Self-Harm: Information for Adults

Summary: Some people use self-harm as a way of coping with difficult feelings or stressful situations when they are overwhelmed. Unfortunately, self-harm usually ends up causing more problems and is ultimately not helpful. The good news, is that there are many other ways to cope and manage with difficult feelings and stresses.
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What is self-harm?

Self-harm is when people purposely try to hurt themselves. Common ways of self-harm include:

  • Self-cutting
  • Scratching or burning one's skin
  • "Minor" overdosing of medications (taking excess amounts of medications but not enough to kill oneself)
  • Head banging (banging one's head against a wall).Who Self-Harms?

People of all ages may self-harm, though self-injury behaviours start on average at age 15, and is most commonly seen in teenagers and young adults. 

Why do people self-harm?

It is believed that people self-harm in order to cope or deal with some stress. Some of the reasons given include:

  • Getting relief from painful or distressing feelings
  • Dealing with feelings of numbness
  • Communicating pain or distress to others

The good news, is that people with self-harm are trying to cope; the bad news, is that self-harm is usually not a helpful way to cope... 

I want to understand why I hurt myself...

  • Ask yourself these questions to help you better understand the feelings or situations that lead to self-injury (Kilburn & Whitlock, 2009):

    What was going on in my life when I first began to injure myself?
    How do I feel just before I want to injure myself?
    What are my habits and routines? Am I always in the same place or with a particular person when I get the urge to injure myself?
    Do I always feel the same emotion when I get the urge to injure myself?
    How can I better deal with the situations that trigger me?
     
  • Consider keeping a diary where you can write down your feelings at different times so that you can better answer the above questions.

I'd like to find some other way to cope... What can I do instead of self-harming?

If you are feeling sad or depressed

  • Express your feelings
    • Watch a sad movie so that you can cry and release your tears. Or watch a comedy so that you can enjoy a laugh.
  • Connect with other people or creatures. Human beings are social creatures. When we connect in a meaningful way with others, we actually feel better.
    • Hug someone or a stuffed animal. Hugs actually release oxytocin, a chemical which makes us attached to others.
    • Do a favor for someone else. We are social creatures -- acts of altruism do actually help us feel better.
    • Spend time with animals. Take your own dog for a walk, or offer to play or take out someone else's that you know.  
    • Visit someone.
    • Bake something for yourself and so that you can give to others.
  • Find meaning in your life
    • Remind yourself that the most important thing in life is having meaning.
    • What are the things that make your life meaningful?
  • Practice gratitude
    • Make a list of 10 things that you are grateful for, or 10 things that you have that people in other areas in the world wouldn't have
    • Call someone that you appreciate and let them know what you appreciate about them and life

Use your senses to feel better. If you are so overwhelmed, try these distraction strategies to help calm yourself down...

  • Visual
    • Look out the window.
    • Read.
    • Watch TV.
  • Deep pressure
    • Curl up under a heavy blanket
  • Touch
    • Squeeze ice.
    • Put a finger into a frozen food (like ice cream).
    • Take a cold or hot bath.
    • Stomp your feet on the ground.
  • Smell / taste
    • Bite into a hot pepper or chew a piece of ginger root.
    • Take a hot bath with nice smelling soaps and bubble bath.
  • Sound
    • Listen to music
    • Play music, or sing.  
    • Talk with other people.
  • Be mindful
    • Meditate, do yoga,
    • Focus on your breathing
    • Spend time in nature.
    • Play Tetris. Studies show that distracting yourself with activities such as Tetris can keep you distracted long enough, for negative urges to pass... 

If you feel like you are a bad person:

  • Acknowledge that you are not perfect -- "Nobody, absolutely nobody is perfect"
  • Acknowledge that you are just trying to do the best that you can
  • Talk to someone that cares about you, and ask them what they like about you.  
  • Do something nice for someone else.
  • Write down something that you are grateful for.

How can I support a loved one who self-harms?

