One of the traits of many emotional disorders is the consistent use of self-injury as a response to stress and associated painful emotions. It has become especially prevalent among teenagers and young adults. If you self-injure, you will choose from an array of methods, but each has the same effect: self-injury causes bodily pain, which simultaneously distracts you from the overwhelming emotional pain and causes a sudden release of endorphins in your brain. The physical pain is predictable and controlled – you decide what kind and how much pain to inflict. This control factor is very important, since it, along with the presence of endorphins, makes the self-inflicted pain bearable.
Because self-injury is an effective means of dealing with out-of-control emotions, you will probably continue to use it once you have started. Over time, self-injury becomes an addiction. You will harm yourself more frequently and more intensely, just as a drug addict increases the frequency and potency of drug use.
Experience treating other types of addictions has revealed that a person cannot and will not relinquish an addiction unless he or she has other coping mechanisms to replace the unhealthy habit. If you self-injure, you need to learn how to cope with your emotions in order to stop the self-harming behavior.
A simple and highly effective strategy for preventing self-injury is breathing through the emotion that is causing difficulty. You may feel that an emotion such as fear, anger or sadness is consuming you. Sensations throughout your body are enhanced, your nerves become hyperactive, muscles tense, your heart races. Slow, careful breathing calms the entire system, dispersing the excess energy as you exhale. Breathing five counts in and ten counts out is often a good ratio. The goal is to continue this slow breathing until the emotion fades to manageable levels. It will not go away, of course, and that would not be desirable anyway. You just want it reduced in intensity so it no longer controls you.
A second, similar strategy for preventing self-injury is self-soothing. In this technique one or more of the five senses is used to draw attention from the intense emotion. Often this is done with a pleasant or relaxing sight, sound, or smell. However, sometimes a sensation that is not entirely pleasant (the sharp smell of a chemical, cubes of ice held in the hand) is more effective. You should have some method of self-soothing immediately available no matter where you go. This may be an mp3 player with your favorite music, a photograph of a person or a beautiful landscape, or perhaps hand lotion with a calming scent. When you feel emotions starting to rise, get out your self-soother and focus your attention upon that sight, sound, smell, etc. If slow breathing is used simultaneously the results will be especially good!
Third, it is helpful to have a “mantra,” a phrase or sentence, that you can repeat to yourself over and over whenever the urge to self-injure arises. A slogan heard in 12-step settings is “this too shall pass,” and it is very applicable to self-injury. If you repeat the slogan until the emotion starts to fade – again, you can combine this with one or both of the first two strategies – you will find that the urge does pass. Find a mantra that appeals to you and use it consistently.
Fourth, make a crisis card for times when self-injury seems the only way to cope. You should carry this with you at all times too. Start with a large (4”x6”) index card and fold it in half. On one of the outer sections, write five reasons why it would be better not to harm yourself. Open the card, and on the inner left side write five positive statements about yourself. On the inner right side, list ways you can reward yourself if you avoid self-harm. Then, when you get past the impulse, pick a reward! Finally, on the outside make a list of people and places to call for help. These may include friends, family, doctor, therapist, crisis hotline, or hospital. Make sure you have at least five. When you get into a difficult situation and the other strategies are not working, do not hesitate to call one of these numbers. That’s why they are there.
These are relatively simple methods for avoiding the common dilemma of self-injury. But don’t be deceived – they may be simple, but they are not easy. First, you must learn to recognize when your emotions are getting out of control. Second, you must have the will and desire to learn a new way to cope. You may find yourself in an internal struggle between the part that wants to change and the part that is afraid. This is normal, and if you persist, it too shall pass! Give yourself the time you need, and you can learn the skills to avoid self-injury.