Coping skills and other helpful tips on self-harm

These tips were found on www.rethink.com ( I think credit should be given where credit is due.)

Coping strategies

This page provides some ideas to help delay or avoid self-harm  – they’ve all been suggested by people who self-harm as techniques that have helped them to cope.

Self-Harm Coping Strategies and Distractions

These are some ideas for helping people delay or avoid self-harm. People find that different things help, and it isn’t failure if you try something and it doesn’t help. 

Using alternatives to self-harm will help you get through an intense moment when you may feel a strong urge to hurt yourself. But it's never going to be easy, especially when you're trying to break the cycle for the first time. Doing something like squeezing ice won't cure the roots of your distress, but it may help you to use a more productive coping mechanism and show you that you can cope with stress in a less harmful way. You'll have to make a conscious effort not to hurt yourself, but the important thing is that if you do decide to use an alternative, you've made that choice yourself.

Expressing feelings - letting it out physically...

• Scream as loud as you can / scream into an empty room
• Hit a cushion / punch bag or throw a cushion against a wall
• Smash a watermelon
• Kick a football against a wall
• Squeeze a stress ball
• Sing
• Tear up a newspaper/phone directory
• Play loud music and dance energetically – be as wild as you like
• Spend some energy doing physical exercise - go for a walk/swim/go to the gym/ride a bike/go running. 
• Do yoga or Tai Chi
• Make a small doll and cut or tear it as if it was you
• Throw ice in the bath or  against a wall to smash it
• Sketch yourself and then draw on the wounds you want to make
• Make play doh or clay models and then smash them up
• Write negative feelings on paper, then rip them up
• Have a pillow fight with a friend or with the bed to get rid of anger
• Make lots of noise
• Tear up bits of paper or rip fabric
• Exercise for a release of endorphins and that feel-good factor.
• Pop bubble wrap 

Trying to work out how you are feeling...

• Get a list of all different kinds of feelings and look at it when you want to identify what you are feeling
• Ask yourself "Do I feel angry?" "Do I feel anxious?" "What about?"
• Ask yourself "What would the razor blade say if it could talk to me?"
• Write a letter to someone you’re angry with, hurt by etc. saying how you feel (No need to send it)
• Write a list of your achievements
• Write a letter to yourself saying ‘I love YOU because….’
• Make a list of things you’re thankful for
• Make a wish list
• Make a thought diary

Talking about it...

• Talk to a friend 
• Call the Samaritans or aother helpline
• Allow yourself to feel emotions - have a cry, shout

Using your creativity...

• Draw / paint / collage / paper mache / finger paint / sculpt in clay -  to express what you want to do or what you are feeling
• Write a poem / story / song / joke / autobiography / parody / musical
• Write a diary / journal or read old diaries (unless there might be triggers)
• Go to myspace.com and write an online journal
• Scribble a word again and again to say how you’re feeling e.g. ‘lonely’, ‘angry’
• Deface a magazine (preferably your own)
• Paint with red paint using your fingers
• Write a message in a self-harm newsgroup on the internet
• Take some photos
• Play an instrument / sing to music as loud as you can
• Put on music which expresses how you are feeling
• Write out the soundtrack to your life if it were a film
• Imagine a colour which expresses your feelings then change it in your mind to another colour
• Make a memory box / happy box and fill it with items that make you feel good
• Make a scrapbook
• Write an alternative ending to a story
• Watch a foreign language channel and make up your own interpretations
• Create your own cartoon characters / legends
• Create a secret code
• Draw your pain and problems
• Write a letter to a person who has hurt you even if you don’t send it
• Write a list of pros and cons to self-harm
• Write all your coping strategies down on separate pieces of paper, put them in a jar and pick one out when you feel like self-harming

Comforting yourself

• Have a bath or shower
• Stay in bed
• Use aromatherapy oils
• Have alternative therapies
• Eat chocolate, sweets or something nice
• Have an ‘emergency box’ with whatever helps you cope 
• Buy something special
• Massage your hands / arms / feet (or the area you want to harm)
• Stroke a pet / cuddle a teddy
• Ask a friend to hold you
• Paint your nails / Have your hair done
• Have a cup of tea
• Rock / hug yourself
• Give yourself a henna tattoo
• Meditate / yoga
• Go to sleep
• Make a tape of feel good songs and play when you feel sad

Distracting yourself - leisure activities...

• Watch television / video / DVD / watch a happy film or comedy
• Play on a computer
• Go on the internet
• Learn a new skill (juggling / making balloon animals)
• Do puzzles / play chess / make your own puzzles
• Origami / Scobidous / make jewellery
• Sew / knit
• Go through a photo album
• Design a dream house
• Have a debate
• Build a card house
• Make a paper chain of the days its been since you last cut (add a new one every day)
• Find out how to put 8 queens on a chessboard without any of them being able to kill each other (There are 92 possible ways to do this!)
• Make a T-shirt
• Look for pictures in the clouds
• Listen to jokes

Distracting yourself - getting out and about...

• Sweep the path
• Wash your car
• Do some gardening
• Go for a drive
• Go to an arcade or playground
• Make a kite/fly a kite
• Get on a train and go to the sea
• Look at constellations
• Join a self-harm support group
• Go shopping
• Visit a zoo or farm

Disctracting yourself - being productive...

