• Kevin Patton

Self Harm

Updated: Sep 17, 2019


Self-harm isn’t a suicide attempt or a cry for attention. However, it can be a way for some people to cope with overwhelming and distressing thoughts or feelings. Self-harm should be taken seriously, whatever the reason behind it.

It is possible to live without self-harm. It is important to know that you won’t always feel the way you do now.

With the right help and support most people who self-harm can and do fully recover.

Self-harm describes any behaviour where someone causes harm to themselves, usually as a way to help cope with difficult or distressing thoughts and feelings. It most frequently takes the form of cutting, burning or non-lethal overdoses. However, it can also be any behaviour that causes injury – no matter how minor, or high-risk behaviours.

Basically, any behaviour that that causes harm or injury to someone as a way to deal with difficult emotions can be seen as self-harm.

The self-harm cycle

Self-harm usually starts as a way to relieve the build-up of pressure from distressing thoughts and feelings. This might give temporary relief from the emotional pain the person is feeling. It’s important to know that this relief is only temporary because the underlying reasons still remain. Soon after, feelings of guilt and shame might follow, which can continue the cycle.

Because there may be some temporary relief at the start, self-harm can become someone’s normal way of dealing with life’s difficulties. This means that it is important to talk to someone as early as possible to get the right support and help. Learning new coping strategies to deal with these difficulties can make it easier to break the cycle of

self-harm in the long term.

Why do people self-harm?

Everyone has different things that cause stress and worry them. Some people can manage these troubles by talking to friends and family, while others may find these difficulties overwhelming. When we don’t express our emotions and talk about the things that make us distressed, angry or upset, the pressure can build up and become unbearable. Some people turn this in on themselves and use their bodies as a way to express the thoughts and feelings they can’t say aloud. People often harm themselves when this all gets too much. If you self-harm, you might find that when you feel angry, distressed, worried or depressed, you feel the urge to hurt yourself even more.

Someone’s reason to self-harm can be very different from other people who self-harm. Some of the reasons that people report as triggers or reasons that lead them to self-harm include:

• difficulties at home

• arguments or problems with friends

• school/work pressures

• bullying

• depression

• anxiety

• low self-esteem

• transitions and changes

• alcohol and drug use.

When a few of these issues come together they can quickly feel overwhelming and become too much for one person to deal with. As one person said, many people self-harm to ‘get out the hurt, anger and pain’ caused by pressures in their lives. They hurt themselves because they didn’t know what else to do and didn’t feel like they had any other options.

Talking to someone you trust or a healthcare professional can help you find other options for coping with the emotional pain you are feeling.

Breaking down the myths

There are lots of myths attached to self-harm. This isn’t surprising – myths and misunderstandings often arise when a problem like self-harm is poorly understood.

Negative stereotypes can be powerful. They need to be challenged because they stop people talking about their issues and asking for help. These myths also mean that professionals, family and friends can misunderstand people who self-harm.

MYTH: ‘Self-harm is attention-seeking’

One of the most common stereotypes is that self-harm is about ‘attention seeking’. This is not the case. Many people who self-harm don’t talk to anyone about what they are going through for a long time and it can be very hard for them to find enough courage to ask for help.

MYTH: ‘Self-harm is a goth thing’

Self-harm has been stereotyped to be seen as part of youth subcultures such as “goth” or “emo”. While there is some research suggesting a link, there is no conclusive evidence of this with little or no evidence supporting the belief that self-harm is part of any particular subculture.

MYTH: ‘Only women self-harm’

It is often assumed that women and girls are more likely than men to self-harm, however it isn’t clear if this is true. Men and women may engage with different self -harming behaviours or have different reasons for hurting themselves, but this doesn’t make it any less serious.

MYTH: ‘People who self-harm must enjoy it’

Some people believe that people who self-harm take pleasure in the pain or risk associated in the behaviour.

There is no evidence that people who self-harm feel pain differently than anyone else. The harming behaviour often causes people great pain. For some, being depressed has left them numb and they want to feel anything to remind them they are alive, even if it hurts. Others have described this pain as punishment.

