Self-harm is often a subject people try to avoid talking about, especially in the context of harm minimisation and the use of self-harm substitutes. However, I think talking about self-harm substitutes in this kind of context is important to the conversation, no matter if some might find it uncomfortable.
This article will talk about self-harm minimisation strategies that involve self-harm substitutes that might be triggering for some people, although no content will be glorifying self-harm. This article will take about self-harm in a realistic and helpful way for the purpose of trying to support those that self-harm with their recovery.
What Is Self-Harm?
Laye-Gindhu and Schonert-Reichl (2005) described self-harm as being a voluntary and deliberate act to physically cause injury to oneself that is non-life-threatening with intent and not an act of suicidal behaviour.
Examples of self-harming
- Severely scratching your skin.
- Burning or scalding yourself.
- Hitting yourself or banging your head (something I did – Traction Alopecia: The Hair Pulling Question).
- Punching hard objects.
- Throwing yourself into a wall.
Why Do People Self-Harm?
There are several reasons why someone might engage in self-harm. Some people might engage in self-harm as a way to cope with feelings like self-loathing, sadness, emptiness, guilt, and rage. In short, because they have strong negative emotions they’re unable to manage. Thus, self-harming can be used as a way to release pain and tension building up inside. Self-harm might also be used to express feelings the person is unable to verbalise in words, which is something that needs to be watched for in those with learning disabilities.
Another common reason for engaging in self-harm might be due to needing to gain some sort of control in their lives or as punishment for something they have done or something they’ve imagined they’ve done. Not only that, but it could even be used as a distraction for other life circumstances or as a way to feel something if the person feels numb so they can feel alive.
My Self-Harm Story
I became suicidal when I was eight years old and on an almost daily basis, I would have an emotional breakdown and take the meat cleaver from the kitchen draw and stand at the kitchen sink crying as I thought about chopping off my left hand. Luckily, I never went through with it. But I’ve had to deal with almost daily suicidal ideation ever since my first breakdown first started at eight.
I didn’t start cutting myself until I was in my late teens/early tweenies, and it only lasted a few years before the unhealthy coping strategy was no longer needed.
I can’t speak for how or why other people do it, or what they get from doing it, but for me, I got into cutting myself because other people I knew were doing it and I need a way to manage my suicidal impulses. Cutting was a normalised behaviour within the subculture I belonged to. The only difference was where they would cut themselves where others could see, I did not. I harmed my upper arm, legs, and abdomen. All places that I would always be able to cover up unless I was naked.
But even then, it wasn’t something I engaged in right away because people within my subculture were doing it. I was badly struggling with my mental health because I was developing drug-induced psychosis, which would go on to leave me with two anxiety disorders that trigger psychotic episodes for the rest of my life.
I was an emotional train wreck during this time and I was hiding it from everyone around me. Not a good idea.
I was having so many emotional breakdowns and struggling with psychosis all at the same time, that something was going to give. My suicidal ideation and willingness to follow through on my thoughts was a constant problem. Then one day I went for a walk late at night crying and just cut myself. It didn’t help with the breakdown per se, but it gave me a way to channel my unrelenting pain, and that was enough.
To me, cutting didn’t make me feel better, it was more close to being a coping mechanism, just a bad one. One that would stop me from tipping over the edge into the abyss. That’s because my suicide attempts seem to be atypical, I don’t plan, I don’t think about it, I just do it as an automated response of spiralling too deep into despair. Usual I’d try to take my life with minutes of reaching such an emotional state.
Each time I cut myself it would only be once or twice each time, but often they’d be really deep and wide that the muscle tissue would be exposed. So I don’t have many scars, but some of the ones I do have are big.
I also didn’t harm myself that frequently. Cutting myself was only something I did when I was having an emotional breakdown, but even then, not every time. I had to be in a state where I was slipping into my suicidal despair. In short, I was using self-harm as a way to stop myself from trying to take my own life. My last effort to save my life, you could say.
