There are hundreds of theories about Self-harm, although all speculative and individual. The most reliable evidence is provided by sufferers themselves as of late.

Self-harm is always an underlying condition, only fact we know for sure.
It is also extremely versatile.

In my experience, it’s a desperate attempt at self-control and discipline.
One must be aware to self-harm.
Self-harm is carried out dysfunctionally for a purpose.

In my case, the most common form of self-harm is face shaving.
I’m not talking aesthetics here, though true Obsession.
Shamefully, the Beauty Industry has found a multimillion business in ‘grooming’ with so-called ‘safety razors’, shaving tutorials, etc., to the point of replacing fully fledged dermatologists.

Shaving is an imposed societal rule.

Shaving is mandatory for public employees.
Clean-shaven is synonym of smartness, so that every man is indirectly compelled to shave.

Don’t believe to proud ‘bearded models’, they know deep inside that they have shaving phobia. They try to mask it by sporting ridiculous  ‘designer beards’.

Those who can’t afford to go unshaven, self-harm with painful razor cuts.
This becomes a compulsion, a punishment.

Females have other ways of self-harming, despite my take on the commonality: self-punishment in order to conform to a society that still shuns neurodiversity.

How OCD impacts Self-harm.

OCD is characterized by hurting repetitive physical and mental behaviors.
Repetition is always harmful for the body: overshaving, overwashing, overthinking, rituals…

Scientists identified the triggering Signal of OCD in the Orbitofrontal Cortex, part of the Reward System. Once again, dopamine is involved in OCD in addition to anxiety.

The OCD brain uses more timescales to carry on tasks, making every task more demanding. This extra energy causes the brain to dissociate from Sequences like dressing up, so that each step is processed individually and repeated several times. It takes double time for OCD people to start their day by stopping and thinking about the next step. Severe cases resort to Counting, e.g. 1- biological needs 2- wearing socks 3- shaving 4- choosing clothes, 5- coffee, etc…whereas the Neurotypical would follow an uninterrupted daily Sequence.

Can you see the correlation with ADHD Worry-paralysis?
Could OCD be Worry-paralysis?
From my ADHD perspective, it could.

SSRIs are weak in abating OCD.
Dopaminergic compounds prove more effective in combination with Brain-stimulation’s TMS treatment.
Nonetheless, OCD is rampant in ADHD and Autism.

TMS-Transcranial Magnetic Stimulation-is the safer noninvasive replacement of dirty old ECT, originally designed for MDD. Only recently, TMS has been introduced in the treatment of OCD.
MRI scans show decreased neural activity in Clinical Depression and OCD.
TMS delivers magnetic pulses to stimulate nerve cells.
The results are mostly successful within 4/6 weeks.

It is now evident that the brain functions on Stimuli and Interconnectivity between all regions.
The last frontier will be understanding what causes hypo-stimulation in the Neurodivergent Brain.
A lengthy study as the million components of Neuroanatomy.

The race has just started.