Things to do instead of self harm

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I’d like to share some ideas for readers who have struggled with, or currently struggle with, self harming behaviour of any kind.  Self harm can include physical injuring, substance abuse, eating disorder habits, workaholism, over exercise etc.

Personally, I find harm reduction models to be the most effective in reducing self harming behaviour.  Because self harming is a coping method, and has served a purpose, it is often difficult to abstain from doing it.  I also believe that the majority of habitual self harming behaviour is shame and avoidance based in at least some ways.   I have found it easier to live with the idea that I will sometimes engage in behaviours that are not 100% beneficial to my health.  By acknowledging this openly, I reduce the level of shame I feel when I do make a mistake, slip or relapse.  Relapse is a part of recovery in a harm reduction model.  I don’t need to feel ashamed if I go back to my old way of coping in a crisis.  Those ways worked for me for a long time and they are  habitual and comfortable to slip into.

If I have a slip, I don’t make a big deal about it.  I just move forward and try to make a different more self caring choice in the future.  Removing the intense lens of self judgment from the situation has been helpful for me.

When suggesting alternatives to self harming behaviours, I acknowledge openly that not all options are available to all people.  This is not  a list that says “you should do this” but just some options that have worked for me personally.  Using the word “should” can increase feelings of guilt and shame if you do engage in self harm. I highly encourage you to use this as a model, and make your own list that feels right for you.  Give yourself permission to explore different coping options, keep the ones that work and leave the ones that do not.  Personalizing your recovery plan is another factor that will lead to greater success within harm reduction.

  1. Give yourself permission to struggle.  It’s okay that you feel bad right now.  Your feelings will have a beginning, a middle and an end and you can survive them.  Sitting with your feelings is an option, even if it is very uncomfortable
  2. Get safe.  Often urges to self harm are a red flag for me that I’m not feeling safe or I’m feeling overwhelmed.   Reduce any stress you have control over.  Relocate to an environment that feels secure.
  3. Spend time in nature.  The trees are not oppressive, nature is forgiving.  Nature can just mean getting outside, walking around the block, sitting in a park and breathing deeply.  Noticing the colours in the leaves outside.
  4. Wrap yourself up in warm blankets, quilts, cozy sweaters etc.  For me feeling safe often involves feeling warm and wrapped up tight.  Sometimes even the weight of the blankets is calming to me
  5. Prepare a hot or cold beverage.  The warmth or chill of the cup in your hands can help to ground you.  Focus on the temperature of the glass, and the feeling of the cold or warm liquid in your mouth.  Taste the flavours in your drink and take time to breathe.
  6. Draw, scribble, write, paint -express your feelings.  Artistic self expression has helped me avoid self harm.  You don’t need to be an artist to do this, you don’t need expensive art supplies.  Sometimes just a piece of paper and pen is enough.  Feel free to destroy your creation after.
  7. Reach out.  Call a friend, a family member, a support or crisis line.  If you don’t feel comfortable calling anyone, try going to a public place like a library or coffee shop and just break the isolation by sitting there with people around you.  Talking to a safe person is often a good way to work through urges to self harm.  You have the choice to tell the person you are struggling or not.
  8. Distract yourself with an enjoyable TV show, youtube video, magazine, book or music.  Lose yourself in another world for a short time.  Choose something that will cheer you, not something triggering.
  9. Exercise.  Use your large muscle groups.  Walk, do jumping jacks, stretch, yoga, lifting cans in your kitchen, anything you feel able to do and have access to.  Moving your body can help you process intense feelings like anger.
  10. Connect with spirituality, meditate, religion etc.  Connect with a higher power.  For me this means visiting nature and getting in touch with how small I am compared with the power of the natural world
  11. Spend time with someone very young or very old, or a pet.  Volunteer, connect with a family member, visit a neighbour with a new baby, offer to pick up groceries for a senior living in your area.  Walk your neighbour’s dog, take care of your own pets. Helping others, even in small ways, can be an option and alternative to self destructive coping.  For me, being able to help another person reduces my sense of shame and hopelessness and increases my connections.
  12. Hug a stuffed animal.  Sometimes I need comfort and stuffed animals are a good option for me and help me feel safe.
  13. Spend time around water.  Take a bath or shower.  Walk by the river, ocean or lake.  Go swimming.  Run warm or cold water over your hands and wrists.   Flowing water can be very calming.
  14. Use positive affirmations, ideally ones you have prepared yourself.  Sometimes self harming is driven by negative self talk and negative shame based messages you are giving yourself.  You can find ideas for affirmations on the internet and rework them to suit your purpose.  If an affirmation seems unrealistic try adding “I’m learning to…” at the beginning.   For example, “I’m learning to love myself.
  15. Remind yourself that you are doing the best you can.  That you are surviving and sometimes that is enough.  Some days all we can do is survive and that’s okay.

These are just a few ideas I’ve worked with over the years.  I hope you find them helpful.  Please feel free to comment with your coping ideas!

Why I sometimes miss self harm…

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<trigger warning for description of self harm>

It’s a strange thing to admit, but if I’m 100% honest with you, I still miss self harm.  As a coping mechanism it has to be considered one of the worst.  Almost my entire body is covered with permanent scars.  The scars cause me to be self conscious and feel shame.  The scars also result in social stigma, and difficulty in being taken seriously by health care providers.  They itch as they heal and sometimes they hurt.  They are constant reminders of parts of my past that I’d rather forget.

