Substitutes

What do I do when I get that urge to self-harm, right now?

There are several substitute strategies one can use to get through a crisis without resorting to self-injury. These techniques vary greatly. It is important to identify the emotions behind the urge to self-injure in any specific event in order to best associate the appropriate substitute technique, although some techniques will work no matter how you may feel. You should review all of the techniques and keep a list with you so that when the urge hits, you can go down the list and try as many as is needed. It is important that you plan ahead.

If you are feeling disassociated, numb and need to feel sensation:

Repeat a grounding phrase;

Smell perfume; use aromatherapy to awaken your senses and ground yourself (Lavender and Chamomile are soothing, Rosemary, Orange and Bergamot help lift a depressed mood, Peppermint is stimulating

Do relaxation exercises; try muscle relaxation exercises, tensing and relaxing each large muscle group throughout your body;

Be mindful of your breathing, slowly inhaling and exhaling 10 times;

Sit in a chair and stomp your feet on the ground feeling the ground below your feet, tell yourself you are safe, the date, where you are, repeat;

Squeeze a rubber ball;

If you are feeling angry and frustrated:

	Exercise vigorously; go jogging, swimming, play tennis, etc.;
	Play the music loudly and dance, dance, dance;
	Hit a punching bag or pillows;
	Rip up a newspaper or telephone book;
	Yell, rant;
	Throw out all your sharps and/or lighters, whatever you used to use to self-harm;
	Clean your house, your car, your closets, do gardening;

If you are feeling sad, depressed, hurt:

	Visualize a stop sign;
	Write in a journal; scribble; do free association writing;
	Draw; free drawing or drawing to music;
	Walk your dog; groom your pets;
	Reach out and talk to a friend;
	Take a bubble bath, put clean sheets on your bed and indulge in little luxuries;
	Give yourself a manicure or pedicure;
	Listen to uplifting music;

If you absolutely need to see blood or scars:

	Draw on yourself with a red pen or with food coloring where you would normally cut yourself;
	Apply a henna tattoo to the area where you would normally cut;

If you absolutely need to feel some mild pain*, although I do not recommend this:

	Take a very hot or cold shower but be careful not to scald yourself;
	Slap your hand; clap your hands; or snap your wrist with an elastic;
	Hold ice cubes or any frozen food (for example a bag of frozen peas will do);

*I do not believe that you can substitute self-harm with self-harm thus do not recommend that you in any way cause yourself pain to overcome your urge to cut or burn yourself; it may be all to tempting to go overboard and harm yourself just as much if not more but in a different manner. I’ve included these strategies for completeness and because they are widely used when one is feeling disassociated, numb, and craving sensation.

Other strategies include:

	Engage in your favorite hobbies; read a book (suggested by Rose B.), needlepoint, etc.;
	Have a cup of herbal tea, no caffeinated drinks, no alcohol;
	Meditate;
	Watch a movie that will evoke a different emotion: scary, funny, religious, etc.;
	Surround yourself by nature;
	Make a list of the reasons why you want to stop self-injuring;
	Work.

Surviving a crisis without harming yourself means that not only have you spared yourself from injury but also from the shame and guilt which always follow. Moreover, next time you face a crisis, you will know you now have alternative choices to injuring yourself, and with practice it will become easier to avoid self-harm.

If you have any other techniques you would like to share which have helped you through tough times, please email them to me at [email protected]

Revised April 2005