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Indirect Self-Harm: The Hidden Struggle Impacting Mental Wellbeing

By Dr. Marianne Trent and Eva Perry

This article has been adapted from episode 134 of The Aspiring psychologist Podcast. If you prefer you can listen here or watch here. 


Have you ever wondered about the subtle ways we might be harming our own physical or mental wellbeing? While direct self-harm, such as cutting or burning, often captures attention, there's a lesser-known yet equally significant concept: indirect self-harm. This form of self-harm includes behaviours that, while not immediately visible or intentional, can still have profound negative effects on our health. In a recent episode of the Aspiring Psychologist Podcast, I had the pleasure of discussing this with Eva Perry, a psychology postgraduate student with a keen interest in this area.

Understanding Indirect Self-Harm

Indirect self-harm encompasses behaviours that might cause unintended harm, such as social isolation, sleep deprivation, neglecting personal hygiene, excessive alcohol consumption, and perfectionism. These actions may not be deliberate attempts to cause harm, but their cumulative impact can be detrimental.

Eva Perry's undergraduate research explored this emerging concept. Inspired by her coursework and a placement year focused on self-harm and suicide prevention, she delved into the nuances of indirect self-harm. She found it fascinating that such behaviours, although culturally and socially acceptable, can still pose significant risks.

Examples and Cultural Acceptance

Take, for example, university students. Excessive drinking, experimenting with drugs, and pushing oneself to perfection are often seen as rites of passage. However, these behaviours can be problematic and fall under the category of indirect self-harm. Eva pointed out that it's crucial to recognise these behaviours early, as they often serve as precursors to more severe forms of self-harm.

Another example is neglecting one's health, such as a high intake of sugary foods and drinks. My own experience with my husband's love for sweets highlighted this. His dentist noted severe acid erosion on his teeth, raising concerns about potential long-term harm. It made us realise how even seemingly harmless habits could indirectly damage health.

The Role of Awareness and Support

Awareness is key. As mental health professionals, we need to recognise the early signs of indirect self-harm and intervene before these behaviours escalate. For instance, eating disorders often involve indirect self-harm. Bulimia, for example, not only affects physical health through tooth erosion and acid reflux but also has profound mental health implications.

Eva's research found that individuals often engage in multiple indirect self-harming behaviours. On average, she noted 10 to 12 different behaviours per month. Common behaviours include self-defeating thoughts, comfort eating, and declining to ask for help when struggling emotionally or physically.

The Importance of Mindfulness and Support Networks

Mindfulness plays a significant role in addressing indirect self-harm. Being in tune with our body's signals and understanding the knock-on effects of our behaviours can help us make healthier choices. Additionally, surrounding ourselves with supportive people can make a difference. As Eva noted, support networks are crucial in reducing harmful behaviours and fostering positive change.


Indirect self-harm is a complex and under-researched area that deserves more attention. By raising awareness and promoting discussions, we can better understand these behaviours and develop strategies to mitigate their impact. If you found this topic interesting, I encourage you to share it with your network and consider joining the Aspiring Psychologist community on Facebook for more insightful discussions.

For those working in mental health services, whether as aspiring or qualified psychologists, recognising and addressing indirect self-harm can make a significant difference in your clients' lives. Let's continue to educate ourselves and others, fostering a culture of mindfulness and support.

Stay kind to yourself and remember, it's okay to ask for help.

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