Do's

  • Express your caring and concern, e.g. "I love you / I care about you" and "I am worried about you."
  • Acknowledge that the person may be under stress or feeling extremely distressed, e.g. "I'm going to guess that things must be pretty stressful for you right now..."
  • Ask how to be supportive, e.g. "How can I be helpful?" or "How can I support you?"
  • Common self-soothing strategies are below:

Type of Strategy

Description

Sound

Listening to soothing music

Movement

Going for a walk, going to work out, hitting a pillow or punching bag, ripping up a phone book, newspaper or magazine, cut or smashing Play-Do or clay sculptures, throwing ice against a brick wall, dancing to loud music, stomp around in heavy shoes

Touch

Deep pressure (such as a massage!), a warm bath, or a cold shower, depending on the person's mood

Smell

Lighting incense, scented candles, potpourri, having a bubble bath with scented soaps

Oral

Chewing gum, drinking ice water, crunching ice

 

  • Learn basic First Aid to know how to deal with any cuts or self-injuries. For minor cuts or  injuries, wash them with mild soap and water so that they don't get infected. For more serious cutting that may require professional medical care (such as stitches), offer to take your child to the nearest walk-in clinic, doctor's office, or hospital emergency room.
  • Let the person know that if they want to talk about their self-harm (and stress), that you are ready to listen without judging.
  • You might say: "I'm worried about you. If there's something you want to talk about, let me know. I promise I'll listen, and I won't get upset or angry at you, no matter what it is. I love you no matter what."

Don'ts

  • Don't try to make the person guilty or ashamed; don't show disgust or revulsion at the person. Making the person feel guilty or ashamed does not usually help. Worse, you may end up making them feel bad about themselves, which usually leads to the person not wanting to trust you or be with you.
  • Don't simply tell the person to stop self-harming. Self-harm is a way of coping; simply taking away the person's coping strategy without offering an agreed upon alternative can even be dangerous because then the person may act on impulses to end his/her life. In the least, it can end up making the person distrustful of you.

How you can support a loved one in the long run

Do's

  • Ask the person what stresses s/he is under that might be contributing to the self-harm

Identify stress

"What's the problem that makes you feel like hurting yourself?" or "What's the problem that made you feel like hurting yourself yesterday?"

"What makes you feel like hurting yourself?"

 

 

 

If the other person responds, "I don't know!", you could list some choices: "Normal stresses are things like work, school, friends and family. And then you could go through each one in detail. You might say: "So how are things at work? How are your co-workers? How are your bosses? How's the work? etc..."

Try to help the other person person problem-solve whatever the stress is
 

Find goals / solutions

"What do you wish could be different (with the stress/trigger)?"

Come up with possible solutions to try

"What are things that we could try? That you could try?"

Try out a solution

"What would you like to try first?"

Evaluation whether or not that solution is helpful

"How do you think that worked out?"

 

If not, then do something different

"What other things could we try instead?"

If helpful, continue to do it

"It looks like that worked - what shall we keep on doing then?"

Getting Professional Help

If you or a loved one are self-harming, then see a professional such as:

  • Family physician
  • Mental health professionals such as psychologists, social workers, certified counselors 

Why is it important to get help?

The good news, is that most of the time, people that self-harm are not trying to end their lives. Rather, they are actually trying to cope with feelings or life situations that are overwhelming.

 

The bad news however, is that self-harm behaviours can continue, and sometimes even get worse, if the underlying issues are not dealt with.

 

For this reason, it is important to get help if things are not getting better on their own.

Summary

When under stress, some people may turn to self-injury as a way of coping. Fortunately, there are many ways to support someone who is self-harming. The most important is to acknowledge that they are trying to cope with some stress, and to provide emotional support. It is important to focus on providing support, as opposed to focusing on the cutting behaviour.

References

Kilburn, E. & Whitlock, J.L. (2009). Distraction techniques and alternative coping strategies. The Practical Matters Series, Cornell Research Program on Self-Injury and Recovery. Cornell University. Ithaca, NY. Retrieved Mar 9, 2016 from http://www.selfinjury.bctr.cornell.edu/perch/resources/distraction-techniques-pm-1.pdf  

 

Miller, A.L., Rathus, J.H., & Linehan, M.M. (2007). Dialectical behavior therapy with suicidal adolescents. New York: The Guilford Press.

 

Nixon, M.K., Cloutier, P., & Mikael Jansson, S. (2008). Non-suicidal self-harm in youth: a population-based survey. Canadian Medical Association Journal, 178(3): 306-312.

 

Whitlock, J., & Knox, K.  (2007).  The relationship between self-injurious behaviour and suicide in a young adult population.  Archives of Pediatric Adolescent Medicine, 161(7): 634-640.

About this Document

Written by the eMentalHealth Team.  

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance. 

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Date Posted: Jul 8, 2013
Date of Last Revision: Oct 8, 2016

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