Successful Coping Skill for Self-Injury

Long time no see.

Grad school is stressful (duh) and living on my own, in a new state, means much less support. However, I’ve managed relatively well. I’ve caused some bumps along the way, but I still have my internship and I’ve passed 2 out of 3 semesters. I’m about 1/2 through with my last semester right now!

I haven’t forgotten about the peeps who are just here for the inspirational pic 😉

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However, this week, stress has come to a head. Long story short: I was battling severe Self-injurious behavior urges today.

Details: I hadn’t slept in almost 48 hours because I am overwhelmed with the workload this semester and anxious I won’t pass. Granted, I am always anxious I won’t measure up. To be fair, this semester, the concern is warranted. I am currently failing one class. Uh oh!!

Using the syllabus I calculated the remaining possible points in the course and I can still pass as long as I do well on the midterm and final exams. The midterm is next week! I am extremely behind in reading. The exam is essay based and the questions come from the reading. Of course, this is no ones fault, but my own…

Anyway, the urges were intense enough that I was unable to function. I did not go to work yesterday. I got nothing done for school or my practicum, even though (for once) I was awake all day. This morning, intrusive images made it tough to distract from the urges. When suicidal thoughts and a plan entered the picture, I decided riding out the urges was not a safe option.

Buffy_too much for me want it to be over

In treatment, people sometimes held ice as a coping skill because it causes pain, but no tissue damage (as long as you are careful to watch for frostbite and are able to curtail the SIB urges enough to take off the ice as needed, if tissue damage begins). I find that a little helpful. The pain works to elevate my mood. However, blood is a strong motivation for me as well. It is a discriminative stimulus for relief from overwhelming negative emotions. The sight of my own blood is so strongly paired with SIB that without it, the compulsion remains.

Therefore, I tried something new! I froze ice cubes made by mixing red food coloring with water.

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It worked wonderfully!!! 🙂


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Next time I’ll do a few things differently. I’ll put a towel down under my arm to avoid staining. I got the red  out of the counter tops, but it took a few seconds with a Brillo pad. Additionally, I’ll have paper towels within reach.

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Surprisingly, the red dye came out of the silicon ice cube tray without a hitch,

The important take away is I avoided self-injuring despite struggling with the urges for over 24 hours.


If seeing blood and feeling pain are part of your self-injury, are there other ways you sublimate the urge? What works for you? I hope this helps someone avoid SIB.




Negative Attention

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I went to bed early last night, but I was extremely tired this morning. Half way to work, I realized I’ve forgotten my meds 3 days in a row. That explains the sleepiness because Adderall keeps me awake. However, I was disappointed because I knew I’d be tired all day. When I arrived at work, I considered cutting to wake myself up. I’m not sure, but I think cutting wakes me up and helps me focus because the pain and blood activate Fight or Flight syndrome. Regardless, once that thought crossed my mind, I leaped to staining my clothes with blood on purpose. At that point in my thought process, I paused, realized I was attention seeking and felt crappy about myself.

I sent Ginny a weird text, which was apparently incoherent. I told her I was having attention seeking urges and I didn’t know why, but I was texting her instead. I had to turn my phone off.

Since I woke up, I planned to restrict because I felt guilty for eating candy and I weighed myself last night. When I walked into the lunch room with my diet coke, Ginny was there, eating lunch. Crap! Thankfully, I had an old frozen dinner in the freezer. So, I grabbed that and ate it. I hope she didn’t notice I wasn’t eating at first. Probably not, for all anyone knew, I grabbed a drink before heating up lunch. Anyway, that was slightly awkward.

I was with John all day. He was pretty good. Although, the new BCBA had us ignore him trying to run away. We just blocked and continued ignoring. Usually, we’d count that as unsafe. I’m okay with that, I just want everyone to do the same thing so that he has consistency. Later, he attempted to choke someone, twice, and my boss didn’t prompt him to the Quiet Room. That bothered me. The situation was unique, but it makes me think his increase in aggression is due to lack of consequences for attempted aggression. Nonetheless, most of our day was good. We watched a lot of Mario videos on Youtube and discovered Super Mario 2 is weird!

I need to figure out why I want negative attention and not positive attention. Perhaps Cory can enlighten me. 😉

I think part of it is that I want people’s concern (in this case, Ginny and Iris). There must be something else to it though.

Does anyone have a wild guess as to why I want negative attention??


Edited to Add: I think I do it because negative attention seeking is more efficient (easier and faster) and predictable. In that case, WHAT can I do instead?!?

Running instead of Cutting



I tried running to cope when I wanted to cut earlier. I don’t even remember the trigger anymore. It sort of worked. At first it helped, but once I started breathing normally again, my SIB urges returned. So, I tried running again. This time I ran until I literally could not keep pace anymore. The second time, my SIB urges did not return. However, predictably, I was tired!

Along with eradicating unpleasant emotions and pushing distressing thoughts away, cutting helps me focus. It makes me more alert and concentration is easier. Running did the opposite. I was too tired to focus on the video lecture!

I liked the thought of running because it serves many purposes (self-punishment, emotional regulation, pushing thoughts away, measurable progress). If you use running or exercise to cope, do you always feel tired after or do you get used to it? If you always feel tired, how do you wake yourself up? Or do you have alternate coping skills that serve all these purposes?

So, the search for a replacement behavior continues.

The next class for my course was this evening. It went well, but my stupid internet kicked me offline THREE times! That was hugely triggering and I couldn’t just leave and cut or run because you have to answer questions. Next time I’m going to Starbucks.


