Cope with Self Injury

People self-injure in an attempt to reduce distress, to self-punish, to gain a sense of control, to feel something other than emotional numbness, or as a cry for help. Self-injury can be dangerous; it tends to become an addictive habit that is difficult to stop. There are ways to cope with self-injury; you are not alone in this.

Steps

Taking the First Steps

1. Take the necessary precautions to stay safe. If you can't bring yourself to stop self-harming just now, at least keep from inflicting irreparable harm upon yourself.
   • Don't share cutting or burning implements with anyone. It's just like sharing needles; you can get all sorts of diseases, like Cope if You're Diagnosed With AIDS or Treat Hepatitis A.
   • Sterilize cutting or burning implements to help reduce your chances of infection.
   • If you can't refrain, try to keep cuts shallow to reduce the chances of scarring. Avoid using your fingernails, earrings, and other objects that are unsterile and can cause infection.
   • Keep first aid supplies on hand and know what to do in the case of emergencies. Always have a phone nearby in case you need to call 911.
   • Putting yourself in risky or dangerous situations without regard for your own welfare can also be a form of self-injury. Try to avoid this when you can.
2. Do only the minimum required to ease your pain. Decide how much you are going to allow yourself to do (how many cuts/burns/bruises), keep within those boundaries, and clean yourself up later.
3. Keep a record of when you experience self-harming urges. Triggers are things that give you the urge to hurt yourself or to put yourself in danger. To identify your triggers, write down in a notebook what happened before you last self-harmed.
   • Look for patterns in your responses to identify themes. What kinds of situations trigger the behavior? Do you get the urge to self-harm when you're depressed? Angry? Embarrassed? Self-Conscious? Frustrated? Understanding what triggers your self-injury can help you find other, more positive ways of coping, such as dealing with the triggers head on.
   • For example, you may start to notice that whenever you see a certain person in your life, you get the urge to self-harm. You could then use this information to try to avoid that person, and thus avoid the urge to self-injure, and/or present that information to your therapist and ask for his guidance.
   • Many people use self-injury as a way to cope with stress or to express feelings that they don't know how to express otherwise.
   • Examples of triggers include:
     • People
     • Situations
     • Memories
     • Certain times of the day
     • Certain feelings
     • Certain thoughts
     • Specific bodily sensations
4. Pay attention to your body. Your body goes through some changes when you experience the urge to hurt yourself. You can use this information to predict when you might self-harm and take the necessary precautions, such as getting a phone handy in case you need to call 911. There are some ways urges can manifest:
   • Increased heart rate
   • Nausea
   • Shortness of breath
   • Feelings of heaviness or emptiness
   • Feeling like you are outside your body observing yourself; being disconnected from yourself
   • Powerfully experienced emotions of sadness, anger, fear, or other negative emotions
   • Thoughts such as "I'm going to hurt myself."
   • Risky or dangerous decision-making

Self-inflicted cuts on the forearm (Image: Wikipedia)

Changing the Way You Think

1. Engage in self-compassion. Think about yourself as someone that you love and care for, who is vulnerable and who deserves a break.
   • Try compassion-focused attention. Deliberately pay attention to your experiences as they occur; don't judge your experiences but instead, try to think about them without judgments, with empathy, and with kindness in your heart.
   • Try mindful breathing. Direct your attention to your breathing sensations, re-directing your attention to your breath whenever your mind wanders to other thoughts or feelings.. You can try these techniques on your own but will likely see the best results by working with a qualified therapist.
   • Try engaging in compassion-focused imagery. Conjure up your ideal image of compassion; it should be an image associated with empathy, kindness, and warmth. Visualize this image by imagining you can see it. Next, visualize the compassion as a force that flows from your image through yourself.
2. Look after your well-being. The body and mind are intricately related. You can look after your well-being by taking care of your health.
   • Be sure to get enough sleep, seven to nine hours a night depending on how many you need to feel rested. Try to keep your sleeping schedule as similar as possible every night.
   • Do your best to get consistent exercise. If you are having trouble getting motivated by yourself, join a gym and take part in classes led by an exercise instructor.
   • Eat whole, healthy, lean foods such as lean meats, nuts, fruits, vegetables, and whole grains. Keep a balanced diet and lifestyle and this will contribute to your well-being.
3. Distance yourself from your feelings. If you are having trouble coping with self-injury, try creating some distance between yourself and your thoughts. This can help when you are feeling overwhelmed by your feelings and are having trouble thinking straight
   • To gain distance from your troublesome feelings, try thinking about yourself as a stranger to yourself who is seeing the situation that is causing you distress. You can also try thinking about yourself in the 3rd person (i.e., she shouldn't injure herself because doing so will just make things worse). In becoming an outsider, you may not view yourself as experiencing these intense feelings, which can help to make them feel less overwhelming
4. Be mindful of the present moment. If you are having trouble coping, try focusing on just the present moment. This can help by taking you out of your head and away from your troublesome thoughts; it can help reduce rumination — the tendency to repeatedly think about something negative — and increase your ability to gain control of your thoughts.
   • Get absorbed in the details of your body's sensations by thinking about each one in turn. For example, start with your sense of smell at the moment, then your sense of touch.

