The decision to reduce or stop your self harming can be a very hard one to make. This section is designed to help you think about why you self harm and deal with those issues in order to help you reduce or stop your self harming. Deciding to stop self harming can feel like a very lonely decision. Everyone's glad that you're going to stop, but at the same time you feel like you have no where to turn - you're the only one dealing with the urges, the feeling of weakness that you have to rely on self harm. Often, stopping can become a nightmare, making you feel worse than you did before.

Deciding to reduce your self harm

Why do you want to reduce or stop your self harm?

Try to answer that question. There are many reasons why people want to stop self harming. These can include:

Not having to lie to people's faces about how I am feeling;
To be able to be normal again;
To be able to look my parents and friends in the face without being overwhelmed by shame;
To not be a constant source of worry to those who love me;
To not have to worry about whether tonight will be a victory or a slip-up;
To find my own self-confidence and self-worth;
To like the person I see when I look in the mirror;
To be able to look back on this and say, "I made it through and am stronger for it.";
To be able to wear summer clothing without feeling self conscious.

Think about why you want to stop self harming and write it all down. Don't worry about how silly you think it sounds - these are your reasons and they're perfectly valid. No one is going to see them unless you want them to so write down everything you can think of.

A lot of the time people decide to quit for the 'wrong' reasons, at the wrong time or in the wrong way - sometimes it can feel like you're not ready to stop self harming even though you want to, or you know that you should because you'd be in danger if you continued. We at Scar Tissue believe that you can only really stop when you're ready, and in order to stop self harming you have to want to stop. That's why you've just written down why you want to self harm - I've heard so many times about people who are quitting for their friends, their family, their partner - but not because they want to. It is possible to stop if you're doing it for someone else, but it's much easier to stop if you're doing it for yourself, and by really looking at why you want to stop you now have the reasons why you want to stop harming.

Scar Tissue doesn't force people to stop self harming. We recognise that self harm is a coping mechanism, and in some cases not self harming would lead to something much worse. There is a lot of advice both on the website and the messageboard about stopping or reducing self harm, and coping strategies or distraction techniques, but we encourage people to stop in their own time, after looking at why they self harm and what they hope to achieve through stopping.

Self harm is usually used as a coping mechanism; it's the first thing you think of when things go wrong, or you feel like you need to be punished. As a coping mechanism it works well in the short term. It provides an escape, it gives you release, it grounds you, it's the one thing you can control and it can even punish you, if that's how you use it. But the one thing it fails to do is help you with the issue that made you want to escape in the first place. You wake up the next day with the same stresses, the same problems, but with extra wounds, pain and guilt. In the long term, self harm causes more problems than it appears to solve.

So how can you stop self harming without worrying about slipping up or falling back into old routines? Self harm isn't usually the problem itself, but the way that the problem is expressed, so to stop self harming you need to work out what the problem is and what you can do about it.

Working out the pros and cons

A good way of establishing whether you need to self harm and what you can do instead is to work out the pros and cons. This is something that I do a lot when I'm trying to decide what the best course of action will be and it can be used for anything from deciding whether to have an extra slice of cheesecake to what car I want to buy.

This is an easy exercise to do and consists of writing two sets of lists. It allows you to think about the positive and negative aspects of getting through a crisis without doing something harmful or impulsive, versus the positive and negative aspects of handling the situation by engaging in harmful or destructive behaviour. By doing this you can focus not only on the short term advantages and disadvantages of this behaviour but also take a more long term view and think about some of the negative consequences which accompany destructive behaviour.

Instructions:

Draw up a table divided into four sections.

The upper section is for a list of the pros and cons of not tolerating the distress - that is, coping by hurting yourself, abusing alcohol or drugs or doing something else impulsive or destructive.

The lower section is for another list of the pros and cons of tolerating the distress - that is coping by using the crisis survival skills.

When making these lists look at both the short term positive and negative consequences and more long term positive and negative consequences. Think about and list the positive consequences of tolerating the distress and engaging in more effective behaviour. Imagine in your mind you good you will feel if you achieve your goals, if you don’t act impulsively. Think of all the negative consequences of not tolerating your current distress and of acting impulsively to escape the moment. In your list, focus on your long term goals, the light at the end of the tunnel. Remember times when you have felt better.

If you want to, you can save and print out this picture, giving you some space to analyse the pros and cons of engaging in non-helpful behaviour, or you can use this as the basis for your own table:

The key to reducing or stopping your self harm isn't to find something that makes you feel like you have to quit - the friends, family or partners mentioned above - all that does is place more pressure on you, making you feel as though you've lost your only way of coping and have nothing to replace it with. You have to work on the root issues; the problems that make you want to self harm in the first place, and get to the stage where the urge to self harm lessens, and when it does come you're able to deal with it.

