Coping Skills for Self-Harm

Self-harm is often used as a way to cope with overwhelming emotions, but there are healthier and more sustainable ways to manage distress. This blog will explore a variety of alternative coping skills that can help regulate emotions, build resilience, and promote healing. Check out our blog from January to learn more about what self-harm looks like, why it happens, and first steps to support others (or yourself) going through it. 

Work to understand what is motivating the self-harm

Self-harm occurs for a variety of reasons, and knowing this may help in tailoring an approach to coping with the behavior moving forward. Often, there are patterns of “triggers” that lead to self-harm. Here are some common ones:

• Overwhelming emotions 

• Feeling numb 

• Self-punishment

• Outward expression of difficult, complex emotions 

• An effort to gain a sense of control over emotions/self

If you or a loved one experiences self-harm, the first step to coping is being curious about the triggers. From there, you can build a set of healthy coping skills to use in replacement of self-harm. 

Engage in valued behaviors

 One of the most common reasons for engaging in self-harm is as a method of distraction from overwhelming emotions. However, there are other ways to move away from the urge to self-harm and engage in behaviors and activities that are more helpful in the long term. 

• Step 1: Acknowledge that the urge to self-harm is present

• Step 2: Identify any noticeable emotions or triggers that are present

• Step 3: Redirect to an alternative activity, ideally something you enjoy or that takes you away from the urge to self-harm

Try something creative, or physically engaging that raises your heart rate. Think of 5 activities that you enjoy and find soothing, and keep them listed as coping skills. 

Try distress tolerance skills

Self-harm almost always includes some amount of distress; whether before, during, or after it occurs. These distress tolerance skills are specifically designed to provide a healthy distraction from high levels of distress. 

• Use a shock of temperature change by placing your face into a bowl of cold water, if you can’t access this in the moment, try running your hands under a cold tap and splashing some of the water onto your face or chest.

• Use an ice pack on your forehead or chest. Try holding an ice cube in your hand if you don’t have access to an ice pack. 

• Utilize intense exercise to get your heart rate up and move away from the experience of intense emotions

• Suck on a sour candy to redirect attention to the taste buds

• Use a strong scent, like peppermint or citrus, to redirect attention to your sense of smell

Use emotional regulation skills

These skills can help lower the intensity of the emotions

• Deep breathing or paced breathing: take 10 deep breaths, ensuring the exhale is longer than the inhale. Use paced breathing to time the intervals of your breathing 

• Paired muscle relaxation: tense and relax the muscles of each major portion of your body. Start from your legs and move your way up

• Grounding exercises: utilize your senses to redirect attention to your environment, as opposed to your emotions. Notice 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.

Express emotions safely

If self-harm serves the primary function of expressing emotions, consider other ways to create an outlet for these feelings. 

• Write your thoughts and experiences of your emotions in a private journal

• Open up to a trusted friend, family member, or mental health professional

• Express yourself through art, music, or other creative methods

Create a safety plan 

A safety plan is a personalized guide to look to when the urge to self-harm becomes present and/or overwhelming. Having a written plan can help outline alternative coping strategies in a clear and concise way. 

1. Recognize your triggers

1. Write down several of your most common triggers for self-harm

2. Are there specific thoughts, feelings, or situations that trigger self-harm?

3. Are there specific people, places, or memories that intensify your urges to self-harm?

2. Recognize the warning signs 

1. Identify early signs that you may be experiencing a crisis

2. Is there anything you can identify emotionally or physically that signifies a crisis?

3. Coping strategies

1. Try out several coping methods and find out which ones work best for you

2. List 3-5 of the most reliable coping skills in your safety plan

4. People to reach out to

1. Identify 2-3 people you can reach out to for support when you need it

5. Create a safe environment 

1. Do your best to remove or secure items that may be used for self-harm prior to when the urge arises

2. If you cannot remove the items, think about how you can make them less accessible

6. List your emergency contacts

1. If in immediate danger, who can you reach out to?

2. Crisis Text Line: Text HOME to 741741 (24/7 free support)

3. National Suicide Prevention Lifeline: Dial 988 (U.S.)

4. Self-Injury Outreach & Support (SIOS): sioutreach.org

Coping with self-harm can feel overwhelming and isolating. Strong coping skills are a good way to help in the moment, but consider reaching out for long-term support as well. Resources like a strong support system, individual therapy, and group therapy are some of the ways to address the origin of self-harm and work towards long-term healing. It takes courage to recognize and address self-harm, and you don’t have to do it alone. Healing is possible, one step at a time. 

- Claire Adams, LSW Staff Therapist