Here are some simple ideas that you can use to support someone who is trying to reduce how much they self-harm. Be realistic in your expectations and be sure to celebrate progress, no matter how minimal.
Time and Place
People who frequently self-harm will often do so in the same place and at similar times each day. Talk to them about whether it’s possible to try to disrupt this routine. Can you work with them to think of an alternative activity they might be able to do at their trigger time, or is there somewhere different they could go? As a minimum perhaps you can think with them about how to ensure they are not alone at the times when they are most vulnerable from self-harm. If it’s not possible for them to be physically accompanied, you might suggest they phone a helpline such as Childline or the Samaritans so they feel less alone.
Means for Self-Harm
Some people will always use the same implement to self-harm with. If they are ready, they might think about throwing away this implement. Doing so prematurely may leave them feeling very desperate and vulnerable so this needs to be carefully considered. If they are not yet ready to dispose of their implement then they might consider locking it away, either in a safety deposit box or even simply in a shoebox wrapped up with tape or ribbon. Making their preferred implement less available will provide valuable thinking time and remove some of the impulsivity from the act of self-harming, making it a little more likely they’ll be able to think of an alternative coping mechanism.
Another helpful approach is to encourage them to reduce their easy access to items that might be used for self-harming. This might mean locking away or removing things like blades, knives and medicines where they cannot be so easily accessed.
Try to Break Rituals
Self-harming activities can become highly ritualised , adding a feeling of control to the process and providing a sense of relief and release to the person harming. Trying to remove some of the more ritualised or repeated parts of their self-harming behaviours can reduce the reinforcement that young people feel from the activity. It also makes it harder for them to self-harm on auto pilot which, again, reduces the likelihood of them going through with an act of self-harm.
If a young person feels comfortable enough to talk to you about their self-harm rituals, take a real interest and try to understand their motivations behind each part of the process. Question why they do each thing and where possible make suggestions for alternative behaviours. Occasionally your words and questions will have an impact on the sufferer and play back to them during a self-harm act and empower them to stop.
A more general approach to challenging self-harming behaviours is to challenge the thoughts and feelings that surround and trigger those behaviours. Often there are a whole host of negative thoughts that surround each act of self-harm which the sufferer never thinks to challenge. Explore these thoughts and actively challenge them, providing evidence to back up your viewpoint where you can; for example you might challenge the thought ‘I’m a complete failure’ with ‘Do you think perhaps that your standards are unrealistic? Other people would be happy to get 60% on a test but you are upset because you got 80%. Why is 80% not good enough?’ Or ‘Would you consider your friend Daniel a failure if he’d scored 80% on that test? Why not…’ Over time, you can encourage the sufferer to challenge their thoughts in the same way, but it is likely to take quite some time.
If you would like extra help on this topic, Pooky can run a workshop for students, parents or teachers at your school or organisation. Pooky regularly runs workshops on a wide range of mental health and emotional well-being issues. There is more information here or you can fill out an enquiry form or email Pooky – firstname.lastname@example.org.