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Self-harm

Explains self-harm, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

Your stories

My body comes with a trigger warning

Seaneen blogs about living with the scars of self-harm.

Seaneen Molloy-Vaughan
Posted on 23/09/2015

How can I help myself?

If you are thinking about stopping or reducing your self-harm, finding ways of helping yourself can feel very empowering.

This section gives some ideas for things you can do to support yourself better. Some can be done when you feel like self-harming. Others can be done at any time. You may need to try a few to find out what works for you. These techniques may be helpful on their own, or alongside professional help. (See ‘What treatment and support is available?’)

Fifteen years of self-harm was my way of releasing the pain, releasing the lid on a screaming pressure cooker. It gave me tremendous relief. It's 20 years since then, because I learnt to cry, scream, give voice to pain, dance, laugh and sing.

There is no magic solution or quick fix for self-harm, and making changes can take time and involve periods of difficulty. It is common to make some progress and then get back into old behaviours again. If this happens to you, remind yourself that it's not failing – it is simply part of the process.

There is hope, no matter how many times you...[have to]...pull yourself back up. Every day is a new day, and every day is a start to recovery and getting better.

If you do not feel able to stop self-harming completely, it is important to be honest with yourself and consider what else you can do that would feel helpful. For example, you may be able to work towards reducing or stopping your self-harm in the future, even if you find it too difficult to stop self-harming immediately.

Work out your patterns of self-harm

It may be that things happen so fast, it feels impossible to realise you have an urge to self-harm before you find that you are hurting yourself.

Keeping a diary of what happens before, during and after each time you self-harm, can help you work out what gives you the urge to self-harm, and recognise when the urge is coming on. It is helpful to do this over a period of time – maybe a month – so that you start to see patterns.

Learn to recognise triggers

Your triggers are the things that give you the urge to hurt yourself. This could be anything from people, situations, anniversaries, certain times of the day, physical sensations or particular thoughts or feelings.

In your diary, note down what was happening before you last self-harmed.Did you have a particular thought? Did you have an argument? Did you have to see someone you don’t like? Did a situation or object remind you of something difficult?

This can be quite an intense experience and bring up difficult feelings and emotions. If you feel confident to try this on your own, make sure you do something relaxing or enjoyable afterwards. If you find doing this distressing, you may want to ask for support from a trusted friend, family member, or professional. (See ‘What treatment and support is available?’ for more information.)

Learn to recognise urges

The next step is to identify how you experience the urge to self-harm. Urges come in lots of different ways and may be different for you at different times.

Urges can include:

  • physical sensations, such as a racing heart, nausea, or very shallow breath
  • feelings of heaviness, fogginess or blackness
  • disconnecting with yourself, such as feeling like you are outside of your own body or losing all feelings of sensation
  • strong emotions, like sadness, fear, despair or rage
  • specific thoughts, such as 'hurt' or 'I'm going to cut'
  • making decisions that you know aren't good for you, for example by excessive working or exercising rather than experiencing your feelings.

I feel the urge when I have too much feeling inside me, whether anger, sadness or frustration, that I can't seem to contain it inside my mind. I think self-harming was my way of dealing with it.

If you are able to recognise your urges, this can help you take positive steps towards reducing or stopping your self-harm. You might also find it helpful to think about how your urges relate to your triggers.

Even at times when you are unable to resist the urge to self-harm, it is still helpful to think about what happened, so you understand this better next time.

Distract from the urge to self-harm

The urges were overwhelming and would make me panic and feel desperate. Focusing on a specific task such as washing my hands, making a cup of tea, folding clothes, or something destructive like tearing paper or hitting something helped the panic pass.

Distracting yourself is a way of changing the cycle of self-harm by choosing to do something else. A distraction, like hitting a cushion or writing a list, provides something else to focus on and another way of expressing your feelings. This can help reduce the intensity of your urge to self-harm. Distracting can be done when you feel an urge to harm yourself, or as you become aware you are hurting yourself.

Once you know the different feelings and situations that cause you to want to self-harm (your triggers and urges), you can create a personal list of distractions. It is important to notice when a distraction works in one situation or with a certain feeling, but not in another. Then you can consider what you may need to do in different situations or for different urges.

