When someone hurts themselves on purpose, this is called self-harm. Cutting is often the most talked-about form of self-harm, although any deliberate action taken by a person to hurt themselves or to damage their health is also classed as self-harm. Scratching, pulling hair out, hitting or punching yourself, or taking an overdose are also examples of self-harm. People who self-harm do not necessarily want to kill themselves, and there are many reasons why different people hurt themselves.
There is no single reason why people self-harm, and often they may not even know themselves why they do it. Some young people I’ve worked with have told me that they hurt themselves because they don’t know another way to release all the feelings they have pent up inside of them. Others have said they often feel “numb”, and they self-harm in order to feel something. Sometimes self-harm happens after a stressful event, or when a person wants to punish themselves, or feels bad about themselves. Self-harm is not about trying to get attention, but is often the only way a person has figured out how to deal with difficult emotions such as sadness, hate, low self-esteem, loneliness, and feeling out of control.
People who self-harm may think that this is a helpful way of coping, especially if they haven’t discovered any other way of dealing with difficult feelings. However, despite this, the majority of self-harmers will, at some point, decide that they want to stop. They often recognise that they could accidentally go too far and cause some serious damage, which isn’t what they want. They often feel lonely, as self-harm is not something they feel able to talk about; feelings of guilt are also quite common.
Min-jun*, 15, didn’t know why he tried so hard to get into fights at school, or why he punched walls so hard his knuckles bled, but he started to feel his behaviour was not helping him in the long run. Although some of his injuries were caused by others in fights, the fact Min-jun was actively seeking out dangerous situations and getting beaten up was a form of self-harm, as was punching inanimate objects.
When Min-jun first opened up to me, he said he had come to a decision that he wanted to stop hurting himself, but had grown so used to the behaviour he wasn’t sure how, or if he could change. Despite Min-jun’s concerns about not knowing how to stop, the real positive was that he had made the decision to stop. This is a vital step for anyone self-harming. The desire for change has to come from them, and with support, they can begin to make changes.
On the right are some steps Min-jun worked through. If you think you might be deliberately hurting yourself, and would like to stop doing this, read through these ideas and see what works for you.
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Try these steps
**Remember that if you or someone you know is ever seriously injured, seek immediate medical help.**
1. Make a list of reasons why you want to stop
This can be helpful to refer back to, especially at times when you’re tempted to self-harm. Min-jun’s reasons included not wanting to have lots of permanent scars, which might trouble him in the future, and not wanting to risk getting so seriously injured that he would do any long-lasting damage to his body. He also thought there must be less dangerous ways of coping, and was ready to try other ideas.
2. Scale down the self-harm
For some people, going “cold turkey” on hurting themselves can be really challenging. If they are unable to stop immediately, this can make them feel bad about themselves, like they’ve failed. It can be helpful instead to aim to reduce self-harming behaviour first of all, and work towards stopping.
One way of doing this might be to reduce the number of times you self-harm during the week. Reward yourself if you can harm yourself even just one less time than the week before, and work towards lowering the number week by week. Try not to feel disheartened if you have a bad week and your number stays the same or rises. Just know that you can try again the following week.
3. Scale down the intensity
Another technique is to reduce the intensity of the harm. For example, some young people who want to stop self-harming put an elastic band on their wrists, and flick it against their skin whenever they get the urge to self-harm. The band stings, but doesn’t cause as much damage as something like cutting. A similar technique is to hold an ice cube against the skin. It is not comfortable, but again does no permanent damage. Other examples of mimicking self-harm behaviour in a safe way include taking a cold shower, punching pillows or cushions, or drawing a red mark on your skin where you might otherwise cut.
4. Remove temptation
If your method of self-harm involves tools, remove these from your room, and put them somewhere that is difficult for you to access.
Min-jun couldn’t avoid walls, but he did take steps to avoid people that he knew liked to fight. He changed his lunchtime and after-school activities to reduce the chances of getting involved in physical conflicts.
5. Protect someone or something precious
The “butterfly project” refers to a technique where self-harmers choose to draw a butterfly on their skin, in the place they would normally harm themselves. They give the butterfly a name, and decide to keep it safe for as long as possible. Where the person may not have been able to care for themselves, their empathy often allows them to think of others, and it is this concern for the butterfly that helps them stop from harming it, and therefore also themselves.
Min-jun was not keen on drawing a butterfly on himself, but could see the idea might be helpful. Instead, he wrote his mother’s name on his knuckles. Whenever he felt the urge to punch a wall or get into a fight, remembering that he didn’t want to injure his mum’s name often acted as a helpful deterrent.
6. Distract yourself
When people get the urge to harm themselves, it can be helpful to find a distraction until the feeling passes. Distractions can be anything from watching TV or listening to music, to creating art, playing a musical instrument, going for a run, or looking at the clouds.
Min-jun’s preferred distractions were lifting weights and reading, and he started to choose these activities when the urge to hurt himself arose.
While we’re constantly breathing to stay alive, deep breathing is a technique to help you relax. While Min-jun wasn’t convinced at first, a simple method of counting as he inhaled and exhaled helped him calm down when his emotions were getting the better of him. (Read the Anxiety article for more information on breathing techniques.)
8. Talk to someone
A lot of people worry about telling anyone about their self-harming behaviour, and indeed friends and family might be shocked or upset to find out you self-harm. While this may not be helpful for you, remember that the idea of self-harm might be frightening for someone who doesn’t understand this behaviour.
Although it may not be easy, it can be very helpful to share what’s happening with someone who cares about you. Pick a time when neither of you will be rushed, and explain what you are doing to try to stop self-harming. This person can then support you in your steps to recovery.
As well as people you know, professionals such as counsellors and psychologists can work with you to find better ways of coping. They can speak to you about your triggers, and what is behind the behaviour. In time, you can learn more about yourself, and learn to deal with difficult emotions in ways that don’t involve harming yourself physically.
*name has been changed.
- If you or someone you know is in immediate danger or is significantly injured, call the emergency services on 999.
- Take care of any wounds by keeping the skin clean to avoid infection. See a school nurse or other health care professional if you need help with this.
- The Samaritans (2896 0000) is a 24 hour hotline for people who are in emotional distress and want to talk to someone. Calls are confidential, and can be made in English, Cantonese or Mandarin.