How can a person who self-injures stop this self-harming behavior? Here are some good self-harm coping skills.

Most people who self-harm want to stop hurting themselves and they can do this by trying to develop new ways of coping and communicating. However, some people feel a need not only to change their behavior but also to understand why they have resorted to harming themselves.

There are a number of techniques that can reduce the risk of serious injury or minimize the harm caused by self-inflicted injury. This list is not exhaustive - different people find different things useful in various situations. So if one doesn't work, try another.

• stop and try to work out what would have to change to make you no longer feel like hurting yourself
• count down from ten (nine, eight, seven)
• point out five things, one for each sense, in your surroundings to bring your attention on to the present
• breathe slowly - in through the nose and out through the mouth.

If you still feel like cutting, try:

• marking yourself with a red water-soluble felt-tip pen instead of cutting
• a punch bag to vent the anger and frustration
• plunging your hands into a bowl of ice cubes (not for too long, though)
• rubbing ice where you'd otherwise cut yourself

There are several other things you can do to help yourself better cope with self-injury:

• Acknowledge that this is a problem, that you are hurting on the inside, and that you need professional assistance to stop injuring yourself.
• Realize that this is not about being bad or stupid - this is about recognizing that a behavior that somehow was helping you handle your feelings has become as big a problem as the one it was trying to solve in the first place.
• Find one person you trust - maybe a friend, teacher, minister, counselor, or relative - and say that you need to talk about something serious that is bothering you ("How Do You Tell Someone You Self-Injure?").
• Get help in identifying what "triggers" your self-harming behaviors and ask for help in developing ways to either avoid or address those triggers.
• Recognize that self-injury is an attempt to self-sooth, and that you need to develop other, better ways to calm and sooth yourself.

Sources:

Helpguide.org

There is no magic pill for stopping self-harm. Therapeutic approaches help people who self-injure to learn new coping mechanisms to deal with feelings instead of self-injury.

Self-harm is almost always a symptom of another problem comorbid to self-injury. While the problem can be addressed directly through behavioral and stress-management techniques, it may also be necessary to look at and treat other problems. This could involve anything from medication to psychodynamic therapy.

Current methods of treatment involve using medications such as antidepressants, mood stabilizers and anti-anxiety drugs to alleviate the underlying symptoms that patients are attempting to cope with via self-injury. Once the patient becomes stabilized on medication, deeper therapeutic work must be done to deal with any underlying problems that are contributing to these symptoms. Long-term recovery from self-injury involves learning new techniques for coping with turbulent emotions. Perhaps most importantly, patients need to be treated with compassion rather than force.

Hospitalization and taking away implements used for self-injury may make friends and family feel more secure, but the patient is left feeling fearful and completely defenseless. Long-term healing involves helping the patient to control symptoms in a more positive way, such as journaling and anger management skills. If a negative coping skill is removed, it is crucial to replace it with a more positive one. The patient's desire to cooperate and get well is a major factor in recovery.

Finding a Specialist to Treat Self-Injury

Of all disturbing patient behaviors, self-mutilation is often described as the most difficult for clinicians to understand and treat. Typically, these therapists and mental health practitioners are left feeling a combination of helplessness, horror, guilt, fury, and sadness.

Most local mental health teams are prepared to see and assess people who self-harm but, where the underlying problems are too complex, may decide to refer the patient to more specialized services.

There are very few self-injury treatment centers / programs in the U.S. where staff members have the necessary training and experience to allow them to confront and manage such seemingly bizarre behavior. One is the S.A.F.E. Alternatives program, a specialist treatment center for those who suffer from self-injury.

If you are searching for professional help, ask your doctor for a referral, call your county medical society and county psychological association along with area psychiatric hospitals.

When telling someone you self-harm, there are many things to take into consideration. Consider revealing your self-injury to someone you trust.

Telling someone that you are a self-injurer is scary. You don't know how they will react. In a way, it can be viewed as similar to coming out as gay or lesbian. Although it is very common, it may not be considered "acceptable" to others. Be careful whom you choose to tell. Choose someone you really trust. You can disclose in a conversation or in a letter that you present to them or by e-mail. If you choose the last two, be ready to follow it up with a chat session or phone call.

