Does Self-Injury Hurt?

Nonsuicidal self-injury (NSSI) represents a distinct topic in the study of pain in that it involves intentional engagement in behaviors despite, or potentially because of, the physical pain they elicit. This chapter reviews the experience of pain as part of NSSI, discussing research examining whether pain is experienced differently by self-injurers and what functions that pain elicited by NSSI may serve. In particular, the authors discuss the potential emotion regulation functions of pain elicited by NSSI. In addition, they discuss biological and psychological theories about the way pain and NSSI may serve these functions. Lastly, they discuss clinical implications and emphasize the importance for all treatment providers, in both medical and mental health settings, to understand the role of pain in NSSI in order to provide empathetic, nonjudgmental, and effective treatment for the growing number of children, adolescents, and adults engaging in these behaviors.