Getting there isn't easy, I'll be honest, and it's going to be different for each person who tries to stop, so there are no magic answers to be found on this site. If I could wave a magic wand and make everyone's problems go away, believe me I would, but a lot of the time it's not where you're going but how you get there that's important and the same applies in your journey to stop self harm. As you work on the issues that you have to deal with you will find out new things about yourself, and realise that you are much, much stronger than you give yourself credit for.

To begin this journey then, you need to start exploring the reasons why you self harm. You can do this on your own, and we have things that can help you, but you'll need to be prepared to deal with the answers you get. If you can get the support of a therapist, friend (online or off) or family member who you can communicate with and trust it becomes easier to explore these issues, but however you decide to examine yourself it will become clear what it is that is lies at the root of your self harm.

Next you need to establish why you self harm. The list you've made of why you want to stop will be one of the things that helps you when you're looking at why you self harm, and when you're dealing with the urges to.

Examining the reasons behind your self harm

We all know the urge to self harm; the way it feels when you think that nothing other than picking up that knife will help. But before you self harm write down the issue that's hiding behind the urge. Look at it, and ask yourself these questions:

Why do I feel I need to hurt myself? What has brought me to this point?

Have I been here before? What did I do to deal with it? How did I feel then?

What I have done to ease this discomfort so far? What else can I do that won't hurt me?

How do I feel right now?

How will I feel when I am hurting myself?

How will I feel after hurting myself? How will I feel tomorrow morning?

Can I avoid this stressor, or deal with it better in the future?

Do I need to hurt myself?

Write down the answers to those questions. They are difficult ones to ask, and the answers may not be easy to hear, but in order to reduce or stop your self harm you need to look at why you want to do it, and ask yourself if there's anything else you can do.

Once you've thought about those questions, look at these:

How will this situation or feeling change if I hurt myself?

What will hurting myself bring to the situation? What will it take away from the situation?

How do I want to feel about this in the long run? Is hurting myself likely to get me closer to or farther from feeling that way?

If hurting myself seems like my best option right now, how long will the relief it brings last? What will I do when that relief has gone?

What is something I could do now instead of hurting myself? How will it change the situation I'm in? How long will that change last, and what will I do then?

How will I feel tomorrow if I hurt myself? How will I feel tomorrow if I don't hurt myself, but do something to distract myself?

What do I really want to do right now? How can I best honor the self-protective instinct that has me wanting to self-injure right now?

Those questions are similar to the first ones you answered, but they ask you to go into more depth. By really examining the reasons behind your self harm and how you feel about it, as well as looking at alternative options (coping strategies and distraction techniques) you are becoming more aware of yourself - of the way you feel about certain situations, of other ways in which you could deal with them, and of what you really want to achieve.

Accepting Outside Help

Once you've looked at why you self harm and why you want to stop, the next step is to accept outside help. Scar Tissue is a great place to get understanding, advice and support but it should really act as the first step to getting offline help. Scar Tissue is here to prove people can and do care - even when they are half way around the world - but none of us are trained therapists, and when you're halfway round the world it's hard to pop round for a cup of tea and a chat. It is offline help, talking to friends, family or a therapist, that most often holds the best chances of successfully tackling the issues that lead to your self harm.

If this sounds like a daunting and scary prospect, don't worry. Almost everyone who's been in this situation has worried about getting help. What will my family say, how will my friends react, what do I say to my GP, how do I find a therapist? - these are all questions that I, and many others, have certainly asked. But it is much easier than it sounds, and you're already part of the way there; you know why you self harm, and you know why you want to stop.

As I've said before, it is possible to stop self harm without having any mechanisms or support networks in place, but it is much, much easier to quit when you already have these mechanisms in place. The single biggest barrier to quitting self harm (which can also be the single biggest help) is your own mental strength. If you believe that you're going to fail, then you will. If you believe that you're going to succeed then you will make more of an effort to get past the problems you find along the way. I'm not saying that this guide to reducing or stopping your self injury is the definitive one - there are hundreds of ways that people can, and have, stopped self harming. But by following the steps mentioned above I think it becomes much easier to face up to the issues you're dealing with, and overcome them.

