

A final post in the Self-Injury Awareness Day series. This one focuses on healing and learning new strategies for managing the feelings that prompt your impulses to self-harm.

Your alternatives can be as unique as you are! The following are meant to provide examples or things to try if you cannot come up with any ideas of your own. Ideally, this list would be something you can create with input from your therapist in a session.

Make sure you keep your list handy and remember to use it!

Ways to help yourself right now

(This material is excerpted from the secret shame SI info and support website)

This section contains a variety of ways that you can stop yourself from making that cut or burn or bruise right now.

How do I stop? And anyway, aren’t some of these techniques just as “bad” as SI?

There are several different flat-out- in-the-moment strategies typically suggested, such as doing anything that isn’t SI and produces intense sensation: squeezing ice, taking a cold bath or hot or cold shower, biting into something strongly flavored (hot peppers, ginger root, unpeeled lemon/lime/grapefruit), sex, etc. These strategies work because the intense emotions that provoke SI are transient; they come and go like waves, and if you can stay upright through one, you get some breathing room before the next (and you strengthen your muscles). The more waves you tolerate without falling over, the stronger you become.

But, the question arises, aren’t these things equivalent to punishing yourself by cutting or burning or hitting or whatever? The key difference is that they don’t produce lasting results. If you squeeze a handful of ice until it melts or stick a couple of fingers into some ice cream for a few minutes, it’ll hurt intensely but it won’t leave scars, nothing you’ll have to explain away later. You most likely won’t feel guilty afterwards — a little foolish, maybe, and kind of proud that you weathered a crisis without SI, but not guilty.

This kind of distraction isn’t intended to cure the roots of your self-injury; you can’t run a marathon when you’re too tired to cross the room. These techniques serve, rather, to help you get through an intense moment of badness without making things worse for yourself in the long run. They’re training wheels, and they teach you that you can get through a crisis without hurting yourself. You will refine them, even devise more productive coping mechanisms, later, as the urge to self-injure lessens and loses the hold it has on your life. Use these interim methods to demonstrate to yourself that you can cope with distress without permanently injuring your body. Every time you do you score another point and you make SI that much less likely next time you’re in crisis.

Your first task when you’ve decided to stop is to break the cycle, to force yourself to try new coping mechanisms. And you do have to force yourself to do this; it doesn’t just come. You can’t theorize about new coping techniques until one day they’re all in place and your life is changed. You have to work, to struggle, to make yourself do different things. When you pick up that knife or that lighter or get ready to hit that wall, you have to make a conscious decision to do something else. At first, the something else will be a gut- level primitive, maybe even punishing thing, and that’s okay — the important thing is that you made the decision, you chose to do something else. Even if you don’t make that decision the next time, nothing can take away that moment of mastery, of having decided that you were not going to do it that time. If you choose to hurt yourself in the next crisis time, you will know that it is a choice, which implies the existence of alternative choices. It takes the helplessness out of the equation.

So what do I do instead?

You can increase the chances that a distraction/substitution will help calm the urge to self- injure by matching what you do to how you are feeling at the moment.

First, take a few moments and look behind the urge. What are you feeling? Are you angry? Frustrated? Restless? Sad? Craving the feeling of SI? Depersonalized and unreal or numb? Unfocused? Next, match the activity to the feeling. A few examples:

Angry, frustrated, restless

(These strategies work better sometimes if you talk to the object you are cutting/ tearing/ hitting. Start slowly, explaining why you’re hurt and angry. It’s okay if you end up ranting or yelling; it can help a lot to vent feelings that way.)

Try something physical and violent, something not directed at a living thing: Slash an empty plastic soda bottle or a piece of heavy cardboard or an old shirt or sock. Make a soft cloth doll to represent the things you are angry at. Cut and tear it instead of yourself. Flatten aluminum 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 a sketch or photo of yourself, mark in red ink what you want to do. Cut and tear the picture. Make Play-Doh or Sculpey or other clay models and cut or smash them. Get a few packages of Silly-Putty or some physical therapy putty and squeeze it, bounce it off a wall, stretch it and then snap it. Throw ice into the bathtub or against a brick wall hard enough to shatter it. Break sticks. Crank up some 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.

(These strategies work better sometimes if you talk to the object you are cutting/ tearing/ hitting. Start slowly, explaining why you’re hurt and angry. It’s okay if you end up ranting or yelling; it can help a lot to vent feelings that way.) Try something physical and violent, something not directed at a living thing: Sad, soft, melancholy, depressed, unhappy Do something slow and soothing, like taking a hot bath with bath oil or bubbles, curling up under a comforter with hot cocoa and a good book, babying yourself somehow. Do whatever makes you feel taken care of and comforted. Light sweet-smelling incense. Listen to soothing music. Smooth nice body lotion into the parts of yourself you want to hurt. Call a friend and just talk about things that you like. Make a tray of special treats and tuck yourself into bed with it and watch TV or read. Visit a friend.

Craving sensation, 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) or put ice, water, and salt in a pitcher and put your hand in it for a few seconds. 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.

Do something that creates a sharp physical sensation: Wanting focus Do a task (a computer game like Tetris, writing a computer program, needlework, etc.) that is exacting and requires focus and concentration. 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, swallow. Choose an object in the room. Examine it carefully and then write as detailed a description of it as you can. Include everything: size, weight, texture, shape, color, possible uses, feel, etc. Choose a random object, like a paper clip, and try to list 30 different uses for it. Pick a subject and research it on the web.

Wanting to see blood Draw on yourself with a red felt-tip pen. Take a small bottle of liquid red food coloring and warm it slightly by dropping it into a cup of hot water for a few minutes. Uncap the bottle and press its tip against the place you want to cut. Draw the bottle in a cutting motion while squeezing it slightly to let the food color trickle out. Draw on the areas you want to cut using ice that you’ve made by dropping six or seven drops of red food color into each of the ice-cube tray wells. Paint on yourself with red tempera paint or a red lip-liner pen.

Wanting to see scars or pick scabs Get a henna tattoo kit. You put the henna on as a paste and leave it overnight; the next day you can pick it off as you would a scab and it leaves an orange-red mark behind.



Another thing that helps sometimes is the fifteen-minute game. Tell yourself that if you still want to harm yourself in 15 minutes, you can. When the time is up, see if you can go another 15.

©1998-2001 Deb Martinson

Kathleen Young, Psy.D.