Help for self harm
Help from professionals
Many people who self harm recover and don't self harm again. Doctors, psychologists and other professionals can help in many ways. However, many professionals find self harm difficult to understand and you may feel misunderstood. It can help if you are able to find an understanding professional or if you give the professional some addresses of organisations that provide information and advice on people who self harm.
Professionals can help you by providing:
Support, practical help to deal with the situations that led or could lead to self-harm, help understanding the thing that lead you to harm and your motivation for self-harm , an evaluation of the short term risk of suicide, psychiatric assessment to identify mental health difficulties, treatment of mental health difficulties, access to talking therapies such as cognitive behavioural therapy and psychotherapy, access to problem solving therapy/training
There are a number of therapies offered both by the NHS and privately that have proved successful in reducing and stopping self harm
- Cognitive behavioural therapy
- Cognitive analytic therapy
- Psychotherapy
- Medication
- Dialectical behavioural therapy
- Interpersonal group therapy
(The last two are for people with a diagnosis of borderline personality disorder).
Talking treatments
Ultimately talking therapies are better in the long term and often deal with the root cause and not just management of the symptoms. Talking treatments
Medication
Research into the effects of medication on self harm is patchy in many areas and often done on people with learning difficulties in which the motivation for self harm may be different and who often represent a minority of people who self harm. Two of the most researched drugs are naltrexone and naloxone. However, there is conflicting evidence as to their use in treatment of self harm. Medication
There is some evidence that atypical antipsychotics may have some role in treating self harm. Case reports indicate that clozapine, risperidone and olanzapine can reduce self harm in individuals although there are no well-controlled studies of these drugs in the treatment of self harm.
There is also limited evidence that the mood stabilisers carbamazepine and valproate can reduce self harm, and a class of antidepressants known as SSRIs in high doses can be effective.
Most people find stopping self-harm is very difficult. Even if stopping completely is too hard at the moment there is plenty you can do to increase your control over your self-harming behaviour
What can I do to help myself?
Stopping self harm is difficult. The first step is to decide that you want to stop. Thinking about it for the first time, you may see more reasons not to stop and decide that the time is not yet right. Perhaps keep a list of reasons for and against self harm. Often people need a good support network before they can think about stopping.
Deciding to stop
Everybody is unique and what works for one person may not necessarily work for another. Here are some suggestions of things you can do to help yourself gain control over your self-harm and in time these might help you stop completely.
Most of these suggestions are based on the ideas that self-harm is usually a coping mechanism to express distress that you can't find another way of expressing, and that self-harm is often a result of you feeling helpless and out of control over your life.
By finding different ways to express distress and by exercising choice you are loosening the grip of self-harm. Try experimenting with different ideas to find things that help you. For example:
- seek social support from friends and family
- talk to someone who understands what you are going through, this could be a friend, a relative or another person who self-harms
- find other ways to express feelings and relieve tension, such as hitting something, writing, drawing or doing sport
- do anything but self harm, such as doing things that cause intense sensation, such as biting into ginger or squeezing ice. The important thing is that it causes intense sensations, perhaps even pain for a brief time, but does not cause lasting harm
- try to delay self-harming for a short time (e.g. start with 15 minutes and gradually increase this time)
- get up and go round to a friend or relatives house
- do something soothing such as having a hot bath with bath oil or make a hot cup of cocoa and snuggle under the duvet
- do something practical, like write a letter to a friend, choose a random object and think of 30 different uses for it
Before you cut...
Try to ask yourself the following questions and give answers:
Why do I feel I need to hurt myself?
What has brought me to this point?
Have I been here before?
What did I do to deal with it?
How did I feel then?
What I have done to ease this discomfort so far?
What else can I do that won't hurt me?
How do I feel right now?
How will I feel when I am hurting myself?
How will I feel after hurting myself?
How will I feel tomorrow morning?
Can I avoid this stressor, or deal with it better in the future?
Do I need to hurt myself?
Staying safe when cutting
Not sharing cutting implements with other people - many diseases including HIV/AIDS can be transmitted this way;
Trying to keep cuts shallow;
Making sure you have first aid supplies and know some first aid;
Making sure you know what to do in an emergency (e.g. dial 999 if you need an ambulance)
Before you self-harm set yourself limits - deciding how many cuts or burns or bruises and how big they will be - and set these limits so that they are just enough to relieve your distress but no more.