Recapping on what we've discovered so far

Some people won't believe that they have it in them to stop, and some really won't, but many people do, and they do it by finding others to talk to and get support from. Opening up to people doesn't mean releasing every skeleton in the closet. What it means is finding people around you to trust enough to talk to about daily issues and problems so that you can acknowledge and start to deal with them, rather than just hiding them away in a corner of your mind. When you do that it just buids up until one day it all becomes too much, which is exactly what we're trying to avoid.

Exploring yourself and your issues and problems is fundamental to this process. It's so easy to push things away and leave them undealt with and you end up distancing yourself from yourself. By working out what makes you happy, what makes you sad, what makes you feel weak, and what makes you feel strong you can start developing the range of coping mechanisms that you have, and the ones you need to work towards.

By turning over a series of new leaves it's possible to launch quitting self harm into a very different mindset. Some of the fundamental worries about stopping self harm are those where you have to quit, even though you don't want to; where slipping up throws you back into the same pattern of thinking yourself weak and pathetic. If you decide to stop self harming while undertaking some other activities, getting fitter perhaps, or eating more healthily, you catapult yourself into a mindset where you're so busy doing other things that the urge to harm lessens, and where slipping up isn't a reason to hate yourself, but a warning that you need to work on the healthier ways of coping.

Replacing Self Harm

You've come this far and you deserve to feel pleased with yourself. Not only have you established why you self harm, but you've acknowledged that you want to quit and have accepted outside help, from family, friends or a therapist, to keep you on the right path. So what can you do now to make those little slip ups less likely?

Make a list of things you enjoy doing. It doesn't matter what it is, just jot them down. For example, I like reading, music, horse riding, web design, writing and playing badminton. Take a look at your list and divide it into section. Physical, maybe; social; solitary; creative. Now put each of the things you enjoy doing into that section of your list. These are the things that you will be able to rely on when you get the urge to self harm. They're things you enjoy doing, so it should be easy to say 'instead of self harming I'm going to finish that book I started on the weekend'.

But as well as replacing self harm with things that you enjoy, it's worth trying to work other mechanisms into your daily routine so that if and when the urge to self harm hits, you'll have other things to replace it with. Join a gym, or a new class and review your eating, drinking and sleeping patterns. Start taking steps to 'out' some of the things that affect you during the day that you would normally keep to yourself. Try as many new coping mechanisms as you can. You've already made a list of things you enjoy, but go for a walk, or a ride; help others on Scar Tissue or elsewhere (online or off) or take a look at starting new ways of expressing yourself. A new instrument, a new journal, a set of paints or something else creative. These are all things that will reduce your need to self harm, and the great thing is they'll do it often without you realising it.

Try the 15 minute rule or other distraction techniques. It might not help, but then again it might - you won't know until you try. Break your habits - try throwing away all but the most necessary of tools. You can do this with as little or as much ceremony as you like. Throwing them in the bin might work best, or you can really create a ritual of out it and say goodbye to your tools at the same time as saying goodbye to your previous, bad, mindset. It might be hard, but when it's done you'll feel like a chain around you forcing you to continue with old patterns you're trying to break free from has lifted. Learn new ways of releasing pressure and, most of all, communication. These will start having a profound effect on your urges and the strength of them.

Each time you get an urge, talk to someone, take a walk, write in your diary, scream into your pillow, squeeze that ice cube hard in your hand. Do them all at once if that is what it takes. The trick is to keep challenging yourself to see if you can reduce the urge using a different method to self harm. See if you can last another 15 minutes by doing something you know is healthy, and if you can - try it for another 15.

Not all of these methods will work, and not all of the time will you stop that urge. But after a while of sticking with it, of exploring yourself and your issues, of using other coping methods and, most of all, of really wanting to stop, you will realise that you need self harm much less than you did before. And it feels good.

All of the hard work you've put in has paid off and not only do you feel the need to harm less than you did, you know much more about yourself than you did when you began.

Stopping Self Harm

Everything we've discussed so far is about reducing your self harm. If you can get to the stage where you are eating, drinking and sleeping properly, where you talk about problems in your day with those around you, where you can recognise the signs of a change in mood and know how to deal with it, then your journey is almost over. The frequency, length and intensity of the urges will grow less and less over time and you will have become much, much stronger.

It really is the starting that's the hard part; it looks really scary when you've just made the decision to stop self harming and stretching ahead of you are endless questions about how you're going to cope and what you're going to do. But now you're at the end of the journey and you can look back and see the lessons you've learned, and realise that while it might have been difficult, it really was worth it.

