Coping skills: Lesson one **Trigger warning SH**

Self-harm can be a way of coping with problems. It may help you express feelings you can’t put into words, distract you from your life, or release emotional pain. Afterwards, you probably feel better—at least for a little while. But then the painful feelings return, and you feel the urge to hurt yourself again. If you want to stop but don’t know how, remember this: you deserve to feel better, and you can get there without hurting yourself.

Understanding cutting and self-harm

Self-harm is a way of expressing and dealing with deep distress and emotional pain. As counterintuitive as it may sound to those on the outside, hurting yourself makes you feel better. In fact, you may feel like you have no choice. Injuring yourself is the only way you know how to cope with feelings like sadness, self-loathing, emptiness, guilt, and rage.

The problem is that the relief that comes from self-harming doesn’t last very long. It’s like slapping on a Band-Aid when what you really need are stitches. It may temporarily stop the bleeding, but it doesn’t fix the underlying injury. And it also creates its own problems.

If you’re like most people who self-injure, you try to keep what you’re doing secret. Maybe you feel ashamed or maybe you just think that no one would understand. But hiding who you are and what you feel is a heavy burden. Ultimately, the secrecy and guilt affects your relationships with your friends and family members and the way you feel about yourself. It can make you feel even more lonely, worthless, and trapped.

Myths and facts about cutting and self-harm
Because cutting and other means of self-harm tend to be taboo subjects, the people around you—and possibly even you—may harbor serious misconceptions about your motivations and state of mind. Don’t let these myths get in the way of getting help or helping someone you care about.
Myth: People who cut and self-injure are trying to get attention.
Fact: The painful truth is that people who self-harm generally do so in secret. They aren’t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.
Myth: People who self-injure are crazy and/or dangerous.
Fact: It is true that many people who self-harm suffer from anxiety, depression, or a previous trauma—just like millions of others in the general population. Self-injury is how they cope. Slapping them with a “crazy” or “dangerous” label isn’t accurate or helpful.
Myth: People who self-injure want to die.
Fact: Self-injurers usually do not want to die. When they self-harm, they are not trying to kill themselves—they are trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-injure have a much higher risk of suicide, which is why it’s so important to seek help.
Myth: If the wounds aren’t bad, it’s not that serious.
Fact: The severity of a person’s wounds has very little to do with how much he or she may be suffering. Don’t assume that because the wounds or injuries are minor, there’s nothing to worry about.

Signs and symptoms of cutting and self-harm

Self-harm includes anything you do to intentionally injure yourself. Some of the more common ways include:

cutting or severely scratching your skin
burning or scalding yourself
hitting yourself or banging your head
punching things or throwing your body against walls and hard objects
sticking objects into your skin
intentionally preventing wounds from healing
swallowing poisonous substances or inappropriate objects
Self-harm can also include less obvious ways of hurting yourself or putting yourself in danger, such as driving recklessly, binge drinking, taking too many drugs, and having unsafe xes.



Warning signs that a family member or friend is cutting or self-injuring
Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury can be hard to detect. However, there are red flags you can look for (but remember—you don’t have to be sure that you know what’s going on in order to reach out to someone you’re worried about):

Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
Blood stains on clothing, towels, or bedding; blood-soaked tissues.
Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.
Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
Needing to be alone for long periods of time, especially in the bedroom or bathroom.
Isolation and irritability.

How does cutting and self-harm help?
In your own words
“It expresses emotional pain or feelings that I’m unable to put into words. It puts a punctuation mark on what I’m feeling on the inside!”
“It’s a way to have control over my body because I can’t control anything else in my life.”
“I usually feel like I have a black hole in the pit of my stomach, at least if I feel pain it’s better than feeling nothing.”
“I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”
It’s important to acknowledge that self-harm helps you—otherwise you wouldn’t do it. Some of the ways cutting and self-harming can help include:

Expressing feelings you can’t put into words
Releasing the pain and tension you feel inside
Helping you feel in control
Distracting you from overwhelming emotions or difficult life circumstances
Relieving guilt and punishing yourself
Making you feel alive, or simply feel something, instead of feeling numb
Once you better understand why you self-harm, you can learn ways to stop self-harming, and find resources that can support you through this struggle.

If self-harm helps, why stop?
Although self-harm and cutting can give you temporary relief, it comes at a cost. In the long term, it causes far more problems than it solves.
The relief is short lived, and is quickly followed by other feelings like shame and guilt. Meanwhile, it keeps you from learning more effective strategies for feeling better.
Keeping the secret from friends and family members is difficult and lonely.
You can hurt yourself badly, even if you don’t mean to. It’s easy to misjudge the depth of a cut or end up with an infected wound.
If you don’t learn other ways to deal with emotional pain, it puts you at risk for bigger problems down the line, including major depression, drug and alcohol addiction, and suicide.
Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.

The bottom line: self-harm and cutting don’t help you with the issues that made you want to hurt yourself in the first place.
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Help for cutting and self-harm

Find new coping techniques
Self-harm is your way of dealing with feelings and difficult situations. So if you’re going to stop, you need to have alternative ways of coping in place so you can respond differently when you start to feel like cutting or hurting yourself.

If you cut to express pain and intense emotions
Paint, draw, or scribble on a big piece of paper with red ink or paint
Express your feelings in a journal
Compose a poem or song to say what you feel
Write down any negative feelings and then rip the paper up
Listen to music that expresses what you’re feeling
If you cut to calm and soothe yourself
Take a bath or hot shower
Pet or cuddle with a dog or cat
Wrap yourself in a warm blanket
Massage your neck, hands, and feet
Listen to calming music

If you cut because you feel disconnected and numb
Call a friend (you don’t have to talk about self-harm)
Take a cold shower
Hold an ice cube in the crook of your arm or leg
Chew something with a very strong taste, like chili peppers, peppermint, or a grapefruit peel.
Go online to a self-help website, chat room, or message board

If you cut to release tension or vent anger
Exercise vigorously—run, dance, jump rope, or hit a punching bag
Punch a cushion or mattress or scream into your pillow
Squeeze a stress ball or squish Play-Doh or clay
Rip something up (sheets of paper, a magazine)
Make some noise (play an instrument, bang on pots and pans)
Write an angry letter