Helping yourself if you self-harm

I learned distraction techniques. My favourite one was my Positivity Book, a scrap book filled with things which make me happy.

Coping with urges to self-harm right now

The most common ways to cope with an urge to self-harm involve distraction and delay.

Distracting yourself from the urge to self-harm

Distracting yourself from the urge to self-harm can give you breathing space and reduce the intensity of the urge.

You can do distraction activities when you feel the urge to self-harm. Or as soon as you become aware that you're self-harming.

Different distractions work for different people. And the same distraction may not work for you every time. For example, distracting yourself from anger feels very different to distracting yourself from fear.

It can help to have a few different strategies depending on what you're feeling. Here are some suggestions. 

If you feel angry and frustrated

• Hit cushions or a pillow
• Squeeze a rubber ball really hard
• Play loud music
• Tear something up into lots of pieces, like a newspaper or a book you no longer need
• Clench then relax all your muscles
• Write or draw on paper what has made you angry, then scrunch it up

If you feel sad or fearful

• Wrap yourself in something cosy, such as a jumper or blanket
• Spend time with an animal, or cuddle a soft toy
• Go for a walk to somewhere that you find soothing, and take someone with you if this would help
• Journal your feelings - you could write them down, or record a video or audio clip
• Let yourself cry or sleep
• Listen to soothing music
• Call or message someone that you care about
• Call a helpline, such as Samaritans, or use a peer support service like Side by Side
• Lie in a comfortable position and breathe in and out slowly several times, making your out breath longer than your in breath
• Try other relaxation exercises, like those on our relaxation tips page

I like the comfort of my duvet doubled up in bed. And watching YouTube where I can forget and be immersed.

If you feel a need to be in control

• Set yourself a timer and do some tidying up for that amount of time
• Declutter or rearrange your furniture
• Write down or record yourself saying what you’re feeling or thinking, then tear it up or write down all the ways you could challenge this
• Do something creative, like using a colouring book, drawing or learning a new skill
• Play games on your phone, if you have one
• Do some gardening, or plant some seeds in your home

If you feel numb or disconnected

• Smell something with a strong odour
• Wash your face with cold water
• Open a window or blow a fan at full blast
• Hold objects with different textures (soft, smooth, stretchy) and focus on the sensations
• Draw or put a plaster on the area of your body that you want to harm
• Massage the area where you want to harm yourself
• Practise mindfulness

I've learnt that you can't rely on other people or things to save you from self-harm. It has to come from you.

Delaying self-harm

This removes some the pressure to completely stop self-harming. Instead, you commit to a set amount of time that you won't self-harm.

For example, you could set yourself the goal to wait 5, 10 or 15 minutes before you self-harm. It can also help to use distraction techniques during this time.

You may find this really hard. Don't worry if you're not able to wait that long at first.

If you can, slowly increase the time you wait. And gradually build up the gaps between each time you self-harm.

This might help you feel more in control. And for some of us, any urges may pass by the time the waiting is over.

Although it doesn't feel like it, the urges are often short - minutes long. If I can use distraction for just that time, usually by the end of the 15 minutes the really intense urge has passed.

Long-term coping with self-harm

Coping long-term with self-harm can be hard. It can take time and practice. It may also involve understanding why you self-harm. This can help you find alternatives.

You might make some progress and then feel like you're going backwards. If this happens, try and remind yourself that you're not failing. It's a common part of the process.

Physically stepping back from situations that triggered me created a physical space that allowed me to gather my thoughts.

Understand your triggers and urges

Keep track of what happens before, during and after you self-harm. This can help you understand what gives you the urge to self-harm, and recognise these urges more quickly in future. You could use a diary or app, or note things on your phone or a piece of paper.

But doing this can bring up difficult feelings. So make sure you do something relaxing or enjoyable afterwards. You could also ask someone else to help fill in the diary with you.

It may help to break down your experience between triggers and urges.

What are triggers?

Triggers are what give you the urge to hurt yourself. They can be anything. For example, people, situations, anniversaries of events, sensations, specific thoughts or feelings. There doesn't have to be one specific trigger.

Thinking about why you've self-harmed can feel overwhelming. You could note down what happened just before you self-harmed, and how you felt afterwards. For example:

• Did you have particular thoughts or feelings?
• Did a situation, person or object remind you of something difficult?
• What time of day did you feel triggered?
• What urges did you experience and how strong were they?
• Did you try any distractions when you noticed you were triggered? Were they helpful?
• How did you feel after you self-harmed?

What are urges?

An urge is a desire or a craving to do something. When you feel an urge to self-harm, there might be signs in your body, behaviour or emotions, such as:

• Racing heart or feelings of heaviness
• Strong feelings like sadness or anger
• A numbness or disconnection from yourself
• Repetitive thoughts or visions about harming yourself
• Unhealthy behaviours like using alcohol or drugs, or keeping very busy to avoid feelings

Recognising your triggers and urges can help you gradually reduce or stop self-harming. Learning more about them can help you notice them more easily and take action.

I found things to do that I enjoy to keep myself busy, and with that I found the urges started to subside.

Prepare a support plan

If you self-harm regularly, health professionals might suggest that you create a support plan. You might also hear this called a safety plan.