Using Techniques to Cope

1. Use replacement techniques. Replace your self-injurious behavior with somewhat painful but ultimately not harmful experiences. This will allow you to 'hurt yourself' without your actions actually being damaging.
   • For example, rather than engaging in more damaging behaviors, put an ice cube down your shirt, eat something really spicy, or take a cold shower instead.
   • Run an ice cube along areas you would self harm, draw lines with red marker, or doodle on yourself like a tattoo.
   • Create digital cuts instead of real ones.
2. Vent your feelings on paper. Write about all the things that are bothering you. Then fold up the paper and put it away in a drawer or box. As you do it, try to picture yourself locking up your pain inside with that paper. This is called containment; you are symbolically trapping those thoughts and emotions to a place where they can't so easily bother you. You may be surprised at just how much it can help.
3. Distract yourself when you have the urge to self-injure. There are many different strategies you can use before resorting to self-harm. One way to distract yourself from the urge to harm is to engage in harmless behaviors that alleviate the source of your distress.
   • Are you feeling angry or frustrated? Try doing something physical:
     • Flatten aluminum cans.
     • Hit a punching bag.
     • Break sticks.
   • Are you feeling depressed or unhappy? Do something that makes you feel cared for and comforted.
     • Light sweet-smelling incense.
     • Listen to soothing music.
     • Call a friend and talk.
     • Take a hot shower.
   • Do you want to see blood?
     • Draw on yourself with a red felt-tip pen or paint yourself with safe, removable paint.
4. Throw away or hide the implements you use to hurt yourself. If you can't bring yourself to throw these objects out, put them somewhere out of your immediate reach, somewhere that you have to make an extra effort to get them.
   • When you are hurting, impulses are strong — having to go out of your way to take action on those impulses will give you time to resist them.
5. Do something fun and relaxing. Try enjoying a movie, reading a book, or hanging out with friends if you feel like injuring yourself. This can also help you to cope after self-injury by getting your mind off of things.
6. Delay self-harm. If you are thinking of injuring yourself, wait 10 minutes and see how you feel. If you still have the urge, and you feel you must self-harm, let yourself in a safe, controlled way with a phone nearby to dial 911 in the case of an emergency. If not, keep increasing the amount of time you delay, from 10 minutes to 30 minutes to an hour to 2 hours and so on.

Getting Outside Help

1. Talk to a therapist or counselor. Tell him about your struggles with self-injury or whatever else may be bothering you; let him know that you need help. Social support, especially from a professional, can be very beneficial in helping you cope with self-injury. Therapy can help you learn methods to deal with your distress better; it can also aid you in controlling your feelings.
   • Family therapy is recommended for adolescents who self-injure. It's often very effective in helping you identify why you want to self-injure, learn ways to cope, and teach your family how to support you.
   • Cognitive behavior therapy (CBT) is another recommended treatment. This therapy will help you recognize unhelpful ways of thinking and responding to your environment, and will help you learn new ways of behaving.
2. Consider talking to others who self-injure. Although group-therapy is sometimes not recommended for those who self-injure because its efficacy is unclear, it may help to talk in more indirect or casual contexts with others who are going through similar issues. Other people who self-injure can provide unique social support due to an experienced-based ability to empathize with you that can help you cope.
   • To reach out to others, try online forums such as www.psychforums.com/cutting-self-injury
3. Call for help in emergencies. If things get serious, you can call hotlines such as 1-800-273-TALK or 1-800-334-HELP or 1-800-SUICIDE– 24-hour crisis centers available for those who are considering self-injury or suicide.
   • Do not hesitate to use these resources if you are in need; do not worry about being embarrassed — saving your life is more important than potentially enduring a few moments of embarrassment.
4. Join a support group. It can help to be around other people who are also coping with self-injury. To search for a support group to join:
   • Use a search engine online with the terms "self-injury (or self-harm) support group + your city's name or zip code".

Tips

• Look up the butterfly project. Whenever you want to self-harm, draw a butterfly on the spot where you were going to injure yourself, and name it after someone extremely close to you. If you injure it, you kill the butterfly and hypothetically the person it's named after. If you let it wash away into the wild to be free, you have made progress. This works well for cutting and/or burning. You can find more information about the butterfly project here: http://butterfly-project.tumblr.com/
• Draw a small picture on your calendar every day you refrain from self-injury. That way, instead of seeing all your scars, you see all the days you did not harm yourself. Witnessing progress can encourage and motivate you.
• Remember that it may take quite a bit of time for you to stop hurting yourself. Do not expect a speedy recovery — take it one day at a time.
• Instead of cutting when you feel the urge to, draw on yourself instead. Use markers and make patterns on your skin, as it's rather soothing.

Warnings

• Sometimes self-harm may accidentally go farther than intended, and a life-threatening injury may result. If you do get a serious injury, do not hesitate to use emergency services; call 911.
• It's always possible to relapse. If you do, try not to worry or feel bad about it. Just start again and continue taking good care of yourself from that point on.

Related Articles

• Deal with Depression
• Stop Cutting Yourself
• Cope With Suicidal Thoughts
• Prevent a Suicide
• Be Friends with Someone Who Attempted Suicide
• Stop Self Harming
• Recover from Self Injury
• Understand Self Harm (Teenagers)

Sources and Citations

• http://www.helpguide.org/mental/self_injury.htm
• Self Mutilators Anonymous

Useful Forums

• http://www.teenhelp.org
• http://www.recoveryourlife.com

See also

• Help Someone Who Is Taking Grief‐Induced Risks
• Tell if Your Teen Is Cutting
• Stop Self Harming
• Stop Cutting Yourself
• Help Someone Who You Think Is Cutting Themselves
• Hide Self Harm Scars
• Help Someone Who Self Injures
• Tell Someone You Self Harm

What links here

• Cope with Trichotillomania
• Hide Self Harm Scars
• Stop Self Harming
• Tell Someone You Self Harm
• Help an Acquaintance Cope with Suicidal Ideations