If you have a history of self-harm—also known as non-suicidal self-injury (NSSI)—you know the urge to hurt yourself can strike unannounced or in response to certain triggers. Because of that, it’s always helpful to have a toolbox of coping mechanisms and alternatives to self-harm you can tap into to help you resist the urge when it hits. That can be especially true now amid the new coronavirus pandemic. Coping with anxiety, loneliness, depression, and feeling overwhelmed is difficult at the best of times, but on top of that, all this social isolation might have left you without your usual resources and support systems just when you need them most.
While self-harm is best addressed with the help of a professional long-term, there are some coping mechanisms and alternatives to self-harm that experts recommend to help you deal with intense urges in the moment. These mechanisms are often based on cognitive behavioral therapy (CBT), which helps people reframe their thoughts and actions, and dialectical behavior therapy (DBT), a form of CBT that is focused on distress tolerance and emotional regulation. While there’s no one “best” way to treat self-harm therapy-wise, CBT and DBT are mainstays.
Here, we asked experts for a few strategies to keep in mind for the next time you need them. As with any mental health advice, not every tip will be helpful for you personally, so reflect and experiment to find out what works best for you.
1. First, understand why you engage in self-harm.
People self-harm for a few different reasons and understanding your motivation and triggers can help you choose the coping strategies from this list that will be most helpful for you. “We see that when people engage in self-harm they generally describe feeling one of two urges: Either they have so much emotion that it is overwhelming and they self-harm to get a release, or they feel nothing, emotional numbness, and in the desire to feel something, they will self-harm,” Nina Vasan, M.D., M.B.A., clinical assistant professor of psychiatry at the Stanford School of Medicine, tells SELF. Dr. Vasan is also the founder and executive director of Brainstorm, the Stanford Lab for Mental Health Innovation, where she and her team provide consultation to tech companies to help create resources related to self-harm. (As a heads up, I’m an intern at Brainstorm, too.)
According to a 2014 investigative study by the Canadian Psychiatry Association, other reasons people self-injure include wanting to punish themselves, to create physical signs of emotional distress, and to relieve anger. Whatever motivates you to self-harm, you might find you can satisfy an urge in a way that’s less harmful.
Understanding why you engage in self-harm also means learning to recognize what feelings and situations might trigger the urge so you’re better prepared to use your coping mechanisms, according to Mayo Clinic. That way, you can make a long-term plan on how to deal and make different decisions in the moment of distress.
2. Shock your system with something cold.
“Feeling an intense physical sensation can distract you from your emotional distress,” says Dr. Vasan. “For example, holding a cube of ice in your hand and letting it slowly melt with your body heat can make you feel calm.”
For some, the stinging and pain of the freezing cold also satisfy the urge for the pain they seek through self-harm, but in a much safer way. Whether the goal is to achieve calm, activate your senses, or produce a feeling of pain without causing yourself actual damage, other cooling activities like taking a cold shower, drinking cold water, and consuming a cool food (like something with mint) might be helpful alternatives.
3. Or get warm and cozy.
The feeling of warmth can help you stay calm and grounded. “When people feel intensely anxious or overwhelmed, their bodies can show signs of it, whether it is higher heart rate or blood pressure, or feelings of tightness in their chest,” Gowri Aragam, M.D., clinical instructor at Harvard Medical School and psychiatrist at Massachusetts General Hospital, tells SELF. “For certain people, warming up or feeling contained can physically calm their body down [and] release naturally relaxing chemicals, which in turn helps them feel calmer and more in control as well.”
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