Complex trauma leaves profound imprints on those who endure it. When a person experiences repeated and prolonged trauma, particularly in childhood, it reshapes their understanding of themselves and the world. The effects ripple through every facet of life, including emotional regulation, relationships, and self-worth. Among the most stigmatized and misunderstood responses to complex trauma are self-injury and suicidality. These issues are often shrouded in silence, shame, and fear despite their prevalence. If we truly want to support survivors of complex trauma in their healing, we need to start being more honest about these struggles.
The Hidden Reality of Self-Injury and Suicidality
Self-injury, often referred to as non-suicidal self-injury (NSSI), is a coping mechanism used by some who have experienced complex trauma. While it may be difficult for outsiders to understand, self-injury is frequently an attempt to manage overwhelming emotions or a way to feel something when numbness takes over. Similarly, suicidality—whether through fleeting thoughts or more serious considerations—can emerge as a response to the deep pain and hopelessness that often accompany complex trauma.
These behaviours are not signs of weakness or attention-seeking. They are signals of profound distress, and yet, because of the stigma surrounding them, survivors often suffer in isolation. Many fear being judged or misunderstood by those around them, including friends, family, and even mental health professionals.
Why Stigma Makes Things Worse
The stigma surrounding self-injury and suicidality does not only perpetuate silence—it also fuels feelings of shame and unworthiness in those who struggle. When survivors internalize societal messages that their coping mechanisms are wrong or dangerous, they may feel even more isolated and trapped in their pain.
In some cases, survivors are afraid to disclose their struggles to healthcare providers out of fear of being dismissed or subjected to interventions they do not want. This fear can prevent people from seeking help, increasing the risk of harm. By keeping self-injury and suicidality in the shadows, we create barriers to compassionate care.
The Importance of Trauma-Focused Care
Honesty about self-injury and suicidality begins with creating safe spaces where survivors can speak openly without fear of judgment. Trauma-focused care, like that provided by professionals informed by Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy, Cognitive Processing Therapy (CPT), Emotional Processing Therapy (EMT), and Acceptance and Commitment Therapy (ACT), offers a framework for this kind of openness.
Trauma-focused approaches go beyond merely managing symptoms. They seek to understand the roots of these behaviours and help survivors develop healthier ways to cope. By addressing the underlying trauma, these therapies offer a path to genuine healing rather than temporary fixes.
A Call to Action for Mental Health Professionals and Society
For mental health professionals, being honest about self-injury and suicidality means fostering an environment of empathy, curiosity, and non-judgment. It involves asking open-ended questions, listening without assumptions, and offering support that respects the survivor’s autonomy.
At a societal level, we need more conversations about these topics in schools, workplaces, and communities. We must challenge the harmful narratives that paint self-injury and suicidality as mere cries for attention. Instead, we can reframe these behaviours as calls for support—as ways survivors express the inexpressible.
Hope in Honesty
Healing from complex trauma is a journey, and for many, it includes moments of deep despair. By being more honest about the prevalence of self-injury and suicidality among survivors, we can help reduce stigma and open doors to support and healing. Honesty allows survivors to know they are not alone, their struggles are understood, and that help is available.
As a community, our role is not to shy away from difficult conversations but to approach them with empathy and courage. When we do, we create a world where survivors of complex trauma can find hope, connection, and a path forward—no matter how dark things may feel.