-Injury "Adopt respectful curiosity" The language we use to talk about people and the behaviours they engage in is powerful. Language is the medium we use to communicate our understanding of the world, to establish social structures, define cultures, and establish meaning to phenomena and people. Language shapes the way we view the world and our place in it. The language that is commonly used when talking about NSSI and people with lived experience of NSSI is often derogatory, can perpetuate myths and foster stigma, and can make people with lived experience feel even more misunderstood and isolated. Conversely, adopting a "respectful curiosity" and being conscious of using respectful language can open the way for helpful conversations and encourage support seeking. Top Tips Always be respectful when talking about NSSI, or people with a lived experience of NSSI Poorly-considered language can exacerbate stigma among people who already feel highly stigmatised Avoid language that defines a person by their behaviour (e.g., “cutter”; “self-injurer”) Avoid language that is value-laden (e.g., good/bad), or propagates stigma (e.g., attention-seeking) Use of appropriate language can foster open communication and facilitate support-seeking Check out specific guidelines for members of the media in reporting on and writing about NSSI. References Hasking, P., & Boyes, M. (2018). Cutting words: A commentary on language and stigma in the context of nonsuicidal self-injury. Journal of Nervous and Mental Disease , 206 , 829-833. https://doi.org/10.1097/nmd.0000000000000899 Hasking, P., Lewis, S. P., & Boyes, M. E. (2019). When language is maladaptive: Recommendations for discussing self-injury. Journal of Public Mental Health , 18 , 148-152. https://doi.org/10.1108/JPMH-01-2019-0014 Lewis, S. P. (2017). I cut therefore I am? Avoiding labels in the context of self-injury. Medical Humanities , 43 , Article 204. https://doi.org/10.1136/medhum-2017-011221

Greg Lengel, PhD, from Drake University in Iowa walks us through self-harm in the DSM-5 and the six criteria for the proposed diagnosis of Nonsuicidal Self-Injury Disorder. Season 4 | Episode 45 Podcast/ Season 4 | Episode 45 DSM-5 & Nonsuicidal Self-Injury Disorder Jan 26, 2024 with Dr. Greg Lengel DSM-5 & Nonsuicidal Self-Injury Disorder with Dr. Greg Lengel 00:00 / 01:04 In 2013, the 5th edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5) was released, and for the first time it included Nonsuicidal Self-Injury Disorder as a Condition for Further Study. It is not an actual diagnosis at this time, but there are currently six criteria listed (see below, bottom of page). In this episode, Dr. Greg Lengel from Drake University in Iowa walks us through what research says about each of the six criteria, and he discusses the pros and cons of formalizing NSSI Disorder as a diagnosis. Listen to his interview with Dr. Brooke Ammerman from Season 3 ("How Should Self-Harm Be Defined?") here . Learn more about Dr. Lengel at his faculty profile at Drake University here and follow him on Twitter/X at @DrGregLengel . Below are links to many of the papers discussed in this episode as well as other important papers on NSSI as a disorder in the DSM-5: Shaffer, D., & Jacobson, C. (2009). Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder . American Psychiatric Association , 1-21. Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2023). NSSI in the DSM-5 . In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Vol. Eds.), The Oxford Handbook of Nonsuicidal Self-Injury . New York: Oxford University Press . Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2022). Clarifying the definition of nonsuicidal self-injury: Clinician and researcher perspectives . Crisis: The Journal of Crisis Intervention and Suicide Prevention, 43 , 119-126. Lengel, G. J. & Mullins-Sweatt, S. N. (2013). Nonsuicidal self-injury disorder: Clinician and expert ratings . Psychiatry Research , 210 , 940-944. Ammerman, B. A., Jacobucci, R., Kleiman, E. M., Muehlenkamp, J. J., & McCloskey, M. S. (2017). Development and validation of empirically derived frequency criteria for NSSI disorder using exploratory data mining . Psychological Assessment , 29 , 221-231. Ammerman, B. A., Jacobucci, R., & McCloskey, M. S. (2019). Reconsidering important outcomes of the nonsuicidal self‐injury disorder diagnostic criterion A . Journal of Clinical Psychology , 75 , 1084-1097. Ammerman, B. A., Lengel, G. J, & Washburn J. J. (2021). Consideration of clinician and researcher opinions on the parameters of nonsuicidal self-injury disorder diagnostic criteria . Psychiatry Research, 296 , 113642. Ghinea, D., Edinger, A., Parzer, P., Koenig, J., Resch, F., & Kaess, M. (2020). Non-suicidal self-injury disorder as a stand-alone diagnosis in a consecutive help-seeking sample of adolescents . Journal of Affective Disorders, 274 , 1122-1125. Muehlenkamp, J. J. (2005). Self-injurious behavior as a separate clinical syndrome . American Journal of Orthopsychiatry , 75 , 324–333. Muehlenkamp, J. J., Brausch, A. M., & Washburn, J. J. (2017). How much is enough? Examining frequency criteria for NSSI disorder in adolescent inpatients . Journal of Consulting and Clinical Psychology , 85 , 611619. Washburn, J. J., Potthoff, L. M., Juzwin, K. R., & Styer, D. M. (2015). Assessing DSM-5 nonsuicidal self-injury disorder in a clinical sample . Psychological Assessment, 27 , 31-41. Zetterqvist, M. (2015). The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature . Child and Adolescent Psychiatry and Mental Health, 9 , 31. Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS). The Psychology of Self-Injury podcast has been rated #1 by Feedspot in their list of " 10 Best Self Harm Podcasts " and #5 in their " 20 Best Clinical Psychology Podcasts ." It has also been featured in Audible's " Best Mental Health Podcasts to Defy Stigma and Begin to Heal ." If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit. NONSUICIDAL SELF-INJURY DISORDER (PROPOSED DIAGNOSIS): A. In the last year, the individual has, on 5 or more days, engaged in intentional self-inflicted damage to the surface of his or her body of a sort likely to induce bleeding, bruising, or pain (e.g., cutting, burning, stabbing, hitting, excessive rubbing), with the expectation that the injury will lead to only minor or moderate physical harm (i.e., there is no suicidal intent). Note: The absence of suicidal intent has either been stated by the individual or can be inferred by the individual's repeated engagement in a behavior that the individual knows, or has learned, is not likely to result in death. B. The individual engages in the self-injurious behavior with one or more of the following expectations: To obtain relief from a negative feeling or cognitive state. To resolve an interpersonal difficulty. To induce a positive feeling state. Note: The desired relief or response is experienced during or shortly after the self-injury, and the individual may display patterns of behavior suggesting a dependence on repeatedly engaging in it. C. The intentional self-injury is associated with at least one of the following: Interpersonal difficulties or negative feelings or thoughts, such as depression, anxiety, tension, anger, generalized distress, or self-criticism, occurring in the period immediately prior to the self-injurious act. Prior to engaging in the act, a period of preoccupation with the intended behavior that is difficult to control. Thinking about self-injury that occurs frequently, even when it is not acted upon. D. The behavior is not socially sanctioned (e.g., body piercing, tattooing, part of a religious or cultural ritual) and is not restricted to picking a scab or nail biting. E. The behavior or its consequences cause clinically significant distress or interference in interpersonal, academic, or other important areas of functioning. F. The behavior does not occur exclusively during psychotic episodes, delirium, substance intoxication, or substance withdrawal. In individuals with a neurodevelopmental disorder, the behavior is not part of a pattern of repetitive stereotypies. The behavior is not better explained by another mental disorder or medical condition (e.g., psychotic disorder, autism spectrum disorder, intellectual disability, Lesch-Nyhan syndrome, stereotypic movement disorder with self-injury, trichotillomania [hair-pulling disorder], excoriation [skin-picking] disorder). Previous Next

