According to the Swedish document Självskadebeteende by Sofia Åkerman, self-harming individuals tend to have an emotional vulnerability which includes a) high sensitivity to emotional stimuli; b) high intensity in reaction; c) slow return to normal state (Linehan 1993).

Comorbidities mentioned: personality disorders (borderline, histrionic, NOS and possibly antisocial), depression, anxiety disorders (panic, GAD, social phobia, OCD, PTSD),  addictions (drugs, alcohol, shopping, gambling etc), eating disorders.

Autism Spectrum Conditions, ADHD and Sensory Processing Disorder (SPD) are not mentioned, but emotional vulnerability as well as bullying and abuse due to being different is common in these groups, in some cases resulting in self-harm.

Self-reported reasons for self-injuring

(Found in various internet groups for people with Asperger Syndrome or SPD.)

– Severe stress

Either because the situation is one which would be stressful to anyone, or due to being so physically and/or emotionally sensitive that intense stress is caused by anything disharmonious, confusing or overwhelming.

“In certain overwhelming circumstances throughout my life I have responded with a fist into a wall, or a head bang, or the like.. I have sensory triggers as well as the aforementioned communication frustrations which lead to self punishment. I am also sensitive to criticism… Feeling bad makes me feel bad 😦 but I am working on it…”

‘StrangeGirl’, Aspie from UK

– Frustration

“I will admit, there have been times when I have been so frustrated that I have boxed my head in anger and groaned, and, surprisingly enough, it DID feel better!”

Tom, Aspie from USA

“I do still sometimes hit my head… when I feel I’m just not getting through to someone and it literally feels like I AM *banging my head on a brick wall*”

Stawberry’, non-Aspie

– Depression, inner pain and inability to understand or express feelings verbally

“It doesn’t have anything to do with AS per se. It’s connected to depression. It hurts somewhere inside that’s intangible and impossible to describe in words. Deep pain inside. To cut oneself then makes the pain visible, it becomes understandable why it hurts then. You can see it and touch it. It is moving the pain inside that is hard to understand, to a place where it is understandable.”

An AS girl from Sweden

– Abuse

Being a victim of abuse. In the Swedish report “Flickor som skadar sig själva” (2004) 24% of the 205 self-harming girls aged 14–19 år stated they had been physically abused, 33% verbally abused, 27% sexually abused and 37% bullied (source: SHEDO).

“Why did I do it? I think it was because I was sexually abused by my father all my childhood and I hated myself, hated my life, hated being in my body and didn’t feel I belonged or fit in anywhere.”

Strawberry’, non-Aspie

– Control

“I’ve hurt myself with knifes & needles. It gave me a sense of control, a control over pain, I could make the pain go away simply by stop cutting myself and the physical pain also drowned the pain which I couldn’t control.”

Tobias, Aspie from Sweden

“I used to cut my wrists. It gave me a sense of control. Whenever I feel out of control, the one thing I feel that I CAN control is whether I live or die. I can kill myself, or starve myself, or slice my wrists. The more I slice, the better I feel.”

Tom, Aspie from USA

– Release

“I remember self harming in my teens, To be honest doing it was kinda release, if that makes sense? I had a lot of hurt inside (which I did not and still do not understand) and the hurt physically to myself helped in some strange way. It was kinda a phase I went through, even though I’d never heard of self harming. Fortunately I stopped and it was never very serious, just a few little cuts. I do find myself more likely to self harm when I am frustrated. ”

Julie, Aspie from England

“It feels as if my body is going to explode. It’s just like when you shake a can of coke. If I could stop it I would, but it is not like turning a switch off. I know what is right and wrong but it’s like I have to fight with my brain over it.”

Autistic girl, who can be seen in the video stimming, tantruming and headbanging, when was finally able to write down what makes her do it.

– Self-punishment

“It can also be about self-punishment. A sense that something went wrong, that there were misunderstandings. Everything was one’s own fault. Anxiety comes. Bad person has to be punished.”

An AS girl from Sweden

– For sensory integration

Some people on the spectrum are hypo-sensitive to physical pain and may experiment in order to try and produce a sensation.

“When I was younger it was worse I used to pull out my hair, cut myself and crash into everything so that I could feel my body.”

Layla, adult with SID

To produce endorphines

Some use self-harm instead of heavy exercise to make the body produce soothing endorphins.

“I’m a self-harmer, it may count as a compulsion, I don’t know, but I do not have OCD, the reason is rather that I often have anxiety. When you cut yourself anesthetising things come rushing in that make you feel calmer, sort of like when you don’t feel when you get your leg ripped off.  How one quits this habit I have no idea. Get better anxiety-relieving alternatives?”

