Physical self harm, at its most graphic and shocking, involves cutting the skin. Biting fingernails and the skin on the fingers until they bleed or deliver constant pain is a lot more subtle, but it’s the same thing. I do this latter version all the time.

(I wasn’t aware that it’s also a version of self harm, and came from the same ‘family’ of bad stuff we do to ourselves, until a few years back when I talked to a therapist about it. I’ve done it for as long as I can remember, all the way back to childhood.)

Mental self harm could be the way we talk to ourselves in light of whatever choices we make. It could be based on the way we spend our time, or the judgments we make about our behaviour in any circumstances.

Both types can benefit from treatment. Maybe the mental version leads to the physical version. (Of this, I’m not certain, but I suspect there is a strong link.)

They’re definitely both worth working on to remove them from your life.

I see the link between thoughts and actions. Everything starts with our thoughts – the good and the bad. Making an effort to use what we say to ourselves, how we talk to ourselves, as a force for good can be transformational.

Some simple daily reminders of this – triggers for changing the response to something bad, for example – are something I’ve been working on. They make a huge difference.

The plasticity of our brains – neuroplasticity – means that we can change the way we think, but it goes on the ‘too hard’ pile most of the time.

I used to see my brain as a hard drive that worked one way, and was impossible to alter. But this isn’t the case.

The effort to make these changes is never wasted. The consequences of a life spent suffering from self-inflicted pain are not what I want for the rest of my life.