Tactics to help self-harming behavior in an adult?

April 12, 2016 9:43 PM

I have anxiety disorder with panic attacks, and I'm going through an extremely stressful and emotionally difficult period. For the first time in a long time, I am self-harming. I have a psychiatrist, am on medication, and am seeing her next week. I am not suicidal. I know this isn't good for me (and isn't helping the situation). What are some resources/tactics/ways of mentally reframing my feelings that could help?

More details: The self-harm takes the form of biting, slapping, and punching myself during moments of crisis and intense distress. I'm female, 34, and I practiced some of these behaviors as a teenager, but they are more severe now.

I come from an very physically and abusive background (mentally ill, addict parent). While not exactly the same, the current events I'm experiencing are definitely triggering old feelings. I'm on 20mg of Lexapro and Ativan as needed, and until the recent extremely difficult events, was managing my anxiety very well.

What else can I do to stop self-harming?

posted by mostlymartha to Health & Fitness (8 answers total)

When I self-harmed, I used the 4D technique. Delay, Deep breathe, Drink water, Do something else. For delay I would schedule future self-harm. I will cut myself--in three hours, at 1 pm. Usually by the time 1 pm rolled around, I was calm enough to not cut. In the meantime, while I waited for my scheduled self-harm time, I would take some deep, meditative breaths, drink a glass of Crystal Light, and distract myself with an activity. The activity depended on what the trigger was--if it was crisis, I would play a video game. Something relaxing, not too stressful. Minecraft. Terraria. That kind of thing. If it was numbness that was triggering me, I would watch a movie or tv series I felt emotionally invested in. If self-harm time rolled around and I was still feeling the need to do something, I would first try a self-focused body related activity. Doing my nails was good for this--pushing back cuticles, filing, painting my nails, etc. Dyeing my hair. A facial that involved peeling the mask off at the end. Since you aren't a cutter, shaving might be ok.
posted by xyzzy at 10:57 PM on April 12, 2016 [5 favorites]

Lots of good resources from google search self harm peer support. One example. Community forum for people who self harm with resources and conversation threads here. I like this list of distractions.
posted by ClaudiaCenter at 10:59 PM on April 12, 2016 [1 favorite]

I like this checklist for when my anxiety is rising. Everything is not ok. Baths, especially with nice scents and candles, something to do with my hands, knitting, sewing etc. preferably something I'm not too attached to, I just like the mindless focus on repetitive movements.

YMMV, I get anxiety and depression, but not self harm, so it might not be the same.

Dance parties in my room or with my cat also help. Eating as many veggies as possible. Reaching out to friends. (Do you have my number? Call if you need a chat. Any hour of the day or night.)
posted by jonathanstrange at 11:09 PM on April 12, 2016

My self harm takes on a different form (skin picking, scratching, tweezing, etc), and a few triage-y things help me.

One is drawing on myself. A pen or a brush gives different sensations and can satisfy that gone-wrong scratching urge, and the marks they leave can be beautiful or at least not be a mark of self violence, but they are still marks.

Having the right tools to do the tweezing and blemish removal helps me not dig in and make things worse, so maybe you could find a way to get the temporary sensation of a bite or a slap without the bruise? I like to put those big jaw hair clips on my arms and legs sometimes, would that feel like a soft, steady bite? Would something like ice give you a bit of the sting of a slap? Maybe a deep, long stretch of your muscles could feel a little like a bruise?

The best thing I started doing a few years ago when I was getting a lot lower than I had been in a while is painting my nails. The actual painting of my nails didn't matter so much. But scraping the polish off after it dries is amazing. It gives me the same satisfaction as scratching skin combined with a completion feeling when I get a nail really clean and that feeling of removing dead skin without actually removing any skin. The visual evidence is right there and it is a socially acceptable fidget in all but the most formal situations. Maybe this might help you too, even though it's not a direct correlation to your habits?

So anyway, since you seem to be doing the right big things for treating the underlying cause of your self harm symptom, in the meantime think of some safe actions to shift to when you catch yourself at it. That way you can start to feel okay that you stopped instead of piling on guilt that you couldn't.

All the other usual mental health stuff still applies, of course. Checklist! Are you thirsty, sleepy, hungry, having digestive problems? Are you in pain in any unusual places and do you have medication that can help? Try taking a shower or a bath even if you really don't want to. Put on fresh clothes if you have them. When was the last time you hugged a friendly person or animal? Listen to music that takes you outside of yourself. Make sure you have a place to sit or lie down that is a comfortable temperature and has the right light and smell and sound for you to feel safe.

Best of luck being kind to yourself.
posted by Mizu at 12:03 AM on April 13, 2016 [5 favorites]

I did some self harm, though not to a great extent. Fundamentally the desire to self harm comes from wanting to change what you are feeling. So, what helped me was to learn methods to accept what I was feeling rather than try to change them. It stems of ACT, or acceptance therapy. The main idea is that feelings will come and go. They change all the time. But bad feelings can't hurt you, ultimately.
There are plenty or resources out there about ACT, books, therapists etc. Maybe you can find some of these. You have learned one response to unwanted feelings. Another response, is to simply let them go by. But it takes work. I wish you all the best.
posted by jtexman1 at 5:13 AM on April 13, 2016 [1 favorite]

These are all great suggestions. I also went through a period of self-harming and I totally understand how compelling, addictive and sometimes soothing it can be.

What about distracting yourself with cold? Cold packs and ice-cubes in freezer-bags used to help me get my mind off of scratching, burning or cutting. I would hold onto the ice until it melted.

Hang in there - it will get easier.
posted by Dressed to Kill at 6:18 AM on April 13, 2016

i'm also a biter. oral fixation toys can help - even silly things like baby's pacifiers. it lets me move my jaw around and bite into something, but keeps the harm off my skin. sometimes i also...play bite? like i'll put my arm in my mouth and just glacially slowly bring my teeth down and concentrate on breathing. i try to see if i can get the relief of the action without leaving any marks. it's not the best, but better than causing harm.

i'm very proud of you for reaching out. if you need to talk, you know where to find me.
posted by nadawi at 7:04 AM on April 13, 2016 [2 favorites]

So, two thoughts:

Like a fair number of not neurotypical kids, my oldest used to beat his head on the floor when distressed. I asked him about it years later, and he said the pain helped him focus when nothing else could and that meant pain was better to him than letting his mind be a runaway train. It was kind of like rebooting a computer.

So, it may help to find things that help you focus or that distract you so your mind is not a runaway train.

Also, my son watched some videotape of a confrontation with police that resulted in a physical fight. There was a hand clap just before the guy threw the first punch. This was explained as the point of no return, the point at which talking was not going to de-escalate it. The clap is a priming mechanism.

So, this might be a factor in what your are doing. Understanding that may help you solve it. I mean, part of the point may be prepping yourself to cope with a thing. It may not be self destructive. It may be a kind of self protection. Understanding it that way may help.

Best of luck.
posted by Michele in California at 1:38 PM on April 13, 2016