MsTibbs, Aspie from Sweden

– Adverse reaction to drugs

“I was put on Prilosec after a stomach bleed in September. I was supposed to take it until the end of December, but by mid-November, I couldn’t tolerate the side-effects any more. It made me SO much more sensitive to sensory input. I always considered my sensory issues to be pretty severe, but when I was on Prilosec, I thought I’d gone to Hell. I’ve NEVER experienced sensory issues so severe that I started pulling at my hair, hitting myself, but that happened while I was on Prilosec, and although it isn’t as constant now, I still have days where I feel like I have bugs crawling all over me and it makes me want to rip my hair out, claw my eyes out, you get the picture.”

Tracey, adult with SID

– Inner voices

Schizo-affective types may harm themselves on the command of inner voices, or as a way of temporarily blanking out the voices by creating a stronger stimuli – pain.

“In my case, the harmful voices start yelling at me to harm myself when I am dealing with some great stress.”

Female HSP/ADD & Schizo-affective adult from USA

Additional reasons from the Åkerman document (besides some from the above list):

To calm oneself down

To move the pain

To feel alive

To make others see and understand


What to do about it?

• First try to determine the cause.

• Find out what the person is most sensitive to, what areas are most stressful or painful.

• Minimise stress, harsh words and sensory overstimulation.

• Treat or medicate the underlying anxiety, compulsive thoughts and voices.

• Find other ways of channeling the frustration, anxiety etc.

“I do find it distressing to see my son (dx HFA) self harm and have taught him other ways to diffuse his frustration/anger; for example he likes to rip newspapers up and he cleans up afterwards too 🙂 I came up with the idea of him ripping newspaper up after I caught him ripping a book up. I just handed him a newspaper and said if you want to rip something up, rip this up – it seems to have worked. He used to headbang when he was younger, but seemed to grow out of it.”

Julie, Aspie from England

Additional suggestions from Sofia Åkerman:

• Confirm the person’s feelings in connection with the wounds.

• Focus on competence and abilities.

• Involve the person on decisions concerning her.

• Avoid judging.

• Don’t give the self-harm too much positive or negative attention.

• Be friendly and neutral and suggest alternative solutions.

And a new tip from an Aspie girl who has had self-harming behaviour herself:

“I have AS, am bipolar + having harmed myself until I tried this about a month ago. I have tried, when overcome by anxiety and thoughts of harming myself, lying on a spike mat!!

“It is SOOO incredibly effective that it’s just overwhelmed me. The pain one feels the first 10 minutes or so, feels just like when one cuts oneself, so it is a better choice to lie on a spike mat than to harm oneself. After lying 10-15 minutes the pain diminishes and the blood circulation increases. This gives a pleasant feeling of warmth on one’s back which means you relax and the anxiety goes away completely. I lie between 30 and 60 minutes on one of my mats and about 40 minutes on the other (there are very different and one is sharper than the other [due to the spikes being longer and placed wider apart] = better for those with self-harming problems).

“I am depressed now and just started with Venlafaxin but I have to say that when I wake up around 4 AM I have a lot of anxiety and self-harming thoughts. Then I lie on the spike mat for an hour (others may need less), then I remove it from my bed and am totally calm and can go back to bed and fall asleep within 30 minutes!!

“I can also tell you about a friend of mine. She cuts herself EVERY day and is sectioned since about a year and a half. She has such severe problems that my highest wish was to be able to help her. Then when this with the spike mat helped me, it struck me that she may ALSO be helped with her anxiety and severe self-harming problems. So I lent her my mat and it has SUCCEEDED. She has not cut herself once since she borrowed it a week and a half ago and that is A LOT for this girl. I’ve told her she can keep it because it helps her so much. She is very happy over this and I’m equally glad that I’ve been able to help her.”

– Ann-Charlotte, Aspie/bipolar girl from Sweden



  1. Doug said,

    Veryy helpful . i bang my head sometimes usually when im at the end of my rope and its mostly a reflex i cant stop once im to that point. I suffer from ptsd depression anxiety and sexual abuse… safe haven is being alone in a quiet place and to listen to my heartbeat and listen to myself breath and count my hearbeat…..and it calms me down slowly

  2. Arora said,

    I feel like i am being punched in the heart right now

  3. Sean said,

    In the more recent years, I’ve begun banging my head a lot, sometimes until i see stars, but in the end, it actually feels better. The burning like flames in my head stops. Frustration and feeling overwhelmed seems to trigger the fires too. I just don’t know how to stop, should I even stop because it does feel much better.

  4. Crazygal said,

    I think i need to get some help.

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