Allison from Washington State shares her story of lived experience of self-injury, scarring, and shame as well as how she makes sense of her self-harm scars in the context of her faith. Season 3 | Episode 42 Podcast/ Season 3 | Episode 42 Lived Experience: Allison's Story of Self-Injury & Scarring Oct 27, 2023 Lived Experience: Allison's Story of Self-Injury & Scarring 00:00 / 01:04 In this episode, Allison details her experience of engaging in nonsuicidal self-injury (NSSI) beginning in 9th grade and into her 20's. She explains the complex relationship she and many others have with their self-harm scars and discusses how her husband has supported her when she has self-injured. She also shares about how she makes sense of her scars in the context of her faith as a Christian. Read her To Write Love On Her Arms (TWLOHA) blog, "You are so much more than your pain," at https://twloha.com/blog/more-than-your-pain/ . Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS). The Psychology of Self-Injury podcast has been rated as one of the " 10 Best Self Harm Podcasts " and " 20 Best Clinical Psychology Podcasts " by Feedspot and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's " Best Mental Health Podcasts to Defy Stigma and Begin to Heal ." If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit. Previous Next

Special Interest Groups Collaboration / Special Interest Groups Groups with a Special Focus Special interest groups (SIGs) are groups of researchers, clinicians, and other stakeholders (including individuals with lived and/or living experience) who share an interest in a specific area of focus. Find out more about each SIG below. Research on NSSI in Daily Life Conduct and disseminate ethical, accessible, and priority-driven research to advance understanding, assessment, treatment, and prevention of NSSI. More ICSES The International Consortium on Self-Injury in Educational Settings is an interdisciplinary and international research group focused on prevention and intervention in educational settings. More Stigma, Recovery, & Lived Experience The Stigma, Recovery, and Lived Experience Special Interest Group focuses on the lived experiences of self-injury, paying particular attention to issues related to stigma and recovery. More Biological Factors and NSSI The Biological Factors and NSSI Special Interest Group focuses on neurological and physiological processes that impact NSSI. More