What to do instead of self-harm

It’s normal to need a release when you experience uncomfortable, challenging, or painful emotions. After a negative work performance evaluation, for example, you might go for a long run. Or you might vent to a friend about your partner’s upsetting behavior. These are all healthy responses to emotions that can be difficult to handle. 

However, some people turn toward self-harm. Self-harm is when you physically hurt yourself on purpose, like banging your head or burning your skin. This is an unhealthy — and often harmful — way to cope with upsetting emotions. It’s important to note, however, that people who engage in self-harm usually aren’t trying to attempt suicide.*

Around 5% of adults self-harm during their lives, and between 35% and 50% of those are people assigned male at birth. About 15% of college students intentionally hurt themselves. And 17% of adolescents also engage in this behavior. 

If you self-harm, it’s important to learn and rely on healthy alternatives. Know that you can live a life free from self-harm, and the support of a therapist can make all the difference. 

*The 988 Suicide and Crisis Lifeline offers 24/7 confidential support through trained crisis counselors. If you or someone you care about is experiencing emotional distress, self-harm, or a suicidal crisis, please call or text 988. For life-threatening emergencies or immediate assistance, call 911. 

How to handle the urge to self-harm

It can be difficult to resist the urge to self-harm. Often, people feel good right after they self-harm, which can make the urge to do it again stronger. It might also be difficult to identify what to do  instead of self-harm.  

This behavior might also confuse you. If you or a loved one self-harms, you might not completely understand where the impulse comes from. It can help to learn why you self-harm because it can help you better manage it. 

Some common reasons why people might engage in self-harm include to:

• Release strong emotions: Did you know that emotional pain can build up in your body? You might feel like the only way to get rid of intense emotions is to cause yourself physical pain. 
• Feel emotions: Sometimes, people who self-harm feel numb or have trouble accessing their emotions, which can be uncomfortable. Physical pain can be a temporary antidote to this discomfort. 
• Be in control of emotions: Self-harm can be a way that people seek control in their lives. This can be especially powerful for people who feel like they can’t make choices about their own lives.
• Discipline themselves: Sometimes, people use self-harm to punish themselves, like after a perceived social faux pas or mess-up at work.

Self-harm can become addictive because it can make you feel better temporarily. Even though it usually causes bodily injury, it can provide a brief sense of emotional relief. Over time, you might begin to feel like the only way to relieve difficult emotions is with self-harm. 

But there are replacements for self-harm. It may be easiest to first take a small step away from self-harming. For example, you can hit a pillow and imagine that you’re hitting yourself. Or you can draw on your skin with markers if you usually cut your skin. Sometimes, distracting yourself with alternatives like these is enough for the urge to self-harm to pass.

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Alternative coping strategies to replace self-harm

However, having alternative forms of coping with the same distress that may have led you to self-harm in the past is essential. You might use these options to lean on when the urge to self-harm is especially strong or long lasting. 

Here are some alternatives to self-harm that can help in most situations you might find yourself in:

If you feel angry or frustrated, try:

• Playing distracting or loud music 
• Squeezing a ball
• Hitting a cushion
• Tearing up something, like paper or a magazine
• Squeezing then relaxing your muscles
• Writing or drawing what’s making you angry and then tearing it up

If you feel sad or scared, try:

• Placing a weighted blanket on top of you
• Cuddling with a pet 
• Playing calming music
• Writing down your feelings
• Talking with a trusted friend and sharing your feelings
• Talking with a therapist
• Practicing deep breathing
• Practicing relaxation exercises
• Crying 
• Sleeping

If you feel out of control, try:

• Cleaning dishes
• Organizing your room
• Engaging in a creative activity, like coloring or dancing
• Gardening

If you feel numb or disconnected, try:

• Doing something that brings you back to your senses, like putting ice on your face or smelling a strong odor
• Practicing mindfulness exercises
• Holding objects that have different textures and focusing on how they feel
• Massaging the part of your body that you want to hurt

If you feel guilty, try:

• Reminiscing on a happy memory
• Writing down things you like about yourself, like accomplishments or personal characteristics 
• Writing down negative thoughts you’re having and rewriting them in a positive and helpful way

Preventing future self-harm with treatment

If you find yourself controlled by self-harm urges or falling back into this behavior after attempting to stop, you might need professional support, and that’s OK. Self-harm can be challenging to manage by yourself.

Effective professional treatments for self-harm include:

• Cognitive behavioral therapy (CBT): CBT is a type of talk therapy. It helps people recognize their negative and untrue thought patterns and reframe them in a positive and accurate way. With CBT, a therapist can help you recognize what thoughts may trigger you to self-harm and how to change them.
• Dialectical behavior therapy (DBT): DBT has been shown to reduce self-harming behavior. At its core, DBT helps people learn emotional regulation. You may rush to self-harm because it temporarily helps you feel better. DBT can help you slow down, process your feelings, and manage them effectively. By that time, the urge to self-harm may pass.
• Psychodynamic therapy: With psychodynamic therapy, a therapist helps you explore how your experiences influence how you behave now. For example, you may have some unprocessed experiences that cause you to engage in self-harm. 

Find care with Rula

Self-harm can be a way to help you deal with difficult or distressing emotions. But this behavior is also dangerous because of the physical pain, potential damage from the behavior, and cyclical nature of self-harm. While self-harm can be hard to stop, support is available. 

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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