Thus, when I learnt to control and suppress my emotions, I stopped entering a state where I would try to take my own life within minutes of this feeling hitting me. Without that crippling suicidal despite, I had no reason to self-harm anymore.
The last time I cut myself was also the last time I tried to kill myself in 2003, and up until last year, I hadn’t entered an actionable suicidal state until the summer of 2020. But I didn’t fall back into my bad coping strategy of cutting myself when that happened.
Until recently, when I wrote my articles, Life With My Hair Destroying Behaviours and Life With My Hair Destroying Behaviours, I hadn’t realised that other behaviours I was engaging in that led to me permanently losing my hair, leaving me with a patchy mess, was also a form of self-harming. But I won’t go into that here as we’ll be here all day if I do. But feel free to check out those two articles by clicking here and here, if you’re interested in finding out more.
My Thoughts On Self-Harm
People should be aware that those that do self-harm have their own personal reasons for doing so. Meaning, you can’t just see all those who do it or did do it as being the same.
For some, self-harming is akin to being an automated behaviour. Like anything you engage in regularly, you’ll start doing it without thinking. I know I had the same issues with my hair damaging behaviours that caused me to develop permanent traction alopecia. In that kind of situation, I personally believe it is better seen as being like an addiction, because often you know it’s not helping you, but you can’t stop yourself from doing it anyway.
Thus, a lot of the work done within the field of addiction can be quite helpful with this kind of self-harming. Such as identifying triggers; finding a replacement; creating a healthy rewards system; and creating a reduction plan rather than going cold turkey, can, in some cases, make it easier to recover.
This addiction comparison approach for self-harming can also make it easier to explain it to those who don’t understand self-harming.
Furthermore, self-harming, in general, isn’t something you can try and force someone to stop doing, it is only something that you can try to talk to the person about in a caring empathetic manner to try and help them change this behaviour of their own accord.
To those reading this that are engaging in self-harm, know that you can and will get better, and there are people and places you can go to to help recover. Stay strong, you are deserving of a good and happy life.
Standard Self-Harm Alternatives
- Do something creative.
- Go for a walk.
- Play some music.
- Watch a film or TV show.
- Hug yourself.
- Make a coffee, tea, or hot chocolate.
- Make a wish list.
- Read a book.
- Play a videogame.
- Visit a friend or family member.
- Call or message a friend, family member, or support line.
- Go for a drive.
- Go to the park.
- Have a bath.
- Write in your journal.
- Use aromatherapy oils.
- Hug yourself or a teddy.
- Count to 100.
- Do chores.
Harm Minimisation Theory
Harm minimisation, also known as the harm reduction method, is a well-established approach based on strong empirical evidence originally designed to reduce substance abuse (Measham, 2006). In the field of addiction, harm minimisation made reducing harm the primary motive rather than abstinence, which is hard to achieve and riddled with failure if abstinence is the only goal (Strang and Farrell, 1992).
By creating a treatment situation that isn’t only about abstinence, you can work with the person experiencing substance dependence to take back control of their lives, work through a series of goals (Strang and Farrell, 1992), and help people be safe while they’re doing it. Not only that, but it also helps to make society safer as well, so it’s not just focused on the individual.
According to Measham (2006), harm minimisation reduces harm to individuals, as well as protecting society from the selling and consumption of illegal drugs and their paraphilia, by applying measures to tackle them. For example, providing clean needle exchanges to people who inject and a safe box to store used needles reduces the risk of bloodborne viruses to the user, but also to the community as needles are less likely to be abandoned in parks and on the street.
Just to be clear, when harm minimisation is applied to self-harming, it’s not about condoning self-harm, but rather accepting that the self-harmer is going to cause themself self-injury regardless, so it’s about supporting them to be safe while they learn alternative healthy coping behaviours (Gutridge, 2010).
