How can self-harm be best conceptualized within the DBT model?

Self-harm can be best conceptualized within the DBT model as maladaptive problem solving. This perspective sees self-harm not as a goal in itself, but as a strategy individuals may use to cope with distressing emotions or situations. In DBT, self-harm is often viewed as a way to address overwhelming feelings, regulate emotional pain, or communicate distress. It represents a means to an end rather than a healthy or effective coping strategy.

DBT emphasizes that while the individual may feel temporary relief or a sense of control through self-harm, it ultimately does not solve the underlying issues they are facing. Instead, it can lead to further emotional dysregulation and negative consequences, thereby worsening the person’s situation over time. This conceptualization aligns with DBT's focus on teaching more effective interpersonal and emotional regulation skills to replace such maladaptive behaviors.

Understanding self-harm through this lens helps inform treatment strategies that aim to develop healthier coping mechanisms and problem-solving skills, highlighting the importance of skill acquisition rather than managing the self-harm behavior alone.