Below, there is the beginning of a list of distractions for you to build on. Try to come up with five different things for each one of the feelings that causes you to want to self-harm. You can build this list up over time if you find it difficult to think of five things straight away.

 

Feelings

Possible distractions

Distractions that work for me

Anger and

frustration

Express it physically:

  • exercise in a way that feels helpful rather than harmful
  • hit cushions
  • shout
  • dance
  • shake
  • bite on bunched up material
  • tear something up into hundreds of pieces

 

Sadness and fear

  •  wrap a blanket round you
  • spend time with an animal
  • walk in nature
  • let yourself cry or sleep
  • listen to soothing music
  • tell someone how you feel
  • massage your hands
  • lie in a comfortable position and breathe in deeply – then breathe out slowly, making your out-breath longer than your in-breath. Repeat until you feel more relaxed. (See relaxation)

 

Need to control

  • write lists
  • tidy up
  • have a throw-out
  • write a letter saying everything you are feeling and burn it
  • weed a garden
  • clench then relax all your muscles

 

Numb and disconnected

  • flick elastic bands on wrists
  • hold ice cubes
  • eat something with a strong taste like chilli or peppermint
  • smell something with strong odour
  • have a very cold shower

 

I use my art to cope, although it does not always work. I either draw very angry scribbling on big sheets of paper or use plasticine to get a lot of the energy out. I have only recently realised that a lot of the self-harm thoughts and feelings come from anger being directed inward.

Delay self-harm

Another technique is to wait ten minutes before you self-harm. If you still have the urge, then let yourself. If not, increase the time you wait to half an hour, a morning, a day, a week etc. By doing this, you slowly build up the gaps between each time you self-harm, and reduce how often you feel the need to do it. Even if you start self-harming again, you will now know that you can go for periods of time without doing so.

Other ways of making long term changes

It is also helpful to think about steps you can take to understand your self-harm and to find other ways of supporting yourself.

Build your self-esteem

Practising positive and encouraging self-talk can help make a difference to how you feel. As you experience urges to self-harm, try reminding yourself why you are having certain thoughts or feelings. For example: ‘I feel like I want to cut because I don’t think that person likes me’. Then replace it with another thought, like: 'Even though I feel like cutting, I am going to find another way to express how upset I feel'.

It can also help to explore personal beliefs about yourself and others by writing them down in a diary. For example, you may believe you will never be able to stop hurting yourself or that no one will be able to help you. Ask yourself if you can be absolutely sure that these beliefs are true and how it would feel for you to let them go or change them. If you find this difficult, you may want to ask for support from a trusted friend, family member, or professional. (See ‘What treatment and support is available?’)

It might also be helpful to write down all the things you like about yourself, no matter how small. Try to do this on a regular basis, perhaps every week. This will help shift your attention from negative feelings to more positive ones, and help you build your self-esteem over time. (See 'How to increase your self-esteem' for more suggestions.)

Look after your general wellbeing

Looking after yourself can help you feel more positive. For example:

  • Doing regular physical activity can boost your mood and reduce stress.
  • Eating regular meals with plenty of fresh fruit and vegetables can also help.
  • Making sure you get enough sleep helps you feel better and more able to cope. (See 'sleep problems'.)
  • Doing something creative can help you express your feelings. For example, write a song, story or blog, paint, draw or use clay.
  • Spending time every week doing things that you enjoy, such as seeing friends or going for a walk, is also important. Try to make time to do this, no matter what else is going on.

Reach out for support

Reaching out can feel hard, especially if you worry that people will judge you or if you believe that other people might not want to help you. Try to remind yourself that everyone needs support at different times, and that it is OK to ask for help.

When you are ready to reach out, choose someone that you trust to talk to about how you are feeling. This could be a friend, a family member, a counsellor, health professional or psychologist (see ‘What treatment and support is available?’).

You may also find it helpful to write a list of all the people, organisations and websites that you can go to for help when you are finding things difficult. This will remind you that you are not alone, and where you can get help. (See ‘Useful contacts’)

 


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