A support plan can help keep you safe if you feel like self-harming. Your plan is personal to you, but it could include:

• How to recognise your warning signs. You could think about any changes in your thoughts, feelings or behaviour that you noticed before you last self-harmed.
• Your coping strategies. You may have found certain things helpful for coping with difficult feelings in the past. Try thinking about how you can use these things to help yourself now.
• Names and contact details of people you trust. These are people you can ask for help if you're feeling distressed.
• Names and contact details of professionals who can support you. This could include your local crisis team.
• Details of helplines and listening services. These can help you when you're feeling distressed. Trained professionals can listen to how you feel and keep you company, for as long as you need. See our helplines page for more information.
• What you can do to make your environment safe. For example, removing things you could use to self-harm.
• Details of a safe place you can go for support. This could be the home of a friend, family member, or someone else you trust.

If you can, try to make the plan when you're feeling a bit better. It helps if you can think clearly about what you'd find helpful when you're struggling.

It might also help to make the plan with someone you trust. For example, a friend or therapist.

See our information on support plans for tips on what to include. You can also download an example of a safety plan from the Samaritans website.

Create a self-care box

You might find it helpful to keep a box of items to open when you feel like you want to self-harm.

This could include items that can help you distract yourself from self-harm. And things that feel comforting to see, hear, touch, taste and smell.

This might include:

• Photographs of people or places you care about
• Art supplies, such as colouring books, pens and pencils
• Activities, such as puzzle books, other books you find interesting, cross-stitch, or any games you can play
• Something to do with your hands, such as a fidget toy or playdough
• Soft items, such as a blanket or a pair of cosy socks
• Something that smells nice, such as a scented candle
• Something to listen to, such a link to a playlist or audiobook you find comforting
• A notepad and pen to write down how you feel

Your box should be personalised to you. Make sure you include things that will soothe you, and you will find helpful.

Practise self-compassion

Being compassionate to yourself can be hard, especially if you have low self-esteem.

But you can start small and build up. And it can make a big difference to your relationship with yourself, and with self-harm.

Here are some things you could try:

• Practise speaking and thinking more kindly about yourself, in the same way as you would about someone you care about. Ask yourself questions like “What would I say to a friend going through this situation?”
• Write a letter from the part of you that feels you want to punish yourself, then write back with as much compassion and acceptance as you can
• Say affirmations to yourself. For example, “even though I feel like hurting myself, I am going to find another way to express how upset I feel"
• Celebrate wins, no matter how small. For example, if you wanted to self-harm but didn't, or managed to go longer than usual without self-harming. Try to focus on these achievements. Writing them down might help.
• Write down three things you appreciate about yourself, no matter how small. If you’re finding this difficult, ask someone you care about to do it for you. If you’re seeing a therapist, they can also help you identify these.
• Try mindful self-compassion. Notice and name feelings as you become aware of them, without judging them.

See our information about self-esteem for more suggestions.

Reach out for support

Asking for help can feel hard, especially if you worry that people might judge you or not be supportive. Remind yourself that everyone needs support at different times, and that it's ok to ask for help.

If you feel able to share your experience, it can make a big difference to how you feel. It can help reduce feelings of shame and isolation. And it will increase the chance of you getting the support you need.

If you feel ready, choose someone you trust to talk to about how you’re feeling. This could be a friend, family member, therapist or health professional.

Remember that you're in control of what you say. And you don't have to say anything that you're not ready to share. You could write things down if you're struggling to talk about your feelings.

If people aren’t supportive

If the reactions from people in your life aren't supportive, this can be really hard. It might make you more afraid of opening up again in future or seeking help. You may feel like you need to cover up your self-harm, or lie to others about it, to prevent them from getting upset.

Write a list of the people, organisations and websites that you can go to for help when you are finding things difficult. This will remind you that you're not alone, and where you can get help. This could be a helpline if you don’t feel you have anyone you can trust.

Having a therapist who'd never judge and remained constant and calm made a huge difference. I was able to open up.

Be kind to yourself if you relapse

You might have gone some time without self-harming, but then started again. This is sometimes called a relapse.

There could be a number of reasons why you've started self-harming again. But having more difficult times doesn't mean you've failed or gone backwards. Ups and downs are a normal part of managing self-harm.

When you're feeling a bit better, try to understand why you self-harmed. This could help you make changes and prepare for similar situations in the future.

You could think about when you stopped self-harming before, and what helped and didn't help last time. And whether there's anything you can do again now.

Starting the process of not self-harming again shows your strength. And you know you were already successful in stopping once. So this time, you may find it easier to stay free from self-harm for longer.

Learn as much as possible from everything - the relapses, the ups, the downs. See each experience as an opportunity for growth.

Look after your scars

Some types of self-harm may leave you with physical scars. What these scars mean is different for everyone.

You may see self-harm scars as an important part of your story and a reminder of your progress. You might feel comfortable with them.

Or you may prefer not to have a physical reminder of difficult thoughts and feelings. Or you might feel ashamed or embarrassed about them. You might try to hide parts of your body to stop others from seeing them.

It’s important to do what feels right for you so that you feel comfortable in yourself. If you want to cover or reduce your scarring, treatments are available. See the LifeSIGNS website to learn more about scar reduction and skin camouflage.

Published: August 2024

Next review planned: August 2027

References and bibliography available on request.

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