Cope with Self Injury

Some of us bear pain that others cannot begin to imagine. When it becomes too hard to bear without taking action, some people inflict harm upon themselves. It's a defense mechanism which they come to believe will allow them to be in control of their pain, to make it appear in a tangible way, or to distract themselves from their internal anguish. Getting help seems impossible, but it can be done with patience and perseverance. Meanwhile, know that these are not bad people, but rather, people in pain.

Steps

 * 1) Acknowledge the problem. Don't pretend it isn't a problem. Self-injury is very dangerous, and you should try to stop as soon as possible. One danger connected with self-injury is that it tends to become an addictive behavior, a habit that is difficult to break even when you want to stop. It's best to put an end to it as early as possible.
 * 2) Identify your methods. What type of self-harm do you inflict?
 * 3) *Cutting - involves cutting your body with a sharp object, such as earrings, knives, pins, needles, razor blades or even fingernails.
 * 4) *Picking at skin or re-opening wounds/scabs - is a type of self-harm characterised by the repeated urge to pick at one's own skin.
 * 5) *Hitting - actually using an object to cause bruises.
 * 6) *Branding – burning your skin with a hot object, like an iron or a cigarette.
 * 7) *Self-strangulation - choking yourself with a scarf or rope.
 * 8) *Friction burning – rubbing your skin until burn-like marks appear; usually, an object like a pencil eraser is rubbed harshly on the skin.
 * 9) *Drinking harmful substances
 * 10) *Trichotillomania - ripping out one's hair.
 * 11) Take the necessary precautions to stay safe. If you can't bring yourself to stop just now, at least keep from inflicting irreparable harm upon yourself, no matter how great the temptation to do so:
 * 12) *Don't share cutting implements with anyone. It's just like sharing needles; you can get all sorts of diseases, like HIV or hepatitis.
 * 13) *Try to keep cuts shallow.
 * 14) *Keep first aid supplies on hand and know what to do in the case of emergencies.
 * 15) *Do only the minimum required to ease your pain. Decide how much you are going to allow yourself to do (how many cuts/burns/bruises), keep within those boundaries, and clean yourself up later.
 * 16) Know that the fact that you self-injure does not make you a bad person. Some feel that if they can see the pain on the outside, the emotional pain will go away. Others do it as a means of showing others just how much agony they feel. Deliberate self-harm can distract from emotional pain and stop feelings of numbness; it is also way to express things that can't be put into words such as displaying anger or seeking support and help. This behaviour usually indicates a lack of coping skills when  overwhelming feelings arise. You're not a bad person; you just never learned positive ways to deal with your feelings.
 * 17) Understand that self-harm is often a self-soothing behavior, especially if you do not have other means to calm intense emotions. Self-injury followed by tending to one's own wounds is a way to express self-care and be self-nurturing.
 * 18) Find someone to talk to. It's best to find someone you trust and tell them about your struggles with self-injury; if you aren't able to tell them about that, at least tell them that you're struggling with depression, stress, or talk about your feelings. If you have no trusted friend or relative to talk with, consider calling a crisis hotline. Counselors there may be able to provide compassionate help.
 * 19) Take stock of how you feel when you self-injure. What kinds of situations trigger the behavior? Do you get the urge to self-harm when you're depressed? Angry? Embarrassed? Self-Conscious? Frustrated? Understanding what triggers your self-injury can help you find other, more positive ways of coping.
 * 20) Think of things you can do to manage stressful situations. If arguments are triggering your self-injury, for example, you might try talking to the people around you about more constructive ways to resolve conflicts. If you have stress at school, talk to your teachers or counselors about ways to make it better.
 * 21) Vent your feelings on paper. Write about all the things that are bothering you. Then fold up the paper and put it away in a drawer or box. As you do it, try to picture yourself locking up your pain inside with that paper. This is called containment; you are symbolically trapping those thoughts and emotions where they can't bother you. You may be surprised at just how much it can help.
 * 22) Distract yourself when you have the urge to self-injure. There are many different strategies you can use before resorting to self-harm. One way to increase the chances of a distraction helping calm the urge to harm is to match what you do to how you are feeling.
 * 23) *Are you feeling angry or frustrated? Try doing something physical:
 * 24) **Flatten aluminium cans for recycling.
 * 25) **Hit a punching bag.
 * 26) **Break sticks.
 * 27) *Are you feeling depressed or unhappy? Do something that makes you feel cared for and comforted.
 * 28) **Light sweet-smelling incense.
 * 29) **Listen to soothing music.
 * 30) **Call a friend and just talk.
 * 31) **Take a hot shower.
 * 32) *Are you feeling depersonalized and unreal? Do something that causes a sharp physical sensation.
 * 33) **Squeeze an ice cube. This is especially effective if you burn yourself often, as putting ice on a spot you want to burn gives you a strong painful sensation and leaves a red mark afterwards.
 * 34) **Bite into a hot pepper or citrus peels, or chew on a piece of ginger root.
 * 35) **Take a cold shower.
 * 36) *Do you want to see blood?
 * 37) **Draw on yourself with a red felt-tip pen, or paint yourself with red tempera paint.
 * 38) Put away the implements that you use to hurt yourself. Put those items somewhere out of your immediate reach, somewhere that you have to make an extra effort to go get them. When you are hurting, impulses are strong - having to go out of your way to take action on those impulses will give you time to think and resist them.
 * 39) Get help. Cutting or other forms of self-injury allow an already painful cycle to continue. Talk to a counselor, therapist, or doctor. They can help you find ways of coping, and address any depression or other problems that may be contributing to your self-injury. If you go to one source, such as a counselor or therapist, and you feel you are not being helped, leave and find another one. You are not chained to one doctor or counselor. Go to another and another until you find a person you feel a connection with, and feel helped by your interaction.
 * 40) *There is a type of therapy called DBT, Dialectical behavior therapy, that is specifically for self harm. It can be done in a group setting or one to one with your therapist.

