Coping with self-harming urges

Self harm is a behaviour distinct from attempting suicide. For some people it becomes a ‘coping strategy’ for dealing with overwhelming or painful feelings. Coping with the urges to self harm requires learning different ways to deal with these feelings.

Read with caution

This information has been provided to allow you to think constructively about your self harming behaviour. However, if you are aware that reading about self harm practices might feel ‘triggering’ for you then make sure you read this with someone else present or find another way to reduce the risk.

Work on things step by step

If self harming has become a kind of coping strategy, it is not usually helpful to focus on complete abstinence or banning the behaviour in one sudden step. Instead, it is helpful to build new strategies for dealing with difficult feelings which can gradually take the place of self harm. In the first instance it can be useful to consider learning first aid and knowing how to take care of yourself practically if you do self harm.

Creating a personal self harm safety plan is a useful way to remind yourself of things you can do when you feel an urge to self harm. These include ways to manage and reduce self harming behaviours in the short term, so that they are less damaging, as well as alternative ways to manage difficult feelings which can replace self harm in the longer term.

De-escalate the intensity of self harm

A first step can be to think about trying to slowly reduce the damage caused by your self harming behaviour (eg cutting less deeply). Then try to move to less damaging practices like writing on your skin with red felt tip instead of cutting.

Direct the harming urge at something else

Some people find squeezing an ice cube provides an alternative that is helpful. Hit pillows or cushions. Flick an elastic band on your wrist. Take a cold bath or shower.

Make a list of distractions

Make a list of activities that you can use to distract yourself. Trying to be with other people is particularly effective.

Know your triggers and reduce the risks

Knowing what kinds of situations are particularly risky for you can help you plan to reduce the risks. For example, it is harder to manage your feelings effectively when you are under the influence of drugs or alcohol. Go easy on these if you are aware that you are feeling less stable.

Learn to tune in to your feelings

In the longer-term you can start to learn how to identify the experiences and feelings which are most likely to trigger your urges to self harm. Learning the skill of ‘mindfulness’ – being tuned in to what you are feeling in the present moment, without judgement or attempt to change it – is invaluable in the move towards being able to manage or ‘ride out’ difficult feelings, rather than trying to eliminate them.

Find constructive outlets for feelings

Having a good cry is the natural way to get rid of built up stress hormones and get feelings out. Experiment with different ways to express feelings when they seem to be building up inside, to see what works for you.
 Keeping a diary can be a useful habit for getting feelings ‘out’.  Just write it all down without censorship, then close it and put it away.  Or it might be helpful to do something symbolic like writing it all down then scribbling it out or tearing it up.
 Vigorous activity or exercise can be another helpful way to get rid of pent up feelings.

Learn how to self soothe

Make a conscious effort to take care of yourself and comfort yourself with difficult feelings. Try out different things to see what you find most comforting. Breathing and relaxation exercises can be very useful. A relaxing soak in a bubble bath, hugs or a massage, eating something sweet (in moderation), stroking a pet, listening to uplifting music, knitting or crafts… Find what works for you!

Get support and professional help

Having people you can talk to and a good support network is a vital protection against both self harm and suicidal thinking. See ‘Build support networks’ for how to make a start with this.

Talking about the inner feelings that fuel your self harm is potentially useful whoever you talk to, but counsellors are professionally trained to work with self harm and will be best placed to support you in finding constructive alternatives. See the ‘Counsellors & doctors’ section for more.

Next: Build support networks

Take Action

Self harm coping plan

Related

Focusing outward
Practising mindfulness
Increasing exercise