Over the years as Dialectical Behavior Therapy specialists, we have helped many individuals who use self-harm as a coping mechanism. Let me repeat that: self-harm is a coping mechanism. When feelings get to be too much to handle, it makes sense that you or someone you love may use self-harm to escape from reality for a moment. While there are other healthier ways to handle intense emotions, if you’ve never learned other coping skills, self-harm may be your only tool in your toolbox.
If you or someone you know is self-harming, there are ways to reduce or stop the behavior. And often in our work as DBT therapists, we have noticed that clients turn to self-harm when it seems there is no other coping strategy available. Today, we will discuss some alternative coping mechanisms to self-harm and how to use them.
Types of Self-Harm
Contrary to popular belief, there are many ways that self-harm shows up for people who engage in this behavior. Typically when we think of self-harm, we think of cutting. However, other forms of self-harm include substance abuse, suicidal thoughts, and interpersonal conflict or relationship issues. Further, those who engage in self-harm often have trouble with ruminating on thoughts, struggling with identity issues, or feel detached from themselves. Many of these self-harming tendencies are rooted in emotional dysregulation.
In Dialectical Behavior Therapy (DBT), one of our main treatment focuses is emotional dysregulation. This refers to an inability to regulate emotions or having imbalanced emotions. Emotional dysregulation often results when folks don’t have coping skills, hold negative beliefs about themselves or the world, or are struggling with mood disorders like anxiety, depression, or bipolar disorder.
DBT helps by looking at the different areas of emotional dysregulation, including the emotional, behavioral, cognitive, and interpersonal struggles. Often, these areas are where imbalance has come up and unhealthy coping techniques, like self-harm, come into the picture.
How DBT Helps Reduce or Eliminate Self-Harm
In the DBT program at our Los Angeles area therapy practice, we help clients reduce and eliminate their self-harming tendencies. To make this happen, we teach coping skills like mindfulness to help folks stay in the present moment. We also provide psychoeducation, so that our clients can understand more about why these urges arise. In therapy, we help individuals challenge the negative core beliefs they hold and provide validation to help them understand why those make sense given their lived experiences. In our DBT skills group, we help clients learn a variety of coping skills to reduce their urges to self-harm.
Mindfulness Skills for Self-Harm
Much of the work we do with clients in DBT is rooted in mindfulness. As DBT therapists, we find the power of mindfulness to be incredibly grounding and effective in curbing unhealthy behaviors. Here are a few mindfulness skills for when you or someone you love is experiencing the urge to self-harm.
In mindfulness practices, breathing and the breath itself are important components. When you feel the urge to self-harm come up, take a breath. More specifically, take a long exhale first. This should last for a count of eight. Then, after all the air has been pushed out, inhale for a count of four. Try to do this for at least ten minutes before engaging in self-harming behaviors.
When you feel the urge to self-harm, in whatever way that looks like for you, challenge yourself to put off the urge for a certain amount of time, then revisit it until the urge dissipates. For example, you feel the urge coming up, then set a 5-minute timer. Sit with the urge for five minutes. If it has not subsided by the end of your timer, set the timer for another five minutes. Keep sitting with the urge and resetting your timer until the urge has subsided.
When you feel the urge to self-harm arise, observe it. Sit with it and think about the emotions and body sensations that are happening internally. This can help you stay more present with the challenging emotions and sensations, instead of jumping to a solution that may be unhealthy. Sit with the feelings. Yes, it will be emotionally difficult. But challenge yourself to sit in the moment and let the feelings and sensations run their course.
Ride the Wave
This skill can be done during urge surfing and observing. While you are taking note of the emotions and sensations in your body, think about this: the urge to self-harm will peak and come down. Think of this as a wave. While you are observing what’s going on in your brain and body, the urge may intensify, then decrease, then go through multiple cycles. By sitting with the urge while it cycles, you are learning distress tolerance. This will help you become more resilient to the urge to self-harm both in the present moment and in future incidences.
Do Something Else
My last tip is to just do something with your hands. Preoccupy yourself with a task. Perhaps you choose to color, paint, draw, cook, knit, brush your hair, or paint your nails. The idea is to do anything to keep your hands busy while you are riding the wave and waiting for the urge to pass.
DBT in Los Angeles, CA Can Help with Self-Harm
While our DBT therapists want you to be able to find healthy coping strategies, we understand that it’s not as easy as it seems to stop self-harming. And if you’re still struggling with this, it’s okay. We are all doing the best we can. And we understand that you may be using self-harm because it helps reduce your distress, helps you feel alive, or decreases your mood disorder symptoms. Whatever the reason, we know that you are doing the best you can.
If you are struggling with self-harming behaviors and are ready to get support, our DBT therapists are ready to provide just that. Our comprehensive DBT program at our Los Angeles-based therapy practice includes individual therapy sessions, phone coaching, and a skills group to help you learn emotional regulation and other helpful tools. If you are ready to begin DBT to help with self-harm in Los Angeles, CA, follow the steps below.
- Connect with us using the contact form.
- Start getting support from a DBT therapist.
- Begin DBT and find alternative ways to manage intense emotions.
Other Services at the DBT Center of the South Bay
The DBT program offered at our practice located in Los Angeles, CA can help with a variety of mental health struggles. We help those with self-harming tendencies, suicidal thoughts, and isolation and loneliness. Additionally, we assist those in need of help with managing anger and engaging in healthier family dynamics. Our services are available in-person or online in California and Las Vegas.