Keep these points in mind:

• Be willing to give the person some time to digest what you have told them. You may have caught them by surprise and first reactions are not always the best indicators of their feelings. Give them some space, but be ready for their questions.
• Be as open as you can and give them as much information as you can. Give them internet addresses like this one or ways to get additional information or books to read. People are afraid of things that they don't understand.
• Try to anticipate what questions they might ask. If they ask you something that you are not ready to talk about yet, tell them that.
• Realize that it can be as difficult for them to hear what you have to say, as it is for you to say it. Anyone that you are that close to will not want you to hurt and will want to help. They may wonder where they went wrong and feel guilty that they did not notice. Be sure to tell them that this is a choice you made and you were not ready for their help earlier but need it now.
• You do not have to accept their value judgments about your self-injury.
• Let the person know you are telling them because you trust them, not because you are trying to punish, manipulate or guilt-trip them.
• Never tell someone in anger. ("You made me cut/burn/hit.") Do not blame the person for their behaviors which may have triggered you or for not seeing your pain. They'll get defensive and angry. You want their understanding, not their guilt and besides, self-injury is always your choice.
• If you have a friend or a counselor that you trust you may want them to be present to give you support, but do not expect them to tell the other person for you.
• It's usually best to avoid graphic descriptions of your injuries. You are not trying to freak them out. They probably don't need a technicolor description of your worst incident. If they have any questions later then you can give them the details in another conversation once they have had a chance to absorb what you told them.

For many people, the thought of self-injury is shocking; an incomprehensible thought. Here are the reasons why people self-injure, engage in self-injurious behaviors, and commit acts of self-harm.

For many, self-harming behavior starts in childhood, disguising scratches and bumps as accidents and progressing to more systematic cutting and burning in adolescence.

There are different theories as to why people self-mutilate. One is that because victims of childhood sexual abuse were forbidden to reveal the truth about their abuse, they use self-mutilation or self-cutting to express the horror of their abuse to the world.

Another theory is that sexual abuse in early childhood leads to extremely low self-esteem. If very low self-esteem develops, self-harm as an expression of self-hatred is understandable.

One research finding is that self-harmers tend to grow up in an 'invalidating environment' - one where the communication of private experiences is met with unreliable, inappropriate or extreme responses. As a result, expressing private experiences is not validated, instead, it's trivialized or punished.

The problem with these theories is that (in the case of the sexual abuse theory, for example) not everyone who's been sexually abused starts to self-harm, and not everyone who self-harms has been sexually abused.

Pain and Pleasure of Self-Injury

Another theory for self-cutting is that it triggers release of the body's natural opiate-like chemicals to reduce the pain. Perhaps self-cutters have become addicted to their body's heroin-like reaction to cutting, which is why they do it again and again. They may also experience withdrawal if they haven't done it for a while.

Drugs used to treat heroin addicts may be helpful with self-cutters, but mostly for those who describe a 'high' after they've cut themselves.

Another theory, which in-patient units often use, is based on the psychological principle that all behavior has consequences that are somehow rewarding. Cutting usually leads to a sequence of behavior - increased attention, for example - that may become a rewarding reason to repeat the behavior.

Staff in hospital specialist units are specially trained to ensure that no consequences follow from an episode of cutting that could be rewarding. Instead, when the patient stops cutting themselves they're rewarded with increased attention from staff.

Sources:

• Favazza, A. R. (1989). Why patients mutilate themselves. Hospital and Community Psychiatry.
• Solomon, Y. & Farrand, J. (1996). "Why don't you do it properly?" Young women who self-injure. Journal of Adolescence, 19(2), 111-119.
• Miller, D. (1994). Women Who Hurt Themselves: A Book of Hope and Understanding. New York: BasicBooks.

Self-injury is defined as any intentional injury to one's own body. It can include cutting, burning, and other forms of self-harm, self-mutilation. Here are the signs of self-injury.