MYTH: ‘People who self-harm are suicidal’

Self-harm is sometimes viewed as a suicide attempt by people who don’t understand it. For many people self-harm is about trying to cope with difficult feelings and circumstances. Some people have described it as a way of staying alive and surviving these difficulties. However, some people who self-harm can feel suicidal and might attempt to take their own life, which is why it must always be taken seriously.

What help is available for me?

There are lots of support services and treatments available when you feel ready to seek help. If you seek help from your GP, it is likely they will offer you counselling, where a professional will listen and help you to work on solutions and strategies to cope with the problems you are dealing with.

Behavioural approaches, such as CBT, DBT and ACT, focus on building coping strategies and problem solving skills and have been found to be very effective in helping to reduce self-harm.

There are also a number of charities and self-help groups throughout the UK that can support you through this experience. People who have self-harmed have said that it can be helpful to hear from other people who have experienced self-harm.

Recovery

It’s important to remember that you won’t always feel the way you do now. The problems that are causing you to self-harm can, with help and support, become more manageable over time or even go away. Things can and do get better!

‘Take time and be patient with yourself. getting your life back doesn’t happen overnight - it can be a slow process. Start to learn how to care for yourself.’

Some people who have moved away from self-harm say that changes over time and changes in circumstances in life (for example moving home, changing schools, finishing exams, going to university, changing jobs or changed financial circumstances) helped them to recover. Once one or two of the main factors that were causing them to self-harm (such as their family situation, or bullying at school) were removed, they felt they didn’t have to use self-harm as a coping strategy.

Others explained that coming back to the person they want to be was about finding new coping strategies and more helpful ways of dealing with emotions or distress.

How can I stop harming myself?

Asking for help and having support is very important if you are trying to stop self-harming. It is important that you do this when you feel ready to talk about it. It doesn’t matter who you talk to, as long as it’s someone you trust and feel comfortable with. Talking to someone is what is important. You don’t have to feel that you need to deal with this on your own. For people used to carrying burdens on their own, it can be hard to receive support. Part of recovery is trusting people enough to let them help you.

Finding out what makes you happy, sad, angry, isolated, vulnerable or strong can help you develop other ways of dealing with these feelings. Approaches such as CBT, DBT and ACT are good ways of exploring these internal experiences and some are available through your GP.

These suggestions are meant as alternatives to Self-Injury in times of dire crisis and overwhelming urges. They are “Intermediate coping strategies,” designed to help you move into a less emotionally volatile state.

They are not a replacement for developing Distress Tolerance skills.

They are about being effective in the moment - which means doing

what it takes to be safe. Believe it or not, even the ones that sound

stupid usually help a little, and the best skill of all is to wait 15 min, and

then ask yourself if you can wait 15 more, and so on. If 15 min is a long time for you, try 5.

The point is, when urges hit, you want to do it right now. If you can wait, then maybe you don't have to do it at all.

Emotions come to us in waves. The longer you wait, the more likely the urgent need will dissipate.

As you go along in life without self harm, one day you will think about doing it and a little voice says, "Ouch! That would hurt! That's not going to make me feel better."

Self harm can be addictive but over time, with practice, you'll find other ways to tolerate distress and it will become more manageable.

Angry, Frustrated or Restless?

Try something physical and violent, something not directed at a living thing:

· Slash an empty plastic soda bottle, a piece of heavy cardboard or an old shirt.

· Make a soft cloth doll to represent the things you are angry at. Cut and tear it in-stead of yourself.

· Flatten aluminium cans for recycling, seeing how fast you can go.

· Hit a punching bag.

· Use a pillow to hit a wall, pillow-fight style.

· Rip up an old newspaper or phone book.

· On sketch or photo of yourself, mark in red ink what you want to do. Cut and tear the picture.

· Throw ice into the bathtub or against a brick wall hard enough to shatter it.

· Break sticks.

