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Advice: self-harm

February 01 2023
Some suggest drawing a butterfly on the place you want to harm. © Graham Milldrum Some suggest drawing a butterfly on the place you want to harm. © Graham Milldrum
Our mental health nurse looks at how to address the problem

Metal health nurse Chrissie Clark looks at how to address self-harm.

Why do people self-harm?

Self-harm is a physical response to emotional pain. It can include anything from cutting yourself to abusing drugs and alcohol to not eating enough, overeating or even eating the wrong foods. This type of behaviour can be highly addictive, and it’s important to recognise when you need help and how to access that support as soon as possible.

Self-harm can often happen when someone feels strong feelings of anger, sadness, anxiety or low self-esteem, and can often be perceived as an act of self-punishment. But what causes someone to self-harm in the first place differs from person to person. It could happen following an argument or a feeling of rejection. It may also come after a situation that has left you feeling humiliated, upset or angry. It may sometimes be a sign of an underlying mental health problem, which may need treating. Seeking help as soon as you can is very important.

How can I help myself?

Making changes can be difficult and can take time. In my experience as a mental health nurse, it may be common for people to make progress and then return to old behaviours – REMEMBER: this is not failing; rather, it’s all part of a process. If you feel as though it may be impossible to stop self-harming, then perhaps you may find it helpful to work on reducing the frequency or consider what you can do to work on the anxiety or feelings that make you want to self-harm in the first place.

Some tips to help you along

Keeping a diary can be helpful to understand any urges and patterns you have before, during and after self-harm behaviour. It can help to identify certain ‘triggers’.

Recognise triggers: these are the things that urge you to self-harm. Examples could include certain people, situations, or particular thoughts or feelings. In your diary, write down what was happening before you self-harmed, for example, an argument that may have taken place or particular thoughts or feelings that you were having at the time.

Identify the urges: it’s important to recognise how you experience the urge to self-harm. Urges can come in lots of different ways, for example: increased heart rate; feeling sick; feeling removed from your body and feelings of sadness or anger

Distraction and alternatives: a distraction, like hitting a cushion or writing a list, provides something else to focus on and another way of expressing your feelings. This can help reduce the intensity of your urge to self-harm.

When you feel like harming yourself here are some distractions and alternatives that you may find helpful:
•  Hitting cushions instead of objects, shouting loudly or screaming into a pillow
•  Dancing to loud music
•  Tearing up a piece of paper or fabric into lots of pieces
•  Write a letter saying everything you are feeling and burn it
•  Clench then relax all your muscles
•  Flicking elastic bands on your wrists
•  Holding an ice cube against your skin
•  Eating something with a strong taste like chilli or peppermint
•  Having a cold shower or splashing your face with cold water.

To help relax you when feeling anxious you may want to try:
•  Taking a long walk
•  Allowing yourself to cry
•  Listening to calming music.

Look after your general and overall wellbeing. Make sure you are taking regular walks and paying close attention to your nutrition. Sleep is also very important.

Ask for help. Taking the steps to ask for help can be difficult. It is important to talk to someone you trust and feel safe with, a friend or family member, a counsellor or a healthcare professional.

Support and treatment

Contact your GP: In order to access professional help, the first step is to visit your GP.

They will be able to assess your current safety, inform you about treatment options and refer you to a specialist. Remember: if you are not registered, there are centres in most cities who work with homeless people with no fixed address – see the List for details.

Talking treatments are carried out by therapists or counsellors who are trained to listen in a confidential and non-judgmental way. They will explore your feelings, thoughts and behaviour, and begin to look at making positive changes. Many talking treatments are free on the NHS and your GP will know how to access these/make a referral.

Support groups: These allow people who are experiencing similar experiences to meet and share useful tips on how to cope. Ask your support worker about finding out more.

Online support: Many people I work with can sometimes find talking face-to-face with someone quite intimidating and may prefer to access online support. Online support offers confidential email and text support. You can access the internet in many day centres and libraries.

Useful numbers and websites

The Basement Project
01873 856 524;
Information and support about self-harm and childhood abuse.

User-led organisation for people who self-harm, friends and families.

National Self Harm Network (NSHN)
Survivor-led forum for people who self-harm, friends and families.

Rehab 4 Addiction
We offer guidance and support for people experiencing problems with substance misuse and co-occurring mental health problems.

Freepost RSRB-KKBY-CYJK, Chris, PO Box 90 90, Stirling, FK8 2SA;
24-hour helpline: 116 123 (free);;
24-hour emotional support for anyone feeling isolated, distressed or struggling to cope.

0845 767 8000;
Support and information about mental health problems including online support.

The Site
Support for people aged 16–25.

OK Rehab
OK Rehab specialises in local drug and alcohol rehab and addiction treatment.