People who self-harm become very adept at hiding scars or explaining them away. Look for signs such as a preference for wearing concealing clothing at all times (e.g. long sleeves in hot weather), an avoidance of situations where more revealing clothing might be expected (e.g. unexplained refusal to go to a party), or unusually frequent complaints of accidental injury (e.g. a cat owner who frequently has scratches on their arms).

Types of Self-Harm

The most common forms are cutting the arms, hands, and legs, and less commonly the face, abdomen, breasts and even genitals. Some people burn or scald themselves, others inflict blows on their bodies, or bang themselves against something.

Other forms of self-harm include scratching, picking, biting, scraping and occasionally inserting sharp objects under the skin or into body orifices, and swallowing sharp objects or harmful substances ("Why Do Self-Injurers Engage in Self-Harm?").

Common forms of self-injury that rarely reach medical attention include people pulling out their own hair and eyelashes, and scrubbing themselves so hard they break the skin (sometimes using cleaners such as bleach).

Additional forms of self-harm may include:

• carving
• branding
• marking
• biting
• headbanging
• bruising
• hitting
• tattooing
• excessive body piercing

There are various reasons why self-injurers hurt themselves. However, self-injurers also share common psychological characteristics.

Although self-injury is recognized as a common problem among the teenage population, it is not limited to adolescents. People of all sexes, nationalities, socioeconomic groups and ages can be self-injurers.

Self-injurers suffer in silent shame and isolation. It is estimated that self-injurers comprise at least 1% of the population, with a higher proportion being female, and nearly half admitting to being victims of physical and/or sexual abuse in childhood. A significant number of self-mutilators also suffer from eating disorders, alcohol abuse and/or drug abuse problems, personality disorders, and/or mood disorders. While each self-mutilator has a different story to tell, all share certain characteristics:

• The self-harm behavior is recurrent.
• The self-injurer experiences a mounting sense of fear, dread, anxiety, anger, or tension before the event.
• A sense of relief accompanies the event.
• A sense of deep shame follows.
• The self-injurer attempts to cover-up any evidence (e.g. scars) of his/her act.

More on the psychological characteristics common in self-injurers here

The Adolescent Self-injurer

Some adolescents may self-mutilate to take risks, rebel, reject their parents' values, state their individuality or merely be accepted. Others, however, may injure themselves out of desperation or anger to seek attention, to show their hopelessness and worthlessness, or because they have suicidal thoughts. These children may suffer from serious psychiatric problems such as depression, psychosis, Posttraumatic Stress Disorder (PTSD) and Bipolar Disorder. Additionally, some adolescents who engage in self-injury may develop Borderline Personality Disorder as adults. Some young children may resort to self-injurious acts from time to time but often grow out of it. Children with mental retardation and/or autism as well as children who have been abused or abandoned may also show these behaviors.

Sources:

• Levenkron, S. (1998) Cutting: Understanding and Overcoming Self-Mutilation. New York: W. W. Norton
• The American Academy of Child and Adolescent Psychiatry, Self-Injury In Adolescents, No. 73, Dec. 1999.

next: Who self-injures? Psychological Characteristics Common in Self-Injurers

Note: this is only a brief excerpt from the above manuscript to give the reader an overview of dissociative symptoms.

Many patients with dissociative disorders need to express the "memories and feelings connected to their traumas, but are afraid to, because of the fear, pain, anger, and shame connected to them, of which they may not even be conscious" (Franklin, 1988, p.29). Franklin suggests that this leads to a conflict between expression and hiding which often leads to a compromise where the memories and feelings escape through subtle signs of dissociation. In relation to models of suppression and repression, Franklin states that the subtle signs are returns of the dissociated rather than a return of the repressed and that internal or external stressors may serve as triggers which activate these memories.

