What's making me want to self-harm?

At times, we all might use destructive behaviours to cope with stress. For example, some people may drink too much or take drugs. If you're self-harming, it might be your way of dealing with overwhelming emotions or painful thoughts perhaps caused by traumatic, abusive or difficult experiences in the past.

Difficult feelings, like anger or guilt, can build up inside you until they become unbearable. You might feel the only way to find relief is to self-harm, distracting yourself from the emotional pain by concentrating on the physical one. But if you don't deal with the underlying emotional issues behind your self-harm, each episode may only provide temporary relief and the urge to harm yourself will keep coming back.

Put your feelings down on paper

Why can I control an urge one day and not another?

When stressful events push any of us over our emotional threshold, it can make us feel overwhelmed and more likely to head for a bottle of vodka than an early night. If things come to a head, the feelings can become so intense that things you normally take in your stride become too much to cope with, causing you to seek immediate release through self-harm. But if things are going well and you're feeling in control, the urges are much easier to resist. "You might be able to live with the urge to self-harm for days and then it can fade, but at other times you can only bear the urge for a few hours before a trigger event takes you over the edge into self-injury," says Wedge, who runs First Signs.

When you don't feel like self-harming

If you're not feeling the urge to self-harm, it's a good time to think about what coping strategies have been helpful in the past that you could use again in the future:

• Think of the last time you went through something stressful but didn't self-harm and write down anything you did differently. What specific things did you think or do which helped you?
• Try to work out what thoughts and feelings lead you to feel the urge to self-harm. List 10 different ways you could deal with these triggers in the future.
• How does self-harming make you feel? If it makes you feel in control, think of things you could do to get the same feeling but without hurting yourself.
• Write down things you like about yourself and why you want to stop self-harming so you can review it at times you're feeling low.
• Choose someone you can quickly get in touch with for a chat when you feel like self-harming.

Self-help tips

There are many self-help tips that may help you, otherwise known as 'alternatives to self-harm', or 'coping tips and distractions'. You might find some are more effective than others. Don't be disheartened if a technique isn't successful. Try a different one to see if it works better for you. Here are a few you might want to try:

• The 15-minute rule - if you're feeling the urge to self-harm, give yourself 15 minutes before you do. Distract yourself by going for a run or writing down your feelings. When the time's up, see if you can extend it by another 15 minutes. Try to keep going until the urge subsides.
• Meditation - try to visualise the urge as an emotional wave you can surf. Imagine it reaching a crescendo then breaking as you successfully resist its force.
• Write a list of things you've achieved that make you feel proud, or fill a box with things that make you happy, such as pictures of friends and loved ones. Keep them handy and look at them when you're feeling bad.
• Practice expressing your emotions and feelings through art or writing or talking to a friend.

Questions to ask before you self-harm

If you can recognise the triggers or thoughts involved in the build up to self-harm, you may be able to use alternative coping strategies before the urge gets too strong. Try asking yourself the following questions:

• Why am I feeling the need to hurt myself? What thoughts, feelings or events have made me feel this way?
• How am I feeling right now and when was the last time I felt this? How did I deal with it then and how did that make me feel?
• If I do self-harm, how will I feel about myself later?
• Is there anything else I can do to ease this feeling that doesn't involve hurting myself?

Overcoming the urge to self-harm can be an uphill struggle and you may have to push yourself to use these alternatives. Finding ways of dealing with difficult feelings without hurting yourself is an important step towards recovery.

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Updated: 31/01/2012

Written by Marcella Carnevale