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Self harm Self HarmCopingstrategiesCoping StrategiesGloucestershireHarmGloucestershire SelfSelf HarmHelpline ServiceHelpline

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People can self harm for different reasons. It may be to deal withdifficult feelings1 or to give someone release or escape.2 Somemay find the physical pain of self harm distracts them from theemotional pain they are feeling.3 For some they may need to selfharm to let other people know how they are feeling.4 Others mayfeel it is the only way to feel in control of their body 5 or to punishthemselves because they feel guilty.Learning of different ways to cope with these feelings can help instopping the urge to self harm. 6Beating the urge to self-harm can be an uphill struggle. You mayhave to work hard to start using different ways of dealing withdifficult feelings. 7 But doing this is an important step towardsrecovery.Some people may find distraction or coping techniques one way tohelp delay or avoid self-harm. You need to find out what copingstrategies work for you. You will need to have a few differentstrategies you can use depending on how you are feeling. Thesame technique may not work for every time.It may be helpful to match your coping strategy with how you arefeeling. For example you may want to do something thatcomforts you if you feel low or release energy if you feel angry.This booklet goes through some different things you can try tohelp cope with the urge to self harm. It goes through how todistract yourself, how to do something that makes you feel betteror give yourself strength.This is not a therapy book and doesn’t replace treatment. But itmay be useful for you to put some alternatives to self harming inplace. There are treatments available for self harming so talk toyour doctor if you want to find out more about these.www.rethink.org Rethink 20145

How to distract yourself from how you are feelingYou can try and distract yourself because it will give you some time to think aboutwhat you want to do or how you are feeling. 8,9,10 Draw on the area you would liketo self-harm with a red pen or usefake blood or food colouring tosimulate self-harm Bite into a chilli Put an elastic band or severalelastic bands around your wristand ping them to cause a stingingsensation Put red food dye in ice cubesand then grip them to causenumbness and have red dyereleased4 Wax your legs Put warm candle wax onyourself and then peel, rubor scratch it off Make a lot of noise such asplaying the drums, playing musicloudly or banging pots together Splash cold water on your face Cut into fruit such as a grapefruitor bananawww.rethink.org Rethink 2014

Release energy ortensionIf you feel angry or upset you mayfind it useful to do something thatwill release energy. 11 Kick a football or throw a ball ata wall Do exercise such as go to thegym, go for a walk or run Smash a watermelon or an icecube off the wall Hit a pillow or punch bag ashard as you can Squeeze a stress ball Play loud music and dance a lot Tear up paperwork, fabric,material or phone books Scream as loud as you caninto an empty room or pillow Make a play-doh model ofyourself or of somethingelse and then smash it up Do yoga or tai chi Play a computer game such asthe Wii fit or Play Station Pop bubble wrap Write all over a magazine orphotos Stick pins in a pin cushion Draw faces of people you areangry with on balloons and popthem Rethink 2014 www.rethink.orgBe creativeIf you feel low, empty or lost you mayfind doing something creative can helpby distracting you and by doingsomething that you enjoy. 12 Create something that is likehow you are feeling, you candraw, paint, or use clay to dothis Write a poem, song, joke, orplay about how you feel Take some photos of things thatyou like Create your own cartooncharacters Sing to music or play instruments Make beaded braceletsor other jewellery Write a blog or an online journal Sew, knit or cross stitch,you can get tutorialsonline Change your room or homearound, paint rooms or movefurniture into different positions Write in a diary or journal Get a box and fill it with thingsthat make you good, thesecould be photos, music, notes,cards, trinkets Write a different ending to yourfavourite film Write out what you want to sayto someone then rip it up intotiny pieces5

Talk about how you feel13 Call a helplineThings to make you feel morecomforted and relaxed Call a friend Call your support networks Use online supportWork out how you feel and thenlet it go Write words about how you feelover and over again to release it Imagine a colour or shapethat is like how you feel, thentry to turn this into a differentcolour or shape Make a list of things youfeel are happy with orpleased about Write a list of pros and cons ofself harm, how it helps you andwhy you don’t want to do itanymore When you feel in a good placewrite a list or a letter aboutwhat is good about you, read itwhen you feel like self harming Write a list of things you areproud of in your life, thismonth, this day Ask yourself “What am I feeling?”and then “Why?”6 Have a bath or shower Have a massage Paint your nails or haveyour hair done Hold toys or pets in your arms Buy yourself something special Eat something you really like Watch your favourite film, justnot a tear jerker! Have a nap Make yourself something niceto eat Wrap up in blankets Listen to your favourite feelgood songs Buy or make a recoverybracelet Mediate or use relaxation Light some incense Sit in the park or outside andpay attention to nature, listen tothe sounds, really look atplants or flowers, look at theclouds.www.rethink.org Rethink 2014

