Self-harm is a complex and often misunderstood thing; and it affects people from all walks of life. I think it’s a topic worth exploring and understanding whether you’re someone who is experiencing self-harm, a loved one, or mental health professional. Unfortunately, it is also a topic fraught with a history of implicit and explicit shame. We shame ourselves for the behavior, for not stopping it, shame others for “not listening” to our great advice on how to stop it, therapists shame themselves when client’s don’t share with them their self-harm thoughts or behaviors, and when their client’s fail to stop them right away. Given all this shame, we need to approach this topic with love, care, compassion, and evidence-based strategies to support ourselves and the people around us.
Understanding Self-Harm
Self-harm, also known as self-injury or self-mutilation, refers to the intentional act of causing harm to one’s own body without the intent of suicide. Contrary to common misconceptions, self-harm is not attention-seeking behavior or a sign of weakness. It is often a coping mechanism used to deal with overwhelming emotions or distressing situations. Yes, you read that right. Self-harm is a coping skill. In my professional experience it’s a coping skill with high efficacy, meaning it always works. However, it’s not considered a “healthy” coping skill, due to risk, shame, stigma, and cultural/religious views. Which is why for many the knee-jerk reaction to self-harm is to encourage complete abstinence. But that’s not very compassionate. People use self-harm for a lot of reasons, to cope with stress, trauma, emotional pain, feeling empty or numb, and to regain a sense of control. Understanding what the driving factor behind the behavior is essential to provide the right kind of support and intervention.
Compassionate Approaches to Support
Harm reduction approaches focus on minimizing the negative consequences of self-harm while acknowledging that stopping the behavior entirely may not be immediately achievable. Practical harm reduction techniques include distraction techniques, identifying and addressing triggers, and building coping skills and resilience. This can also be reducing the intensity of the self-harm behavior, such as replacing razor blades with duller objects.
For self-harm via cutting harm reduction can be:
- Cutting across rather than lengthwise on wrists to avoid heavy blood loss
- Sterilizing the skin and instruments before and after
- Caring for any cuts after with first aid
- Make surface level cuts, less deep = less risky
- Use the buddy system, tell a trusted friend or counselor when you’re going to self-harm and message them after to let them know you’re okay and don’t need medical attention.
Safety Plans
Another strategy you can use is a safety plan, it’s a reminder to yourself in times of crisis that you have coping skills, people, and places to turn to in times of crisis.
Use this free template from 988 or create your own.
Seeking Professional Help
While self-help strategies and peer support can be beneficial, seeking professional help is sometimes essential for addressing underlying issues driving self-harm. Therapeutic approaches such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness-based interventions have shown effectiveness in treating self-harm behaviors.
When choosing a therapist to help with self-harm it’s important to ask them how they respond to self-harm, do they use harm-reduction, are they trauma informed, what are some examples of interventions they would use. This can give you an idea of what working with them would be like. Your therapist should strive to create a safe and non-judgmental space for you to work through your self-harm without shame.
If you’re ready to start your therapy journey make an appointment today!
with love,
Marty Hosier