Usually when I think about self harm, what stops me is remembering two things

  1. The self harm only ever helps for a brief moment
  2. I will have to hide the wound and feel intense shame about this, as well as worry about the consequences if anyone sees the injury

This usually works, but sometimes I feel bitter and angry.   Sometimes I have thoughts like “If society didn’t consider self harm to be SO AWFUL, I could just keep doing it, because I wouldn’t feel ashamed and I wouldn’t worry about the potential negative consequences on my family.”  I get angry and I feel like my coping mechanism is being taken away from me.  I get angry and think about how some people get fall down drunk on a regular basis and society thinks this is acceptable.   Why isn’t MY coping mechanism acceptable too?  I feel like having a tantrum like a 2 year old child!  I want it and I want it NOW!  But most of the time I refrain from self harming, not just for my children, but for myself too.  It’s not a lifestyle that I want to return to.

I do want to write about some of the complex reasons I miss self harm.  Some of this might sound completely ridiculous to you.  I’m worried about being honest and just writing this down.  I’m worried about being judged for liking some aspects of this self destructive habit.

Self harm gave me something physical to take care of, and be taken care of for,  when my inner pain was un-fixable and unreachable.

Even though I experienced a lot of maltreatment and abuse in the psychiatric system and hospital emergency rooms, I sometimes miss having a physical injury that could be fixed.

There were times when I was almost addicted to the process.  The care I received after self harming was almost as important, if not more important, than the ritual itself.  The trip to the emergency room WAS part of the ritual.   To be honest, without this part of the ritual, without the serious self harm, it seems almost useless to hurt myself at all.

There was a predictable ritual to the emergency room visit.  At times, I felt safe and cared for there.  At times it felt like a pause, a break from the day to day stressors in my life, which at that time felt unbearable.   I think there was a part of me that used self harm and suicide attempts as an excuse.  Not a cry for help or attention, but a cry that said: “I can’t do this.  It’s too much.  I need a break.  I need to be cared for.  I’m not capable.  I’m afraid to fail.

I remember some of the times I had multiple serious injuries from self harm.  It took the doctor or medical students a considerable amount of time to fix the cuts.  During that time, the doctor would often speak to me.  I had their full attention.  I was being cared for and I was being symbolically “fixed.”

There was a ritual to the process.  Triage.  Waiting room.  Exam room.  The questions.  The cleaning of the wounds.  The freezing.  The sutures.  The bandaging after.  The conversation.  The questions.  For those hours, if I was treated nicely, it was like being numb and being in another world.    A world where time was stopped, my responsibilities were paused, the outside world did not exist.    I actually FELT better afterwards, like I had been healed, but the improvement was so fleeting.  So very fleeting, that often I was injuring again only a day later.

It was as if the injury gave me an excuse to stop, validation to say “I’m not well.  I’m not coping.  I need help!”  Without the injury, without the physical reason, I struggled to ask for or to accept help.  I still do.

I’ve never really verbalized all this to anyone before.

I remember one time, I cut myself on my stomach.  It was deeper than usual, maybe deeper than I intended or realized, because I was new to injuring in that spot.  Over time I had learned to hurt myself in places I could hide.   (When I first started, I was almost hypomanic from SSRIs and I cut in visible places, places everyone could see and that were very difficult to hide.)

I went to the hospital, as I usually would, alone.  At the triage desk they examined me, discovered the wound was serious and triaged me as Emergent rather than Urgent or Less Urgent.   I was put into a wheelchair and taken back into a part of the ER I’d never seen before.  I think it was the place for seriously ill people. The lights were dimmed and the bed was actually comfortable.  I had my own room, not just a curtained area.  It was quiet and comfortable.  I didn’t have to wait very long and I remember feeling safe and calm and protected.  I felt like my health problem was considered important, legitimate and I was being cared for appropriately.  I had a female doctor and she was kind to me.  She was wearing ordinary clothes rather than scrubs or a gown.  I remember her as being fairly young.  She treated me as if I had a physical health problem, not as a mad, crazy, unworthy self harming psych patient.   I felt bad because she got blood on her clothing while she fixed my injury.   I can’t really describe exactly what happened that night.   But I felt protected and the ritual had worked, my mind was quiet.  The racing thoughts were gone.  It was silent and the room was dimmed, like the thoughts were dimmed as well.  For that time I was in another world.

I’m having a difficult week.  I’m feeling overwhelmed and lonely and scared.  I’d like nothing more than to be cared for.  To be honest, the thought of that quiet, dimly lit emergency room bed is very appealing. But I don’t want to achieve this through self harm.  I don’t want to be “sick” and treated in hospital to get a break or to feel validated in resting.

I want someone to take care of me because they care about me, not because it is their job.  I want comfort because someone loves me, not because they are scared that I might harm myself.

I want to be an adult and not a misbehaving, out of control 2 year old.  This is part of what recovery means to me.  I have to use my words, not my actions to let people know that I’m not okay.

Note: the art was made in 2005