What if the way you have been coping is the one thing you are most afraid to say out loud, and you have been managing it alone because you do not know what would happen if you told someone?
This is therapy for people who have found a way to manage emotional pain that works, until it does not. For teenagers who are terrified of what it means about them. For adults who have been doing this quietly for years. For anyone who knows, somewhere, that something has to change, but does not know what that would even look like.
At Embodied Therapy, self-harm is approached with harm reduction, not shame. You do not have to be ready to stop to reach out. You just have to be willing to have an honest conversation.
If you recognized yourself in any of these, you are in the right place.
Most people who self-harm do not tell anyone for a long time. They have learned that telling people creates panic, creates surveillance, and changes the relationship in ways that feel worse than staying quiet. They have learned to manage this alone because alone has felt safer than the reactions they anticipate.
That isolation is not a personal failure. It is a completely reasonable response to a world that does not know how to respond to self-harm without making it about their own fear.
People who come to Embodied Therapy with self-harm as part of their experience are almost always still functioning. They go to school. They go to work. They show up. From the outside, things may look fine. On the inside, they are carrying something they have never had a safe place to put down.
Therapy here is not about immediately eliminating the behavior and calling it success. It is about understanding what the behavior has been doing, what it has been helping with, and finding a way forward that does not require you to give something up before you have anything to put in its place.
Self-harm, also called self-injury or non-suicidal self-injury (NSSI), refers to deliberately hurting one’s own body as a way of managing emotional pain. It is not the same as suicidal behavior, though it is frequently misunderstood as such. Most people who self-harm do not want to die. They want to change how they feel. Self-harm is a coping mechanism, not a death wish.
This distinction matters because conflating self-harm with suicidality leads to responses that are often more harmful than helpful, responses focused on containment rather than understanding, on stopping the behavior immediately rather than understanding what it is doing.
Self-harm takes many forms. Some are more visible than others. Some leave marks. Some do not. What they have in common is that they provide some form of emotional relief, regulation, or release that the person has not found another way to access.
For people whose internal emotional experience is more intense than average, or whose nervous systems have not developed robust tools for managing that intensity, self-harm can provide rapid and reliable relief from emotional pain. It works. That is why it is hard to stop.
Some people self-harm not to release emotion but to feel anything at all during periods of numbness, dissociation, or emotional disconnection. The physical sensation cuts through in a way that nothing else does.
For some people, the internal experience of distress is so overwhelming that having a physical, visible manifestation of it provides a kind of coherence. The outside matches the inside, and that coherence is itself a form of relief.
In situations where a person feels powerless over their circumstances or their emotions, self-harm can provide a sense of agency. It is the one thing that is theirs to choose.
For people who carry significant shame, self-harm can function as a form of self-directed punishment that temporarily relieves that shame by acting on it.
None of these are irrational. They are all logical responses to experiences of pain that were too much to hold in any other way.
Self-harm affects people across ages, genders, backgrounds, and diagnoses. The cultural image of self-harm as something that happens to teenage girls is inaccurate and causes real harm by leaving everyone else without recognition or support.
Adults self-harm. Men and masculine people self-harm. People who appear highly functional self-harm. People who are not in any other form of mental health crisis self-harm.
Self-harm is particularly common in people navigating:
The presence of self-harm does not define someone. It is information about how much pain has been present and how few resources were available to manage it.
People who self-harm do not ask for help for reasons that make complete sense when you understand them.
They are afraid of the reaction. They have learned, often from direct experience, that telling someone about self-harm creates panic, generates consequences, and shifts the relationship in ways that feel punishing rather than supportive. They do not want to be watched more closely. They do not want their parents called. They do not want to be put on a safety plan that amounts to someone checking in on them every day while nothing actually changes.
They are also frequently carrying significant shame about the behavior itself. Shame that comes from knowing how other people see self-harm. Shame that comes from having tried to stop and not been able to. Shame that comes from not knowing how to explain it in a way that does not make them sound unstable or manipulative.
The shame cycle around self-harm is one of the most important clinical realities to understand. Self-harm is often both driven by shame and a source of more shame. The behavior provides relief from an unbearable internal state and then generates a new source of shame that feeds back into the same cycle.
Breaking that cycle is not about willpower. It is about finding a different relationship with the internal experience that self-harm has been managing.
Many people who self-harm have been in therapy before and it was never addressed. Or it was addressed in ways that felt more like being managed than being understood. Or the therapist’s visible discomfort with the topic made it feel like something that could not be spoken about directly.
Some therapists are not trained to work with self-harm in a way that actually helps. Standard approaches often focus on contracts to stop the behavior, safety planning that focuses on consequences, and skill replacement that assumes the person simply lacks better tools. These approaches miss the function. They address the behavior without understanding what it has been doing, and so they do not hold.
At Embodied Therapy, self-harm is not a topic to be managed around. It is brought directly into the conversation, with curiosity and without alarm.