Sometimes these things work even better if you rant at the thing you are cutting/tearing/hitting. You could start out slowly, explaining why

you are hurt and angry, but you might end up swearing and crying and yelling. It helps a lot to vent like that.

· Crank up the music and dance.

· Clean your room (or your whole house).

· Go for a walk/jog/run.

· Stomp around in heavy shoes.

· Play handball or tennis.

· Play an intense computer game.

Cravings, Feeling Depersonalized, Dissociating, Feeling unreal?

Do something that creates a sharp physical sensation:

· Squeeze ice hard (this really hurts). (Note: putting ice on a spot you want to burn gives you a strong painful sensation and leaves a red mark afterward, kind of like burning would.)

· Put a finger into a frozen food (like ice cream) for a minute.

· Bite into a hot pepper or chew a piece of ginger root.

· Rub liniment under your nose.

· Slap a tabletop hard.

· Snap your wrist with a rubber band.

· Take a cold bath.

· Stomp your feet on the ground.

· Focus on how it feels to breathe. Notice the way your chest and stomach move with each breath.

· Claim your breath and body parts, like “this is my hand, this is my nose.” Touch those parts and notice how they feel as if you’d never touched them before.

· Cover your arms with a layer of glue and let it dry (or dry it with a hairdryer if you are impatient). Slowly, gradually pick the glue off your skin.

Want focus?

· Do a task (making a model, needle-work, etc.) that is exacting and requires focus and concentration.

· Try to balance an egg on it’s short side.

· Memorize a poem or prayer.

· Eat a raisin mindfully. Pick it up, noticing how it feels in your hand. Look at it carefully; see the asymmetries and think about the changes the grape went through. Roll the raisin in your fingers and notice the texture; try to describe it. Bring the raisin up to your mouth, paying attention to how it feels to move your hand that way.

Smell the raisin; what does it remind you of? How does a raisin smell? Notice that you're beginning to salivate, and see how that feels. Open your mouth and put the raisin in, taking time to think about how the raisin feels to your tongue. Chew slowly, noticing how the texture and even the taste of the raisin change as you chew it. Are there little seeds or stems? How is the inside different from the outside? Finally, wallow.

· Choose a random object, like a paper clip, and try to list 30 different uses for it.

If you can’t get your mind from remembering traumatic events or feel like you are in a flashback, try changing perspectives.

· Write about your situation as if you were another person or a piece of furniture or a pet looking at it from a distance.

· Write letters to people who you’d like to say something to. Be bold. Don’t hold back. Then rip it up or dissolve it in water. Journal about your experience.

· Find an old photo of yourself and make up a completely new fictional story about what is happening in the picture. Write a story where the subject is empowered.

· Write your life story as if you had the happiest, most unique life in the world. It doesn’t have to be fiction, use real examples but pretend you see it from a different point of view. Leave out all the bad stuff. The more trauma you leave out, the funnier the story starts to seem.

· In your mind, play out your life worries as cartoon characters. Make the characters ridiculous and give them silly voices.

· Read a children’s story or any other story that’s not too complex out loud as if you were a storyteller.

· Colour in a colouring book.

· Draw pictures with heavy crayons or oil pastels that allow you to distort and mesh the picture by smudging it with your fingers.

• Write down thoughts and feelings that are distressing you; crumple the page up, rip it apart and throw them out as a way to let go of that thought.

• Get some play-dough: stretch it or squeeze it to relieve tension.

• Hit a pillow or cushion to vent your anger and frustration.

• Have a good scream into a pillow or cushion.

• Take a minute and breathe or meditate.

• Go for a walk to take yourself away from triggers. Being in a public place gives you the time and space to reduce the urge to hurt yourself.

• Make lots of noise, either with a musical instrument or just banging on pots and pans.

• Scribble on a large piece of paper with a red crayon or pen.

• Call a friend or family member and talk to them. This doesn’t have to be about self-harm.

• Do something creative: make a collage of colours to represent your mood or to remind you of your favourite things.

• Listen to music you like or watch a film you enjoy.

