Eating Disorder Recovery Dealing with Self Harm and Shame

Woman upset with her dental issues during eating disorder

Self-harm and shame tend to go hand-in-hand for many individuals who also have an eating disorder. Self-injury can be described as hurting oneself on purpose and deliberately.

Individuals self-harm for various reasons, but often to reduce emotional pain of a past or current trauma, unwanted negative thoughts that are common with an underlying mental illness such as depression and anxiety.

Engaging in self-harm behaviors often bring for a ‘release’ of pain, when reported by individuals who participate in this action. Usually, the act of self-harming and the release of dopamine triggers the pleasure and reward center that makes the person want to participate in self-harm again [1].

What Self-Harm Is and Isn’t

Shame, however, is an emotion that also comes with self-harm. Scars from cutting or burning can be permanent. Drinking or using substances and engaging in high-risk behaviors can result in severe injuries.

These can result in feelings of shame and anxiety. With shame comes isolation. Often those who have these emotions withdraw from loved ones may become depressed, and engage in self-harm to feel ‘better’ but end up empowering the cycle of self-injurious behavior.

Self-harm is not suicidal behavior. It is a way for a person to cope with painful emotions and experiences. Typically those who also suffer from bipolar disorder, personality disorders, depression, eating disorders, post-traumatic stress disorder, and anxiety engage in self-harm behaviors.

Woman sad and holding lights

Often these individuals isolate and spend a majority of time alone. Many individuals will also wear long clothing even in hot weather to cover scars or marks from self-injurious behaviors.

According to a study from the University of Exeter, they found that those who self-harm only use emergency hospital care as a last resort due to injuries sustained from self-harm due to the shame and feelings of unworthiness [2]. Many participants reported punitive and/or stigmatizing treatment from staff at hospitals and due to treatment and shame do not return for care.

Often those with eating disorders and self-harm behaviors will keep symptoms secret from others. Signs will consist of scars from burns or cuts, fresh or healing scratches or cuts on arms or legs.

Bruises on the body, hair loss or bald spots from hair pulling. Some individuals will break bones, or have a sharp object or cutting tool on them at all times [3].

Self-harm is typically pre-planned and ritualistic for many. The individual usually engages in the behaviors in a controlled and methodical manner. After the actions, feelings of shame and guilt, as well as, the painful emotions return.

Shame: A Hidden Emotion

Shame is uncomfortable for most people. It is also helpful in understanding this emotion to be able to understand eating disorders and self-harm. Many experiences, especially in childhood, lead to the development of disordered eating and body image distortion [4].

Childhood sexual abuse, neglectful or abusive families, and bullying can all be factors in an eating disorder and self-harm behaviors to emerge.

Studies show that those who are diagnosed with eating disorders tend to have higher, more intense emotions and difficulty dealing with emotions than those who do not have an eating disorder [4].

One of the reasons for both disorders is an unhealthy way to deal with feelings and symptoms of both may offer sufferers with temporary relief. Other studies are showing that shame is one of the most influential emotions that lead up to and following episodes of overeating, binge-eating, and purging [4].


Self-compassion can be a strong tool in the recovery process. These include being able to show kindness and understanding to self is imperative.

Woman struggling with self-injury

Being able to recognize that all humans have similar struggles and can carry on with life and comes through it with support and self-compassion. Being able to learn how to balance painful thoughts and feelings is also a part of self-compassion.

Shame and self-injury can also defeat self-compassion through self-criticism and judgment, isolating or disconnecting from loved ones, and over-identifying with negative emotions.

When in mental or physical pain it can be easy to get lost in the negative feelings or thoughts that underlying disorders can produce.

Being able to learn and practice self-compassion can bring a sense of forgiveness and break a person out of the shame and self-harm cycle.

Working through treatment on self-harm and shame can help the recovery process. Being able to address underlying issues as well as unhealthy coping skills can free a person from the isolation and silence of these struggles.

Addressing the childhood experiences that add in the cycle of self-harm and shame, along with unhealthy coping skills, and patterns of behaviors are essential in the recovery and treatment process. Being able to have various modalities of therapies as well as multiple mediums of expression can aid in treatment and recovery.

Getting help for your eating disorder and self-injurious behaviors is a terrific first step in the process of healing. If you are already connected with a treatment team, you need to be honest about the feelings and thoughts around your behaviors. Working together in a supportive manner can help you recover.

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


[1] NAMI. (n.d.). Retrieved October 03, 2017, from
[2] Self-harming youngsters put at risk by ‘cycle of shame’. (2016, March). Retrieved October 03, 2017, from
[3] Self Mutilation Symptoms and Effects. (n.d.). Retrieved October 03, 2017, from
[4] B. (2015, August 24). Understanding Shame and Self Compassion and Binge Eating Disorder-A Study. Retrieved October 03, 2017, from

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on November 18, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on November 18, 2017.
Published on