Harm Minimisation Self-Harm Substitutes
In an ideal world, self-harming and self-injury wouldn’t be an issue and people that engage in those behaviours would easily be able to switch to other behaviours like drawing or writing instead. Unfortunately, life isn’t that simple. That said, if you are able to do that, then that’s fantastic, please try such methods like the ones I noted above.
If traditional methods of distraction don’t help, however, and you’re already self-harming, such as cutting yourself, then snapping rubber bands could be a viable alternative as a way to practice harm minimisation. If you’re unfamiliar with that term, then it’s the process of finding ways to make established behaviours less harmful. It’s a practice often used in substance abuse, with clean needles and methadone subscriptions being another example of harm minimisation. That’s because it’s unrealistic that someone can go cold turkey from being dependent on something like heroin.
Snapping Rubber bands is a method I talked about in a previous article, where I argued about how such a method could cause someone to develop self-harming behaviours. However, there is a possible good use for snapping rubber bands, and that might be to help someone overcome other, more harmful, self-harming methods. The self-harmer can then formulate a plan to then stop using snapping rubber bands once the transition had been made, such as reducing the number of times they can snap the rubber band in any situation.
Another important harm-minimisation step for people who cut themselves is to make sure they do it as safely as possible. This can be doing something like cleaning the area you plan to cut yourself and cleaning the object you plan to cut yourself with, and then you could then apply a plaster to the area afterwards. All these steps would help reduce the risk of the wound getting infected.
You could also complete a safety plan so you can plan ahead on how to handle your urge to self-harm or use the safety plan workbook to distract you in the moment. If you’re interested in downloading a free copy of a safety plan and a safety plan workbook then you can do so by clicking here and if you want to read my article about how to use either or both of these, then you can do so by clicking here. This method can be useful because the urge to self-harm will pass, and if you can ride that urge until it passes then you’ll train yourself to realise that you can get through such episodes without self-harming.
- Snapping a rubber band around your wrist.
- Hold an ice cube in your hand.
- Rub an ice cube on the area you want to harm.
- Squeeze a stress toy.
- Take a cold shower.
- Eat a lemon.
- Scream into a pillow.
- Tear up some paper.
- Hit a pillow.
- Using a red felt tip pen, draw lines on your skin where you’d normally cut yourself.
- Put hands in freezing cold water.
- Stand on a lego brick.
As always, leave your feedback in the comments section below. Also, feel free to share your experiences of self-harm and harm minimisation in the comments section below as well. Don’t forget to bookmark my site and if you want to stay up-to-date with my blog, then sign up for my newsletter below. Alternatively, get push notifications of new articles by clicking the red bell icon in the bottom right corner.
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Unwanted Life readers.
Gutridge, K. (2010). Safer self-injury or assisted self-harm?. Theoretical Medicine and Bioethics, 31, 79–92. Retrieved from https://doi.org/10.1007/s11017-010-9135-z.
Laye-Gindhu, A., & Schonert-Reichl, K.A. (2005). Nonsuicidal Self-Harm Among Community Adolescents: Understanding the “Whats” and “Whys” of Self-Harm. J Youth Adolescence, 34(5), 447–457. Retrieved from https://doi.org/10.1007/s10964-005-7262-z.
Measham, F. (2006). The new policy mix: Alcohol, harm minimisation, and determined drunkenness in contemporary society. International Journal of Drug Policy, 17(4), 258-268. Retrieved from https://doi.org/10.1016/j.drugpo.2006.02.013.
Strang, J. & Farrell, M. (1992). Harm minimisation for drug misusers. BMJ, 304(6835), 1127–1128. Retrieved from https://dx.doi.org/10.1136%2Fbmj.304.6835.1127 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1882091/pdf/bmj00071-0007.pdf.
Harmless – A self-harm and suicide support organisation.
LifeSIGNS – Self-injury guidance and support network.
Alumina – Self-harm support for 14-19-year-olds.
Self Injury Support – Support service for women and girls affected by self-injury, trauma, and abuse.