Loewenstein (1991) in his interview model created to diagnosis MPD through dissociative signs grouped many of these subtle signs or symptoms into a matrix of outlining symptom clusters:

(1) Process (MPD) symptoms:

• Alter attributes
• Passive influence symptoms/interference phenomena
• Hallucinations/pseudohallucination
• Linguistic usage
• Switching

(2) Amnesia Symptoms

• Blackouts/time loss
• Disremembered behavior
• Fugues
• Unexplained possessions
• Inexplicable changes in relationships
• Fluctuations in skills/habits/knowledge
• Fragmentary recall of entire life history
• Chronic mistaken identity experiences
• "Micro"-dissociations

(3) Autohypnosis Symptoms (Manifest by High Hypnotizability)

• Spontaneous trances
• Enthrallment
• Spontaneous age regression
• Negative hallucinations
• Voluntary anesthesia
• Out-of-body experiences
• Trance logic
• Eye roll and switching

(4) PTSD Symptoms

• Psychological trauma
• Intrusive/imagery/revivification/flashbacks
• Nightmares
• Reactivity to triggers/panic/anxiety
• Hyperarousal/startle response
• Numbing/avoidance/detachment

(5) Somatoform Symptoms

• Conversion symptoms
• Pseudoseizures
• Somatoform pain symptoms
• Somatization disorder/Briquet's syndrome
• Somatic memory

(6) Affective Symptoms

• Depressed mood
• Mood swings
• Vegetative symptoms
• Suicidal thoughts or attempts/self-mutilation
• Guilt
• Helpless/hopeless" (p. 569)

Loewenstien states that many patients show subtle signs of dissociation as expression of the conflict between expression (of memories and feelings connected to their traumas) and hiding. He also states that child abuse, trauma, and family violence is the single largest preventable cause of mental illnes and that it is in this light that dissociative symptoms should be routinely and persistently looked for and inquired after to insure proper mental health care delivery.

__________________________________

References

Franklin, J. (1988) Diagnosis of covert and subtle forms of multiple personality disorder. Dissociation Vol. 1,No. 2, pp 27-32.

Kluft, R.P. (1985) Making the diagnosis of multiple personality disorder (MPD). In F.F. Flach (Ed.), Directions in Psychiatry (Vol. 5, Lesson 23). New York: Haterleigh.

Loewenstein, R.J. (1991) An office mental status examination for complex chronic dissociative symptoms and multiple personality disorder. Psychiatric Clinics of North America, Vol. 14, No. 3, pp 567-604.

Putnam, F.W. (1985) Dissociation as a response to extreme trauma. In R.P. Kluft (Ed.), Childhood antecedents of multiple personality. Washington, DC: American Psychiatric Press.

next:  The Spectrum of Dissociative Disorders: An Overview of Diagnosis and Treatment

We Get LoveNotes from readers. . .

"Thank you. I was afraid and searching today. Your words in this article lifted my spirit and my awareness, and brought me back to center so that I could breathe deeply and view the present with clear perspective instead of through my veils of fear. I was in dire need of a reminder. Ahhhh ... thanks again." - Cathy

I am willing to trust. I know that to the degree I am willing to give up my search for a healthy love relationship, I can have it. I know I can have whatever I am ready and willing to receive. Individual receptivity is everything. Without it, nothing changes. With it, all things are possible. I no longer insist upon my choice.

I know that the only thing I lose when I let go of something I am afraid to live without is the fear itself. I am stronger than anything that frightens me!

I let go of the past, and I am free to think clearly and positively in the present. I am not my past.

Letting go is the natural release which always follows the realization that holding on is an energy drain and it hurts. Letting go happens effortlessly when there is no other choice. Letting go does not mean giving up.

• LoveNote. . . A life without love in it is like a heap of ashes upon a deserted hearth -- with the fire dead, the laughter stilled, and the light extinguished. - Frank P. Tebbetts

Letting go is a journey that never ends. Never. It only begins -- over and over again -- each time I can glimpse something higher than my own painful certainty over who I think I am. There is always something higher; a life beyond the limits of my present sight.

To see what is farther I must be willing to lift my eyes from their present point of focus. Release always follows revelation and real revelation is always a glimpse of something that was only just out of sight.