• Go online and look at self-help websites.

• Talk to someone about what is triggering you or seek help from a professional.

Keeping safe

Self-harm is not a positive way to deal with things. However if you are self-harming it can be difficult to stop, especially when you feel distressed or upset. If you don’t feel you can stop right now, it is important that you do keep yourself safe.

Wounds and injuries of any type can be dangerous and carry the risk of infection, which can be serious, so they need to be looked after. If you have serious injury, feel unwell or feel that you are going into shock (fast breathing, racing heart, feeling faint or panicked) you should seek help immediately. If you find yourself in this situation, find a trusted adult or friend who can get you the medical attention you need. This doesn’t mean you have to discuss your self-harm with them (although it may help); it is about allowing someone to support you medically in a moment of crisis.

Make a ‘safe box’

You can create a safe box to help you through times when you feel overwhelmed by emotion and have the urge to harm yourself. Fill it with things that make you happy and calm, to help you to get through this feeling. Some suggestions: activities such as crosswords, your favourite book, CD or movie. You could also include a list of things to do that make you calm when you are feeling triggered.

Talk to someone

When you are feeling overwhelmed, talk to a friend, family member or trusted adult. Let them know what you are thinking. This can help relieve the pressure that you are feeling. Make a list of people you can talk to at these times and keep it somewhere safe. Knowing who you can talk to in times of crisis at 3am, weekends or when you are at school can make it easier to ask for help when you need it. Add these to your safe box. This will remind you that you are not alone and there are people you can talk to when you need to.

Avoid alcohol and drugs

We often drink alcohol or take drugs to change our mood or to avoid our feelings. Some people drink to deal with fear or loneliness, but like self-harm the effect is only temporary and can end up making you feel worse. Alcohol is a depressant, which means it slows down brain activity.

This changes how you think and feel, so can increase feelings of anxiety and depression. When it wears off you can end up feeling worse because of the effects it has on your brain and your body.

Drinking alcohol or taking drugs can leave you feeling depressed or anxious, and can lower your inhibitions physically, which can lead you back to harming yourself. Visit www.drinkaware.co.uk for more information.

Do something you enjoy

Remember that there is more to you than self-harm. Do things that remind you of this and make you happy. Maybe this is a sport, or a hobby you like doing such as writing.

Doing things that you enjoy and makes you feel happy, helps you look after your mental health. It helps to improve your self-esteem and can help you remember that you are important and have value.

Don’t be too hard on yourself

Many young people who self-harm can be perfectionists and high achievers. You might put pressure on yourself to do things in a certain way, or feel that nothing you do is good enough.

Try to not be so hard on yourself about not getting things perfect. Recovery is about knowing that it is okay for your work or performance to be ‘good enough’.

Many people stop hurting themselves when the time is right for them. Everyone is different and if they feel the need to self-harm at the moment, they shouldn’t feel guilty about it – it is a way of surviving, and doing it now does NOT mean that they will need to do it forever. It is a huge step towards stopping when they begin to talk about it, because it means that they are starting to think about what might take its place eventually.

Further help, information and support

If you are worried about the immediate well-being of yourself or someone else you should call 999 or go straight to A & E.

For non-emergency help you should talk to your GP or contact 111 or NHS Direct on 08454647.

You can also get more information or support through the websites below:

Harmless

Harmless is a user led organisation that provides a range of services about self harm including support, information, training and consultancy to people who self harm, their friends and families and professionals.

http://www.harmless.org.uk/

LifeSigns

LifeSIGNS is a small user-led charity creating understanding about self-injury.

http://www.lifesigns.org.uk/

Some telephone helplines offer specialist advice on self-harm, others operate only as a ‘friendly listening ear’ – something many people have said they value, particularly when they feel they have no-one else that they can turn to.

Helpful telephone numbers include:

• ChildLine – 0800 1111

• Samaritans – 08457 90 90 90

• Family Lives – 0808 800 2222

• Young Minds – 0808 802 5544

• Get Connected – 0808 808 4994


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