Self-Harm and Intrusive Thoughts: Changing Your Perspective

March 18, 2021 Kim Berkley

It can be frustrating, even frightening, to feel as if your thoughts are not entirely your own—to suddenly have a distressing idea or an image flash through your mind against your will. But what is the connection between self-harm and intrusive thoughts, and how can you break the vicious cycle they create?

The Connection Between Self-Harm and Intrusive Thoughts

I've written before about how self-harm and anxiety and self-harm and depression have a relationship similar to the metaphorical chicken and the egg. It's the same with self-harm and intrusive thoughts. For some people, intrusive thoughts may drive the desire to self-harm, while for others, a self-inflicted injury may trigger unwanted thoughts. For me, I think it was always a little bit of both.

The most obviously triggering thoughts were those that were directly tied to my self-harm. In a moment of distress, a mental image of my chosen method of self-harm would flicker through my consciousness—along with the memory of the relief it had provided in the past—and I would feel the old, familiar itch to hurt myself crawling up and down my arms. These were the easiest to identify as intrusive thoughts—but, I think, also the hardest to resist.

It took a long time for me to realize that these weren't the only intrusive thoughts contributing to my self-injury. I used to struggle, often and to great extent, with disturbing images of worst-case scenarios and scenes selected from a few of my deepest, darkest fears. They seemed to come out of nowhere. One moment I'd be thinking about something completely mundane, and the next, I'd suddenly be ambushed with a lightning-flash of nightmare fodder, with no warning and no time to mount a defense.

While these thoughts didn't immediately make me think of hurting myself, in retrospect, it's easy to see how they contributed to the more general depressive and anxious emotions that motivated me to self-harm.

Intrusive Thoughts About Self-Harm and Suicidal Ideation

One thing that particularly frightened me about these thoughts was that, sometimes, I didn't just think about hurting myself. I thought about ending my own life. And it terrified me that those thoughts might eventually lead me down a path of no return.

And yet, I never actually attempted suicide. Though the thought of it was clearly lingering in my subconscious—to the point that it had begun to leak into my waking consciousness—I didn't seem to want to take my own life. I'm only just now beginning to understand that there is a difference between regular intrusive thoughts, suicidal ideation, and actual suicidal intent.

  • Intrusive thoughts are any unwanted and upsetting thoughts that seem to occur out of the blue.
  • Passive suicidal ideation is thinking about death or dying, perhaps even wishing for it, but never actually planning to commit suicide.
  • Active suicidal ideation involves not only wanting to die but intending to—and making concrete plans to commit suicide.

If you are struggling with active suicidal ideation, please seek help urgently. It is never too late to change the course of your life for the better. This is not to say, however, that passive suicidal ideation or nonsuicidal intrusive thoughts aren't serious concerns, too. If you struggle with any of these issues, the best thing to do is to seek support sooner rather than later. Take it from someone who failed to take her own very good advice until many years later—it's far easier to overcome these thought patterns with help than on your own.

Coping with Self-Harm and Intrusive Thoughts

Aside from seeking professional help in coping with self-harm and intrusive thoughts, there are a few things you can try on your own as well to make some progress towards recovery.

One tip it took me a long time to wrap my head around is not to simply try and forcibly suppress these thoughts. It's natural, of course, to want to make them go away, and shoving them back down into the deep, dark pit of your subconscious can seem like the easiest way to be rid of them. But putting them back where they came from and expecting them to stay there is like trying to keep water behind a dam that's already overflowing. It will only be a matter of time before they flood back out again—and eventually, they'll take the whole dam down with them.

Instead, I've found a combination of mindfulness techniques and cognitive behavioral therapy (CBT) to be far more effective. While I wouldn't say I'm completely free of my intrusive thoughts, they have grown significantly fewer and far between over the years, and I find them much more manageable when they do occur (for the most part). Mindfulness techniques like yoga and meditation help to manage the anxiety and depression that can contribute to intrusive thoughts. Cognitive behavioral therapy, meanwhile, can change the way you think so that when distressing thoughts occur, you can more easily reroute your train of thought to a safer, healthier destination.

Do you struggle with self-harm and intrusive thoughts? What therapeutic or medical interventions, if any, help you manage these thoughts and behaviors? Please feel free to share your ideas and experiences in the comments.