So now you're used to dealing with the urges, recognising when you're feeling down and have things in place to stop self harming, what next? Well, you can stick with reducing your self harm using the methods that I've discussed here; methods that you're, by now, familiar and happy with. Or you can just get rid of your tools full stop. It might be a bit daunting, or be a cause for a bit of anxiety, but by now you'll be using your tools very little. Throwing them away for good just reaffirms that you don't need to self harm anymore.

How to stay stopped

Even though you've stopped self harming, it's still a good idea to keep examining your thoughts and feelings. Doing this, and getting to know yourself and your moods better, is one of the key ways by which you've been able to quit, so to stop looking at yourself is a pretty good way of leading yourself back down that slippery slope; pushing feelings into the corner of your mind and isolating yourself.

All of the things I've mentioned so far are good things to keep doing. Exercise helps you keep physically and mentally fit; being creative helps your mind stay active and being sociable allows you to build your confidence and self esteem. If you find it hard to make yourself keep doing these things then create a routine. Set yourself targets and things that you want to do; if you try to think of it as being like a revision timetable (only hopefully more fun!) and do something each day it will soon become routine.

You could then think of adding in more things, for example taking up judo, or getting up a bit earlier on Sunday and doing some painting. Not only will these things help in keeping you physically, mentally and emotionally fit and active, they're great to store up if you do find yourself needing to beat the urge again.

Dealing with slip ups

Slip ups, unfortunately, are one of those things - the majority of people who decide to stop self harming will slip up at some point. It sounds depressing, I know, especially when you've put all that effort into stopping in the first place - it makes you wonder why bother. And that's where you need to stop and think about what you're feeling.

Self harm isn't a nice thing to deal with. We've already found out that self harm is linked closely to your self esteem, confidence and feelings of self worth. One of the reasons people self harm is to try and gain control when it feels like everything's going wrong, and that feeds into slipping up, making you feel like you can't even control yourself and making yourself feel even worse.

The most important thing to remember while reducing and stopping self harm is that it is a coping mechanism. It's what you've used for what ever length of time to help you deal with feelings and situations, and deciding to go cold turkey without having new ways of coping in place is going to lead to one hell of a roller coaster ride of emotions.

Slip ups are there to help you realise when something's not working. Self harm isn't a very good way of dealing with problems, but in the short term it works well and that's why it's hard to give it up. That's also why slipping up can be so easy; it's a case of 'better the devil you know' in some ways - you know self harm's not great, but it works. So why both trying to find something else? If you recognise that slipping up is simply one way of letting you know that what you're doing isn't working it's much easier to let it go.

Don't beat yourself up for cutting when you're trying to stop. Acknowledge it, allow yourself to cut once even, but then continue with quitting. Go back over the methods I've talked about - examine why you needed to cut then, and what methods you were using to stop. Why didn't they work? What can you do next time you feel like that?

Most importantly, don't make it so hard. Learn to recognise that every time you want to cut it's an alarm bell telling you that you need to find another way of release. You've made a list of things you enjoy, you're able to recognise when you're likely to want to self harm; with practice you can learn to use these other, better, ways of dealing with feelings and situations.

A new way to count

People talk about how many days they have been self injury free, then when they slip up they say "nine whole days down the drain", "what a waste of time" or "why do I even bother". We've all been there and we've more than likely said something to that effect ourselves. But saying this makes you, the person who’s trying so hard , sound like a horrible failure.

What we need is a new way of counting, and here it is. Let’s say you’re working on stopping, and you have fifteen days before you slip. That’s not fifteen days wasted at all! Since you only really ‘failed’ on the sixteenth day, let’s make it a ratio: for 15 of the last 16 days, you’ve been self harm free. That’s 15/16, 0.9375, or 93.75%. That's pretty impressive - since you started counting this time, you’ve been self harm free for 93.75% of the time. If you got a score like that on a test you'd be laughing! And that's the key to this method; see self harm like a test. You've worked for it (going through the methods I've discussed); you've practised (how many times have you not given in to the urges?) and you're doing pretty well.

Even if you only had six days SI-free, that’s still 6/7, or 85.7%.

If you feel you’ve lost a huge run of forty-six days, that’s 46/47, or 97.87%.

Looking at it this way is a bit more encouraging than saying, “I just blew twelve days...” which works out at 92.3%!

If you're the sort of person who needs a reminder now and again, you could even plot a graph. On the x-axis, number of times you’ve tried to “quit” and on the y-axis, a scale for percentages. Stick it up somewhere you can see it so it reminds you of how well you're actually doing.

Photographs © Danirat 2008