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I don't think self harm 'works', but I do go back to it. What am I risking?

Q.

I'm someone who self-harms, not regularly, or dangerously, but I've been finding that each time I do it, the scar is a bit bigger. I never draw blood.

On the other hand, my life is going really well and I definitely feel I have some control over my surroundings. There are just times when I fall into a bit of a hole and feel so depressed that I need a circuit breaker.

I don't think self harm 'works', but I do go back to it. What am I risking by engaging in this behaviour?

A.

Hi there. A lot of human behaviour is habit. Habits are a kind of behaviour that isn't natural, but is learnt by being rewarded in some way. There is a cue for the behaviour which gets tied to it in some way, and when the cue (or a similar cue) happens, you get an urge to repeat the action. If you try to resist, you experience tension or stress, which can grow quite uncomfortable until you relieve it by doing the action.

That's the theory. The original cue might not be anywhere in your life today, but any stress, depression or loss that makes you feel as you did when the self-harm started will trigger the old behaviour. Then when you self-harm, you will feel some relief, so in a sense, it does work. But it is mostly relieving the anxiety that comes from resisting it, so it's a sort of vicious cycle.

What you are risking depends on how severe the injury is, how obvious it (and the behaviour) will become, and how supportive your friends and relatives are. The biggest risks are social ones: how will this impact on you friendships and your more significant relationships, or on your ability to develop them?

You also risk the behaviour becoming more dominant, because when you repeat it, it reinforces this as a coping mechanism. That has two consequences: you can fail to develop better, healthier ways of handling things; and you can find you need to deal with more stresses this way, until it takes over your life.

Since you have made so much progress already, I believe you can handle this, too. The best starting place is to develop substitute behaviours: remember, if you just fight the urge, it gets stronger. Instead, when you want to self-harm, do something else that represents it. Plan ahead. If you wait until you "need" to act, you will not succeed, so think up an action that represents your self-harm. It is surprising what helps. People who cut often find that replacing a blade with a red texta works. Others find that a rubber band on the wrist can be "snapped" against their skin, and the sharp sting is enough to interrupt the cycle. Have a look at the link below for more ideas.

Not knowing exactly what you have been doing I can't give you more concrete examples, but you get the idea. There isn't any reason you can't break away and work out better ways to cope. Good luck.

Last modified: 8th November 2010
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