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Start a task or do something Go out to see someoneyou like Listen to jokes or comedy Clean your room or house Cook something you havenot cooked before Go online to a chat room or blog Watch TV Read a book Play a game on your phonesuch as Candy Crush Learn something new from alocal centre or using onlinetutorials such as origami Write yourself a to do list Research something you don’tknow much about Listen to a podcast such asNo Such Thing as a Fish,Answer Me This! or Oh No,Ross and Carrie! Do some gardening Make a paper chain and adda new chain each time youdon’t self-harm Skateboard or rollerblade Go for a day out such as thezoo, the park, museums etc. Go for a swim, walk or drive Make a t-shirt using transfersor patches Have a spring clean and givethings you don’t want to charity Read an inspirational blog8 Go shopping Wash your car Make a list about what positivechanges you have made in yourlife

Give yourself timeWhen you feel like self harming giveyourself a bit of time before you do it.This will allow you a chance to not actimpulsively. Keep things you harm yourselfwith in a locked cupboard or in abox with Sellotape around it.When you are taking the tape offyou have time between wanting toself-harm and doing it. Phone Rethink GloucestershireSelf-harm Helpline. Come upwith some strategies abouthow to not self harm. Agree tocall them in an hour or two andtell them how it went. All the suggestions wealready discussed can beusefultodelayselfharming. Wait 10 or 15 minutes to decideif your urge to self harm is stillas strong. You can decide whatto do at this point.When the feelingwears off I feelFor example:I self harm because it makes me feelcalmer for a while.When the feeling wears off I feelworried because I have gone too far.Below are some of the things youcould be feeling: “I’ve managed for two weekswithout harming. I don’t want tostart again” “Once I start it’s difficult to stop” “It doesn’t help in the long run. Ican self harm now but I’ll need todo it again in a couple of days. “I don’t want to end up in hospital” “If I can hang on the need to selfharm sometimes passes” “There may be consequences Idon’t want e.g. brain damage,paralysis” “I will feel bad if I self-harm now”Reasoning with yourselfWhen you’re not feeling like selfharming, write out why you selfharm and why you don’t want toself harm. This list will be differentfor each person, it’s whatevermakes sense to you. It may behelpful to look at the list when youfeel like self harming. Answer thequestions below.I self harm because it makes mefeel for awhile. Rethink 2014 www.rethink.org10

Making yourself safe Try to work out situations thatmake you feel like self harming.Once you’ve done this you cantry and avoid them or preparefor them Try avoiding things that youmight use to harm yourself Stay with a friend Ask your GP to give you aweekly prescriptions or pick upmedication for two days at atime from the chemistRewarding yourself fornot self-harming Keep a chart – add a star foreach day or hour you have notself-harmed. If you do self-harm,just leave a space and start again Call a helpline or a friend andtalk about positive times whereyou have managed to not selfharm. This stops the focus fromalways being on the negative Don’t buy lots of tablets, ifyou notice this is happeningflush them away or givethem to someone to hold foryou until you feel better11 Rethink 2014 www.rethink.org

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Questions to ask before you self-harmIf you can recognise the triggers or thoughts involved in the build upto self-harm, you may be able to use alternative coping strategiesbefore the urge gets too strong.Try asking yourself the following questions. Why do I feel I need to hurt myself? What has happened that I feellike this? Have I felt like this before? How did I come out the other sidethe last time? Can I do that again now? Is there anything else I can do to get rid of this feeling that doesn’tmean I will hurt myself? How does self-harming make you feel? If it makes you feel incontrol, think of things you could do to get the same feeling but withouthurting yourselfThings to do before you self-harm Remind yourself: I’ve been though painful situations before and I survived I am strong enough to get through this This is a horrible feeling but it will go away Write down things you like about yourself and why you want to stopself-harming so you can review it at times you’re feeling low The 15-minute rule – if you’re feeling the urge to self-harm, give yourself15 minutes before you do. Distract yourself by going for a run or writingdown your feelings. When the time’s up, see if you can extend it byanother 15 minutes. Try to keep going until the urge subsides Visualisation - try to picture the urge as an emotional wave you can surf.Imagine it reaching a crescendo then breaking as you successfullyresist its force Rethink 2014 www.rethink.org13