Tips

 * Try to develop a wide support network. That way, you have more people to turn to, and if one friend or relative is unable to give you the support you need, you can ask someone else.
 * Take some time to really discover yourself - self-injury is sometimes a way to avoid reality.
 * Avoid people that will bring you down further. Don't hang out with losers and lowlifes just because it's easy. You know that they're trouble, but you may think that you can't do or don't deserve any better. You can do better, you deserve better -- find people who motivate you!
 * Remember that it will take quite a bit of time for you to stop hurting yourself. Do not expect a speedy recovery - take it one day at a time.

Warnings

 * Anyone recovering from self-injury knows that it's always possible to relapse. If you do, try not to worry or feel bad about it. Just start again and continue taking good care of yourself from that point on.
 * You may never get over the memory of trying to hurt yourself. But when the memory comes, do whatever you can to keep your mind off it.
 * Sometimes self-harm may accidentally go farther than intended, and a life-threatening injury may result. If you do get a serious injury, do not refuse medical care. EMTs and paramedics are there to help you get better, they are willing to hear what you have to say. This is the reason for getting help as soon as possible and breaking this destructive cycle of pain.
 * If you are under the influence of any drugs or alcohol, seek treatment for that problem before trying to do therapy (DBT). Therapy works best when you are clean and sober.

Related Tips and Steps

 * How to Cope with Depression
 * How to Stop Cutting Yourself
 * How to Cope With Suicidal Thoughts
 * How to Prevent a Suicide
 * How to Be Friends With Someone Who Attempted Suicide

Sources and Citations

 * http://www.helpguide.org/mental/self_injury.htm
 * http://www.palace.net/~llama/psych/fself.html
 * http://www.thursdayschild.org/hframe_index.htm
 * http://www.peabodylibrary.org/ya/hotlines.htm
 * Wikipedia article on self-harm
 * Self Mutilators Anonymous
 * Suicide Prevention
 * Useful Forums
 * http://www.teenhelp.org
 * http://www.recoveryourlife.com
 * http://www.riseandrecover.com