• Catch up on DIY / housework
• Cook/bake something
• Have a clear out – give your old stuff to charity
• Re-arrange your room/decorate
• Read/study
• Give your pets a bath
• Volunteer somewhere
• Join a class
• Think about what you’d like to change about your life and make a plan
• Make forward plans about something in the future

Reasoning with yourself

When you’re not feeling like self-harming, write a list of reasons to avoid self-harm. The list will be different for each person - it's whatever makes sense to you.  Look at the list when you feel like harming yourself.  It could include things like:

• “I’ve managed for two weeks without harming.  I don’t want to start again”
• “Once I start it’s difficult to stop”
• “I’ll regret the damage afterwards”
• “It doesn’t help in the long run.  I can harm now but I’ll need to do it again in a couple of days.”
• “I don’t want to end up in hospital”
• “If I can hang on the need to self-harm sometimes passes”
• “There may be consequences I don’t want e.g. brain damage, paralysis”
• “Self-harm affects my relationships”

Learn CBT (Cognitive Behavioural Therapy) or DBT (Dialectical Behaviour Therapy) techniques. 
http://www.rcpsych.ac.uk/mentalhealthinformation.aspx

• When you’re feeling good write yourself a letter you can read when you want to self-harm.
• Write down why you do not deserve to be hurt.

Making yourself safe

• Try to identify things that prompt you to self-harm.  If possible avoid them or prepare for them
• Avoid shops that sell things you might use to harm yourself
• Stay with a friend
• Ask GP to give you weekly prescriptions or pick up medication for two days at a time from the chemist
• Do not stockpile medication (prescribed or over the counter)

Rewarding yourself for not self-harming

• Keep a chart – add a star for each day / hour you have not self-harmed. 
  If you do self-harm, just leave a space and start again

Delaying self-harm

• Keep things you harm yourself with in a locked cupboard or in a box with sellotape around it.  It gives you time to think between wanting to self-harm and doing it.
• Phone Samaritans / Rethink Gloucestershire Self Harm Helpline – arrange to ring again in an hour/ two hours and promise yourself you will not harm before then
• Use any of the suggestions for avoiding self-harm to try and delay it for a while
• Set yourself a ten or fifteen minute time limit and see if you still feel like you need to self-harm as bad after this time limit has passed. If not then postpone it for longer.

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?
• 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
• 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

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.

Other useful techniques

Deep Breathing

Lots of people dismiss deep breathing before they have actually tried it. However if done correctly it can be of great help. Sit straight on a chair and put one hand gently on your chest and one hand gently on your stomach. Slowly breathe in, feeling the air expanding your lungs. Your stomach should move outwards as the air fills you. Hold the breath for a moment, then breathe out as deeply as possible. This can help to calm you down in situations when you feel panicked.

Relaxation CDs

There are many relaxation CDs which you can buy. Some feature nice noises such as dolphin sonar and the sea; others have someone talking to you. When you begin to feel tense you can put one of these tapes into a personal music player and listen to it whilst lying or sitting somewhere that you feel safe, perhaps with your eyes closed. It can also help if you tense and relax parts of your body whilst listening and feel the tension flowing out of you.

Safe Place

What is your happiest memory? Maybe it’s going to the seaside with your family or friends or taking part in something special at school such as a play etc. Take some time to think of this. Practise going back to this happy memory in your head until you can begin to feel like you are really there again. Then in times of distress close your eyes and really concentrate on this place and this should help your upset/ angry feelings to leave you.

Practice mindfulness

Sit in a quiet space in a chair with your feet on the floor. Hold a small object in your hand. Look at the object, notice how it feels in your hand.

•   How heavy is it?
•   What temperature is it?
•   Is it sharp, rough or smooth?
•   What shape is it?
•   What colour is it?
•   How does it smell?
•   Think of its use

You may find that your mind wanders or that thoughts pop into your head. That’s OK, let the thought come in, acknowledge it and let it go and return to the task This may take practice.

Affirmations

An affirmation is a phrase or sentence that you say to yourself, which is something good about you or something that you want to achieve.  These are normally repeated to yourself five to ten times a day and they enter your unconscious mind and reduce the negative thoughts.

Examples are:

•  I am a good person 
•  I have not asked for people to hurt me; it is not my fault
•  I can achieve what I want to achieve
•  People care about me and I try to care for myself

Invisible circle

This exercise is designed to help you stop thinking so negatively about yourself. Imagine a circle in a room, which is big enough to fit you inside it. This is a power circle. Every day step into your circle and say out loud to yourself five times an affirmation, which means something to you.

Then when you start to feel upset, angry or vulnerable, go into your circle and repeat your affirmation to yourself over and over until you feel safer.

Stop signs

Sometimes, we find ourselves saying critical, hurtful things to ourselves without even realising it. The “inner critic” – the voice inside you that keeps telling you how bad you are – can be a very powerful force sometimes.

One good way to learn to diminish some of this power is to make a list of the most common things you say about yourself, and then write an affirmation to counter it.

Then, the next time you hear that critical voice in your head, imagine a big red STOP sign. Pause, take a deep breath, and say an affirmation over and over in your head instead.

Don’t be discouraged if it seems to take a long time and your thought processes don’t appear to become less negative – remember that you have been thinking negatively for a long time, and it will take equally as much time to get back out of that habit. But that’s all it is, a habit. People give up bad habits, or change their habits all the time. So can you. Persevere, and gradually your thought processes will change.