“Mutilation out of sight”
“Somehow, however, just knowing that I could fully expect unhappiness to return – if not predictably, then nevertheless reliably – was strangely liberating. The point was that even chaos had a structure, a beginning and eventually an end. It was possible to live through it. I’d been doing as much for twenty years”
Last Resort - Papa Roach
Skin Game - Caroline Kettlewell (1999; 168)
While I urge you to seek therapy for your self-injury, perhaps you are unable to do so. Perhaps you are in an abusive home, and are dependent upon your parents’ medical insurance. Maybe you don’t have any insurance. Maybe you are currently on a waiting list to see a therapist. Or perhaps you are in therapy, but struggle between sessions. Maybe you just aren’t quite ready to face therapy. Whatever your reasons may be for needing this chapter, it is here. This chapter contains suggestions on alternatives to self-injuring, ways to get through a bad urge to SI, writing exercises that will help you learn more about your self-injury so you can fight it and overcome it. There is also a resources section in the back of this book, including online support for self-injurers. I encourage you to make use of as many of these as possible. You are worth it. You deserve it.
Self-injury is a cyclic process. The first step in breaking the never-ending cycle into which self-injurers fall is to understand what the cycle is. You need to understand your thoughts and feelings and events before, during, and after the self-injury.
Smith et al. (1998) suggest recording your pattern of SI. They suggest keeping a journal of this (and I recommend strongly that you have a journal, even if just to record random thoughts). When was the longest you went without injuring? How long was that time? Why didn’t you injure? What goes on in your mind before, during, and after injuring? Are there particular types of events or feelings that happen usually? All of this information can help you know what situations to avoid, what feelings should send up a warning signal in your head, and can be useful if given to your therapist as well. Write in your journal when having an urge. Describe your feelings and thoughts, and what has made you feel so bad. If writing is too difficult for you, then use a tape recorder and keep the tapes. Record successes as well. When have you managed to stop yourself? Or even delay yourself? Maybe you could try a similar strategy again.
They also suggest that to disrupt your SI cycle, you can try the following:
1. Share your feelings: If you have someone you can trust with your feelings, tell them about them. Don’t keep them inside. If no one is around, write about them, draw, paint, sculpt, anything that expressed the emotion. If you don’t have words to describe it, try capturing details like where in your body feels tense, or when you have felt this way before.
2. Distract yourself: Find another activity to keep yourself busy. Later in this chapter are numerous examples of distractions you can try.
3. Substitution: These behaviours are frowned upon by some researchers (e.g., Conterio et al., 1998) but others will say that when all else fails, they are better than cutting or burning. These include ideas like squeezing an ice cube, drawing on the skin with a red marker, smashing ice in a bathtub, or snapping a rubber band on the wrist. I personally feel that if nothing else works and drawing with a marker will keep you safe for the moment, then do so.
4. Recognize and avoid triggers: As you learn to identify your cycle, you will also notice certain patterns or events that frequently precede an SI episode. When you have identified them, you can try to avoid them. Common triggers include alcohol consumption, taking illegal drugs, seeing or talking to an abuser and talking to others who self-injure.
5. Care for yourself: Often self-injurers don’t take care of themselves. They may neglect hunger needs or sleep needs, or may not take care of themselves when sick. So take are of yourself! Give yourself a foot bath and pedicure, eat properly, get proper rest. You are worth it. Paying more attention to your hunger and thirst may also help you connect more with your body and create an awareness of it. For dissociative people, this will help a lot.
6. Set limits: You can try creating boundaries to gradually give up self-injuring. For example, you can say, “I will only SI in the bathroom”. By restricting yourself, you are learning to take control. Throw away items you use to injure, one item at a time.
The following list was compiled from the book Women Living With Self-Injury (1999). In her discussions with injurers, Jane Wegscheider Hyman gathered the following ideas to help you get through a bad day, or even a bad week.
1. Be as kind to yourself as possible. Treat yourself for not injuring. Go get a facial. Watch a favourite (non-triggering) movie.
2. Be gentle with yourself when you make a mistake. Remind yourself that everyone makes them, and see them as experiences to learn from.
3. Try making positive statements about yourself. List positive things you have done and positive attributes.
4. Find a place, either a real one in your environment or an imaginary one in your mind, where you feel safe from self-harm. Designate a spot in the house as a “no-harm zone”. Go there.
5. Call someone. Even if you can’t talk about your urge or your feelings, just having a conversation can pass time and keep you busy.
6. Movement is useful. Go for a walk or a run, skip rope, go for a swim.
7. Keep your hands busy. Make a craft, paint, write in a journal, sculpt, anything.
She also suggests the idea of creating a self-care package, containing comforting items, music tapes, pictures, your journal, and anything else you find comforting and helpful in getting through an urge. Keep it readily accessible at home, so when you feel an urge, everything you need is in one place.
Collaborating with a group of self-injurers from the Atforumz SI Forum, the following list of distractions was created. They are numerous, and very helpful! If one doesn’t work, continue down the list.
The book Bodily Harm (Conterio et al., 1998) contains numerous exercises taken from the SAFE Alternatives program, which is designed for self-injurers. These assignments are valuable to try, but are too lengthy to write in detail here. Briefly, the exercises include: writing a complete autobiography, writing about how you see yourself (strengths, weaknesses, your roles in life), discussing influential females and males in your life, discussing emotions surrounding self-injure, ways you like to take care of yourself, the person you want to be in the future, etc. The assignments are in-depth and detailed, but are a great way to look at yourself at many angles and understand yourself better.
The following exercises are adapted from a workbook for self-injurers called The Scarred Soul by Tracy Alderman (1997). The bok is filled with writing exercises to complete, to help you better understand yourself. Below are just the basic ideas of what is offered:
1) Write about how SI has been a part of your life’s course. When did you first begin injuring and why? How has being an injurer affected your life, relationships, choices and other aspects of your life? Have you ever sought help? Have you ever stopped for a while? If so, what brought you back to SI?
2) If your scars could talk, what would they say? To whom would it be said? How do you think they would react? How would you like them to react?
3) Have you encountered SI in the media or through meeting other people? Describe your experiences, how they made you feel about yourself, and why you felt that way.
4) Have you ever told anyone about your self-injuring? If so, how did they react? Describe the situation where you told them and what you said. If not, who would you like to tell and why? How do you hope they will react?
5) Why do you want to stop injuring yourself? Be as detailed as you can be.
I hope you’ve found this section to be useful for you as you struggle with your urges. It is very difficult to fight off urges, particularly when you first begin to stop. However, it does get easier with time. And you can be free of SI. You owe it to yourself to try.