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I know that stress in my love relationship exists because I insist! What I resist, persists. I am tied to whatever I avoid.

• LoveNote. . . The heart loves, but moods have no loyalty. Moods should be heard but never danced to. - Hugh Prather

It is a mistaken belief that I must push my love relationship in the direction I choose that keeps me in a strained and unhappy relationship with it. Reality has its own effortless course, and I can either embrace its way or struggle endlessly with mine.

I do not need power to flow.

I let go of that part of myself that is certain it is better to suffer and feel like someone than it is to just let go and quietly be no one. I give birth to a new me that never has to hold on to anything because it is already everything.

I dare to walk away from all of the familiar but useless mental and emotional relationships that give me a temporary but unsatisfactory sense of self. My true identity is calling me and to hear it I must be willing to endure, for as long as necessary, the fear of self-uncertainty.

This form of seeming self-abandonment eventually turns into my greatest pleasure as it becomes increasingly evident that the only thing certain about fear is that it will always compromise me. When it comes to who I really am, there is no compromise.

Let go of the past. The past is yesterday. It is irretrievable. When you relate to the past, you relate to no one or any thing. You are literally talking to yourself. No one else is listening. You have already heard all you have to say about that, so, let go.

A Course in Miracles says, "You cannot really not let go what has already gone. It must be, therefore, that you are maintaining the illusion that it has not gone because you think it serves some purpose that you want fulfilled."

It is certifiable insanity to conjure up your own reality based on the past and relate to it, rather than to relate to the present which is the only reality.

• LoveNote. . . Relationships are part of a vast plan for our enlightenment, the Holy Spirit's blueprint by which each individual soul is led to greater awareness and expanded love. Relationships are the Holy Spirit's laboratories in which he brings together people who have the maximal opportunity for mutual growth. - Marianne Williamson

I say goodbye to the past and hello to the present.

I am enthusiastic about who I am becoming! I know that no one sincerely asks for a new life until they are thoroughly dissatisfied with the old one. I am and I let go. When I allow myself to let go of what is old, I stay true to what is new.

I believe that as with all insight, higher understanding itself contains not only the instructions I must follow, but the strength I will need to carry them out.

Starting life over again is the key to a new me. I see the beauty and significance of starting over - over and over and over. Every present moment is always new and new is always right now! The new dies to the ever-new in an endless celebration of Life.

This is it!

I live in the present. I never let the past dictate the direction of the present moment. I give my best to my endeavors.

What lies ahead for me can only be good.

True peace and harmony are a part of who I am.

I have come to the realization that what is possible for me to become only truly changes when I am willing to see what is impossible for me to continue being.

My true nature is already fully independent and flying freely. I have found my wings.

I let go and let God. And so it is.

Thank you, Father!

• LoveNote. . . He that loveth not knoweth not God; for God is Love. - I John 4:8

We Get LoveNotes from readers. . .

"I just wanted to let you know that I asked God to show me the way today, and I found your "Affirmation For Letting Go." It is exactly what I need and I read it often in order to see and feel clearly in a time of stress. Thanks again!" - Christine D.

We Get LoveNotes from readers. . .

"Thank you. I had to read it 4 times before I could read it without protest. It has a lot of meaning for me, my present "best friend" and my attempts at self-improvement. I really needed help letting go of my desires and needs without separation." - Paul

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next: Put the Toilet Seat DOWN!

Over the past few days, I've felt an increased awareness of deeper happiness growing inside of me.

First, I am choosing to be happy. I am choosing to see recent events in my life in the best light. I am choosing to believe the best, wait for the best, and see myself as worthy of the best life has to offer. The power and freedom to choose my perspective on life is a great sources of happiness and contentment and serenity.

Second, I have consciously let go of outcomes and expectations regarding recent developments in my life. I am letting each moment bring whatever it brings. I am fully enjoying the serendipity of each moment. And each moment is either a blessing or a lesson. I receive the blessings; I learn the lessons. Whatever happens, happens. As it happens, I am choosing to be happy and content, no matter the outcome.