Our approach is harm reduction first. Harm reduction means we do not require someone to commit to stopping before we can begin. We meet people where they are, not where we want them to be. We start by understanding what self-harm has been doing, what it has been solving for, and what has kept it in place. We do not pathologize the behavior as irrational. We take seriously the fact that it has been working.
From there, we work on the underlying experiences that have made self-harm feel necessary. The emotion dysregulation. The shame. The trauma. The internalized self-criticism. The nervous system that learned that this was the most reliable way to come back to baseline. We build new tools that actually address those underlying experiences, and we build them collaboratively, not prescriptively.
The goal is not to take something away and leave a gap. The goal is to build enough internal ground that self-harm becomes something a person chooses less and less because they have other options that actually work.
We also hold the reality that for some people, reducing harm rather than eliminating it entirely is an appropriate goal, at least for a period of time. Harm reduction does not require perfection. It requires honesty.
People who do this work often find they are able to:
Approaches are chosen together based on what actually fits each person’s brain, nervous system, and life. There is no single method that works for everyone.
DBT was originally developed specifically for people with intense emotional experiences and chronic self-harm. It builds practical skills for tolerating distress, regulating emotion, and improving relationships. The skills are concrete, teachable, and adapted to fit the person's actual life.
Works with the body's role in self-harm. The physiological relief that self-harm provides is a body-based experience, and body-based approaches can help build new pathways to that same relief without the harm. Includes nervous system regulation, breath work, and movement.
Explores the parts of the self that are connected to self-harm. The part that reaches for it under pressure. The part that is ashamed afterward. The part that has been trying to protect the person from something worse. All of these parts have something important to say.
For self-harm that is connected to trauma or to specific experiences that have gotten stuck in the nervous system. Often self-harm and trauma co-occur, and EMDR can address the underlying traumatic experience that the self-harm has been managing.
Addresses the thought patterns that drive the shame cycle and that make self-harm feel like the only option. Builds more accurate and more flexible ways of understanding the self and the situation.
The philosophical foundation of the work. Meeting people where they are. Building gradually. Not requiring perfection before offering support.
This may be a good fit if you are a teen or adult who:
This is also for parents and caregivers who are watching their teenager navigate something that feels bigger than what they know how to hold. You do not have to have the right words to reach out. If you want to learn more about parent support, read more here.
We see clients virtually. Our therapist is licensed in New Mexico, Alaska, Arizona, Florida, Idaho, Oregon, Texas, and Washington.
Our founder, Allison VanGordon (they/she), has worked with self-harm across levels of care since the beginning of their clinical career, including in higher-level eating disorder and trauma settings where self-harm is frequently present. They approach self-harm through a harm reduction lens that is grounded in clinical evidence and in a genuine understanding of what self-harm is doing for the people who use it.
Their training in DBT, EMDR, and somatic approaches gives them the specific clinical tools that research shows are most effective for self-harm treatment. Their PhD research focuses on marginalized communities, including the ways self-harm is more prevalent in populations that experience chronic minority stress and have fewer resources for emotional regulation support.
Read more about Embodied Therapy here and read more about Allison here.
No. You do not have to commit to stopping before we can begin. Harm reduction means meeting people where they are. If you are not ready to stop, we start with understanding. The readiness often develops through the work, not before it.
Confidentiality rules vary by age, state, and circumstances. We talk through exactly what confidentiality looks like at the beginning of treatment so you know what to expect before you share anything. If there is an imminent safety concern, that changes things, and we are honest about when that threshold applies. In most situations involving ongoing self-harm that is not life-threatening, the conversation stays between us.
No, though the two sometimes co-occur. Most people who self-harm do not want to die. They want to change how they feel. Non-suicidal self-injury (NSSI) is a clinically distinct category from suicidal behavior. This distinction matters because the two require different responses and different treatment. We assess both and treat each with the seriousness it deserves.
No. Not being able to stop through willpower alone is not a character flaw. It is information about how much the behavior is doing and how much underlying work there is to do. Previous attempts that did not hold are useful clinical information, not evidence that nothing will.
Yes, and this intersection is a specific area of clinical focus. ADHD, autism, and eating disorders co-occur at high rates, and most standard treatment was not designed with neurodivergent brains in mind. We adapt the approach to fit the person — not the other way around.
Yes. These frequently co-occur, and they often share underlying experiences of emotion dysregulation, shame, and trauma. We hold both with care and without treating one as more important than the other.
The intake session is $250.
Ongoing individual therapy sessions range from $85 to $155, depending on need and availability.
Family and parent support sessions range from $105 to $175.
Sliding scale options are available. You can check your eligibility instantly below — no phone calls, no hassle.
You do not have to be ready to stop. You do not have to know what you want from therapy. You do not have to have the right words for what is going on.
A free consultation is just a conversation. You ask questions. We ask questions. Together we figure out whether this is the right fit before anyone commits to anything.
There is no judgment. There is no script. Just an honest conversation about where you are.
