How to manage or prevent a self-harm relapse

Some people turn to self-harm — also called nonsuicidal self-injury (NSSI) — to cope with emotions like sadness, anger, or frustration. Others might do it to regain a sense of control, numb their pain, or escape distressing thoughts. Self-harm can take many forms, like skin cutting, burning, scratching, and hitting oneself. And when someone who previously stopped self-harming returns to these behaviors, it can be called a self-harm relapse. 

Relapses can happen for various reasons, including increased stress, addictive features like irresistible urges to self-harm, traumatic flashbacks, or substance use. Relapsing during the recovery process is common but doesn’t indicate failure.

If you or someone you care about is self-harming, know that you’re not alone. The first step toward healing is getting help. A therapist can support you in developing safer, more effective coping strategies.

How to prevent self-harming again

If you’ve self-harmed in the past but are working toward healing, it’s important to remember that recovery isn’t always a straight line and setbacks can happen. Mental health is a lifelong journey — and relapse can be part of it. Even though it can feel discouraging, it’s not a sign of failure. And with the right support, you can get back on track. 

Consider these steps: 

• Reach out for support: Talk to someone you trust, like a friend, family member, or therapist. If you don’t feel comfortable talking, you can try texting a crisis line for anonymous support.
• Reevaluate your coping strategies: A relapse could mean your current coping strategies aren’t fully supporting your goals. Try exploring new approaches, like self-care, physical activity, or relaxation exercises, to better support your well-being.
• Reflect on your goals: Think back to why you wanted to stop self-harming in the first place. Maybe it was to protect your health or to find more sustainable ways to cope with negative emotions. Reflecting on this goal can re-motivate you to stop self-harming. 
• Create a safety plan: The free Safety Plan app for smartphones helps people who self-harm  create a personalized safety plan they can share with loved ones. It also allows users to set personal goals, track progress, and explore different coping strategies to manage stress.
• Use distraction techniques: If you feel the urge to self-harm, distraction can help redirect your focus. Many people find that delaying the urge — even for a few minutes — can help it pass. To make distraction more effective, try matching the distraction activity to your current emotion, whether it’s anger, sadness, depression, or guilt. 
• Try grounding techniques: Practice deep-breathing exercises (inhale for four seconds, hold for four, exhale for four) or practice the 5-4-3-2-1 technique (list five things you see, four you touch, three you hear, two you smell, and one you taste). 
• Express emotions through journaling: If self-harm has been a way to release emotions, try putting them into words instead. Journaling can help you process feelings and recognize emotional patterns leading to self-harm.

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What a self-harm relapse could mean

Experiencing a self-harm relapse is a common part of recovery. It can happen for many reasons, including stress, negative emotions, or substance use. Sometimes, a major life event, like a divorce, or death of a loved one, can trigger a relapse — even after a long period without self-injury.

In addition to meeting with a therapist trained in self-harm behaviors, there are steps you can take to reduce the risk of relapse:

• Treat co-existing mental health challenges: People who self-harm often experience co-occurring mental health conditions like depression, anxiety, borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), substance use, and eating disorders. When these conditions go untreated or aren’t properly managed, the risk of relapse can increase. 
• Find a support system: Feeling disconnected or socially isolated can increase the risk of relapse. Stay connected with supportive friends and family members who support and uplift you. Consider joining a virtual support group for self-injury recovery, like those offered by the nonprofit Self-Injury Recovery and Awareness.
• Understand your triggers: Reflect on what self-harm provides for you emotionally. Are you using it to cope with reminders of past trauma, grief, or stress? Are looming deadlines or workplace conflicts making you more prone to self-harm? Identifying your triggers allows you to manage them in healthier ways.
• Pay attention to your needs: Remember to check into your mental space throughout the day and take care of your needs. Being in an emotionally flooded headspace can make you more vulnerable to relapse. Tuning into your emotional needs can help you avoid self-harming. 
• Practice self-care: Neglecting your physical health, like sleep, nutrition, and exercise, may contribute to relapse. Prioritizing self-care helps build resilience and emotional well-being.
• Set realistic expectations for yourself: Expecting recovery to be quick and easy can lead to frustration. Celebrate the progress you’ve made — no matter how small — and remind yourself that setbacks don’t define your journey.

What to do after a self-injury relapse

Therapy can be a powerful tool in preventing and recovering from a self-harm relapse, in addition to providing support, coping strategies, and a safe space to process emotions. In some cases, medication may also be recommended.

Several types of therapy are shown to help people who self-harm, including:

• Dialectical behavioral therapy (DBT): DBT is one of the most effective treatments for self-harm. It’s especially helpful for those with borderline personality disorder (BPD) or who have difficulty regulating emotions. It teaches mindfulness, how to recognize triggers, and healthier coping mechanisms. DBT also helps you challenge negative thoughts and improve communication so you feel heard and understood. 
• Cognitive behavioral therapy (CBT): CBT helps identify and reframe negative beliefs and behaviors, replacing them with more effective coping strategies. 
• Compassion-focused therapy (CFT): This approach to therapy can help if low self-esteem, shame, or self-criticism contribute to self-harm. Through visualization and mindfulness techniques, it encourages shifting from self-judgment to self-compassion.
• Eye movement desensitization and reprocessing (EMDR): Trauma-focused therapy, like EMDR, can be effective if self-harm is in response to past trauma. This type of therapy can help process distressing memories in a safe space, reduce emotional distress, and provide tools to manage overwhelming emotions.

Find care with Rula

If you or someone you care about feels trapped in the cycle of self-harm, help is available. Talking with a therapist can uncover and address the underlying issues that trigger self-injury. If self-harm is a recurring struggle, therapy can provide the support and coping strategies needed for lasting recovery.

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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