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With full respect for how sensitive this topic is, my question is: is self harm usually an impulsive action or a long considered one? Does the word "usually" even apply or is it very individual?
If you're talking about something like cutting and esp that kind of self-harm as a habit, from what I've observed with teens, it's kind of like a drug addiction. It starts out being this weird, out of control, impulsive thing that people do when their emotions are out of control and then it becomes a normalised coping mechanism. It's considered in the sense that people begin to plan the behaviour -- much like a smoker plans their morning cigarette.