Third, I am fully trusting God and turning my life, moment by moment over to Him. My ongoing serenity and renewed happiness are the results of a cooperative effort with Him—not something I've created using my own resources. God is taking care of me and has shown me how to care for myself in many ways. By taking care of myself, I have a greater amount of healthy emotional energy to invest in relationships worthy of my attention. Paradoxical, but true—I love others best when I love myself first.

Fourth, I am happy because my life is healthy. Mentally, emotionally, physically, and spiritually, I see myself today as a whole person, fully capable of giving the best of myself to myself and to the significant people in my life. I've filled myself to overflowing with love, acceptance, encouragement, and strength—and now I'm just learning how to give love, acceptance, encouragement, and strength from my own self-sustaining abundance. And giving these gifts to healthy people who appreciate them feels really nice.

Fifth, I am carefully choosing where to invest my emotional energy. I've let go of some negative people and some negative situations. I've turned my back on certain negative influences and decided that my life is not going to be affected by the expectations or "shoulds" of people who don't really know me or understand what is best for me. I'm happy because I'm taking care of myself, focusing on what is best for me, and choosing to do what I can to make my life the best it can be.

Sixth, I see myself as having arrived at a new plateau in my recovery. Plateaus are exciting places to be, because plateaus mean more growth is on the way. When I'm ready, I'll move on. But for now, I'm catching my breath. I'm enjoying the view. I'm reveling in the health I've attained and anticipating what lies ahead.

Seventh, I've realized that my ego has been through a refining, transforming process. I am no longer the needy, emotional black-hole of a person I was before recovery. I have no need to fear that the demon of my past self will suddenly reassert himself and ruin all the good that has occurred since I began recovery. Sure, I'll have setbacks and new issues to deal with, but I am a new person, with a new perspective on reality and on myself. I am becoming better and better each day.

I am fully focused on expressing love, rather than seeking love, and for me, that is the greatest happiness of all.

Thank You, God for the renewed sense of deep happiness in my life. Thank You for the awareness to see and know that my happiness comes from within me, through the power to take care of myself and through trusting that You are taking care of me, working out details, and that You desire for me to have an abundance of happiness. Thank You for teaching me how to express all the love that is within me.

next: Powerlessness

"The pain associated with this relationship has more to do with my fears then my love."

Who hasn't experienced the pain of love? Or is it the pain of rejection? The pain of self doubt? The pain of fear? It's important to distinguish between love and totally separate feelings.

When it comes to pain surrounding love, we're more likely referring to the "add-ons" of love. The love baggage, we might call it. For some reason, many people assume negative emotions are a part or element of love. But experientially we know this isn't true.

Love is not painful, it feels incredible. The pain and hurt we feel doesn't come from love, it comes from our doubts, fears, anxiety, perceived rejections, broken trusts, anger, jealousy, envy, etc. So why do we as a culture lump all those other feelings in with love?

Perhaps its because we feel these uncomfortable emotions most often in association with our love relationships. Our primary relationships are important to us, so we assume these doubts and fears are all part of the loving experience. But is this really true?

When we are fearful, angry, anxious, unhappy, or jealous, are we truly experiencing a state of love? They sure feel different, don't they? Love feels warm, open, joyous and filled with a deep sense of appreciation. Pain steps into a love relationship when you switch it from a "wanted relationship," into a "needed relationship." You don't NEED any one relationship. Want? Yes. Need? No.

If you go into a relationship not feeling terribly good about yourself, you're more likely to become dependent on your partner to help you feel good about yourself. If we felt empty before they appeared in our lives, we fear the emptiness returning if they leave, so their staying with us becomes paramount. That dependency can create all kinds of fear and unhappiness when there's a perceived threat to you staying together.

If we aren't giving ourselves the acceptance we crave, we look to those around us to provide it for us. Again, none of this has a thing to do with the love you feel, but everything to do with the fear you feel.

If you really want to remove the love baggage of fear and unhappiness, the first step is to improve your self awareness and self acceptance.

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next:Is What I'm Feeling Infatuation or Love?