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Coping with Self-Harm

How to fight thoughts of self-harm.

Source: Pixabay

[Article revised on 3 May 2020.]

Acts of self-harm such as self-cutting or overdosing may be carried out for a variety of reasons, most commonly to:

  • Express and relieve bottled-up anger or tension.
  • Feel more in control of a seemingly desperate life situation.
  • Punish oneself for being a "bad" person.
  • Combat feelings of numbness and deadness and feel more alive and "connected".

For some, the pain inflicted by self-harm is preferable to the numbness and emptiness that it replaces: it is something rather than nothing, and a salutatory reminder that one is still able to feel, that one is still alive.

For others, the pain of self-harm merely replaces a different kind of pain that they can neither understand nor control.

Acts of self-harm reflect deep distress, and are most often used as a desperate and reluctant last resort—a means, if anything, of surviving rather than dying, and sometimes also of attracting much-needed attention and support.

For many people, self-harm is a one-off response to a severe emotional crisis. But for some, it is a more long-term issue. People may carry on self-harming because they carry on suffering from the same problems, or they may stop self-harming for a time, sometimes several years, only to return to it at the next major emotional crisis.

Practical advice

If you are plagued by thoughts of self-harm, here are some coping strategies that might be of help.

If at all possible, find someone that you feel able to talk to, such as a friend, relative, or teacher, and share your feelings with them. If you can’t find anyone, or anyone suitable, there are a number of helplines that you can ring at any time of day or night.

Engaging in creative activities such as writing, drawing, or playing a musical instrument can distract you from the urge to self-harm, while also enabling you to express and explore your feelings.

Other distraction techniques include reading a good book, listening to music, watching a comedy or nature programme (or even a multi-season series), or just going out to the shops, deadheading some flowers, or cooking a simple meal.

Relaxation techniques like deep breathing can also be very helpful, as can yoga and meditation.

However, avoid alcohol and drugs, as these can cloud your thinking, leading to impulsive and dangerous behaviour.

In some cases, the urge to self-harm may be so overwhelming that all you can do is to minimize the risks involved. Things you can try: holding ice cubes in your palm and attempting to crush them, fitting an elastic band around your wrist and flicking it, or plucking the hairs on your arms and legs.

If you have harmed yourself and are in pain or unable to control the bleeding, or if you have taken an overdose of whatever type or size, call emergency services immediately or get someone to rush you to the Emergency Department.

Once things are more settled, consider asking for a talking treatment such as counselling or cognitive behavioural therapy (CBT).

Joining a local support group enables you to meet people with similar problems, that is, people who are likely to accept and understand you, and with whom you may feel more comfortable sharing your thoughts, feelings, and experiences.

But beware of unmonitored online forums and chat groups, which are open to trolling and can leave you feeling even worse than before.

See also my related article, Fighting Suicidal Thoughts

Neel Burton is the author of Growing from Depression, Heaven and Hell: The Psychology of the Emotions, and other books.