APA Reference
Kim Berkley (2021, March 18). Self-Harm and Intrusive Thoughts: Changing Your Perspective, HealthyPlace. Retrieved on 2024, June 15 from

Author: Kim Berkley

Find Kim on Instagram, Facebook and her blog.

April, 10 2023 at 7:03 pm

I've dealt with intrusive thoughts my whole life. I had started getting better about replacing any negative thoughts with more positive healthy thoughts.. but something bad just happened in my life that was my fault, and now the intrusive negative thoughts are back with a vengeance. I don't know what to do, it's hard to sleep or do anything without my mind racing with intrusive thoughts and replaying mistakes over and over and over again. I'm really struggling right now.
I know you're not supposed to just push the thoughts away, but I don't know what to do with them because just letting myself feel them is extremely physically and mentally uncomfortable.

February, 22 2023 at 12:36 am

I’ve been having some scary thoughts of suicide… for the first time ever in my life… which I just thought, was so weird. I’ve never self harmed or thought of suicide. However I did have a baby 7 months ago. I started having the thoughts about a month ago.. and it scared me, I wasn’t sure why I was having them.. and the more I try to not think about them, the more I have them.. I’m trying to get help now. To see a therapist and possibly be medicated, if I’m experiencing postpartum depression. But I was just searching some different things, to try and get some more understanding of what could be happening with my body, maybe find someone who’s gone through the same thing, while I wait trying to get professional help. I came across this though. And it’s what I’m feeling to a ‘T’ it’s like an intrusive thought… I don’t want to hurt myself, I don’t want to die. But it’s this intrusive thought that keeps coming back, the more I push it away, the more I think about it, to the point I’m scared I would/ could actually do it. Like if I think about it too much, I love convince myself this is what I want. When it’s not… I’ve always had intrusive thoughts, I was diagnosed with ADD at a young age, it’s just something that came with it… it’s never been dark thoughts though. This made me a little hopeful though.. that maybe I really can get help, maybe there is a solution. That this won’t be something I’m gonna struggle with for the rest of my life… that’s been really scaring me.

February, 28 2023 at 3:03 pm

Hi Kaelee,
I'm sorry to hear you've been dealing with such difficult and scary intrusive thoughts. Thought spirals like these are so tricky, because they make you feel like the harder you try to escape, the harder it becomes to actually do so. But it's not impossible to break those patterns and create newer, healthier thought patterns to replace them.
It's great that you're looking for help already; that would have been my first bit of advice for you. It's also great that you're trying to educate yourself and explore your options in the meantime. Those are both steps in the right direction. Recovery is definitely possible--and the fact that you've already chosen to pursue it makes healing even more likely to begin sooner, rather than later.
Just remember: YOU are not your thoughts. They do not control you, though it can feel sometimes like they do. Your brain has simply formed some habits that aren't serving you, but with a little time and patience (and active participation in the healing process), you absolutely CAN teach it to let go of those habits and find better ones to hold onto.
I wish you the best of luck. Take care.
Kim Berkley

September, 10 2022 at 3:07 pm

Since I've been thrown out of nearly every job I've been offered this year. I've been having nothing but intrusive disturbing self harming thoughts. Plus I'm tired, but I've been sleeping better again. But I've lost another job last year August on the 25th. And I've had mild anxiety again.

September, 12 2022 at 4:03 pm

Hi Melody,
I'm so sorry to hear you've been struggling with employment issues as well as disturbing intrusive thoughts. It's good that you're sleeping better at least—that can definitely help, though it sounds like in your case, you need more than just a good night's sleep.
Have you considered therapy at all? It really sounds like you could use some more support in your corner, and the right mental health provider could provide invaluable support and guidance to help you cope with those intrusive thoughts and your anxiety, as well as anything else that might be contributing to the problems you've been having with work. If you haven't already, please take a moment to check out our resources page, which includes websites as well as hotlines that have a lot of great info and, in some cases, can help you connect with good professional help:…
If that's not an option for whatever reason (or if you just need something to do in the meantime before your next, or first, appointment), you might want to try journaling. I know it might not sound like much, but simply getting everything out of your head and onto paper can be hugely cathartic. (I talk about this more in the video, if you haven't watched it yet.) You can even try some CBT exercises on your own or with a workbook—I used the Mind Over Matter workbook, but there are others. (Just be sure to get one written by actual, certified mental health professionals.)
I hope that helps. If you have further questions, comments, or concerns, I'll be around—feel free to reply here or elsewhere on the blog.
Take care!

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