Alternatives to Self-Injury and ED


I made a chart to try to help myself think of things I can instead of eating disorder or self-injury behaviors. I’m not done with this chart. I still need to add antecedents (the specific event that causes behavior, Ex. my friend criticizes my clothes) and setting events (any physical, social, environmental, or physiological event that increases the likelihood an antecedent will trigger behavior, Ex. having a cold, being in a crowded room, feeling overheated).

However, I finished the function of behaviors (what the behavior does for me) and replacement behaviors (things I can do instead of ED or SI) sections of my chart. It is still important to identify the setting events and antecedents because that can help me use coping skills before I start feeling upset.


What coping skills or replacement behaviors help you? Do you have any thoughts on what I wrote? Thanks!


Setting Event Antecedent Function Replacement Behavior
    Concern/ caring from others ???
    Pushing people away Just stop talking to them, depression makes you do that anyway. Plus, people seem to drift away even when you don’t want them to. Therefore, you don’t need behaviors to separate the wheat from the chaff. What you really mean is testing loyalty. You want to see who stays, but those who aren’t true friends will eventually leave anyway, why torture yourself to test the people who love you?
    Keeping others close Make an effort to do specific things with people you care about at regular intervals, show them you care, basically, be a friend to have friends
    Distraction This is similar to the boredom ideas, but use things that specifically take your mind away like reading or a movie or an opposite emotion (ex. Comedy) TV show.
    Self-punishment/ Guilt ???
    Expressing anger ???
    Self-esteem Measurable success is part of self-esteem. However, there are other reasons. One way ED, SI, and BDSM give me self-esteem is that I can endure things that are considered torture by civilized societies (starvation, whipping, cutting, burning, and stress positions). This also ties into strength and power. Part of the issue is I KNOW I am good at these things. Ever since I was little my parents remarked on my pain tolerance. My dad and I used to play games to see who (my brother or I) could withstand pain or cold the longest. One time I passed out. Another time, I started bleeding. I KNOW I am good at weight loss. I don’t know if I’m good at anything else.
    Measurable success Lots of things are measurable! How fast or far you can run, how much weight you can lift, etc. Don’t use things that are dependent on others’ evaluation like grades in school or performance evaluations at work. Those aren’t objective.
    Emotional stability Work on emotional regulation techniques in DBT workbook? However, behaviors are more effective because I don’t have to feel things as strongly in the first place! Emotional regulation requires experiencing the full force of my emotion and dealing with them better. With ED especially, I don’t have to feel in the first place. Restricting blunts all my emotions. How can healthy emotional regulation be preferable?
    Strength/ Power/ Control (superiority to others) Most of the time, I feel weak and pathetic. When I use behaviors or endure pain to give someone else pleasure, I show strength and willpower and self-control. Exercising through pain or to exhaustion might have the same effect.
    Alleviates Boredom Incorporate fun things into your daily life, so boredom isn’t a problem. Relearn knitting, horseback riding, reading, etc.
    Alleviates Loneliness Do things on a regular basis with friends. Try, go to classes like art classes at Michaels, go to support groups. However, this requires more effort then behaviors. I KNOW behaviors. Also, how do I know anything other than the first idea will actually work? I don’t, but I guess I should try. I lose nothing by trying. I can’t do things on a regular basis with friends because they don’t actually want to do anything with me. I try to set things up and it never works out.


Head Banging Substitute

Ginny had an excellent, simple idea! When you want to hurt yourself lie down in bed with a pillow and hit your head there. I tried it tonight and it worked! Incredibly it worked better than my earlier binge.

Cara's DANG or OH WOW face

I FINALLY found something less destructive that works as well as my maladaptive coping mechanisms!! It isn’t perfect because it is uncomfortably close to self-injury, but it is huge progress.

Self-Injury Alternatives

In my experience, my emotion determines which coping skills works. For example, when I’m intropunitively angry I feel the need to punish myself, but when I’m sad distraction might help alleviate the urges.

Alternatives for when you’re feeling angry or restless:

  • Scribble on photos of people in magazines
  • Viciously stab an orange
  • Throw an apple/pair of socks against the wall
  • Have a pillow fight with the wall
  • Scream very loudly
  • Tear apart newspapers, photos, or magazines
  • Go to the gym, dance, exercise
  • Listen to music and sing along loudly
  • Draw a picture of what is making you angry
  • Beat up a stuffed bear
  • Pop bubble wrap
  • Pop balloons
  • Splatter paint
  • Scribble on a piece of paper until the whole page is black
  • Filling a piece of paper with drawing cross hatches
  • Throw darts at a dartboard
  • Go for a run
  • Write your feelings on paper then rip it up
  • Use stress relievers
  • Build a fort of pillows and then destroy it
  • Throw ice cubes at the bathtub wall, at a tree, etc.
  • Get out a fine tooth comb and vigorously brush the fur of a stuffed animal (but use gentle vigor)
  • Slash an empty plastic soda bottle or a piece of heavy cardboard or an old shirt or sock
  • Make a soft cloth doll to represent the things you are angry at; cut and tear it instead of yourself
  • Flatten aluminum cans for recycling, seeing how fast you can go
  • On a sketch or photo of yourself, mark in red ink what you want to do. Cut and tear the picture
  • Break sticks
  • Cut up fruits
  • Make yourself as comfortable as possible
  • Stomp around in heavy shoes
  • Play handball or tennis
  • Yell at what you are breaking and tell it why you are angry, hurt, upset, etc.
  • Buy a cheap plate and decorate it with markers, stickers, cut outs from magazines, words, images, what ever that expresses your pain and sadness and when you’re done, smash it. (Please be careful when doing this)
  • The Calm Jar (Fill a mason jar or similar with colored water and glitter. When feeling upset or angry you can shake it to disturb the glitter and focus on that until the glitter settles.)
  • Blow up a balloon and pop it
  • Pull weeds

Alternatives that will give you a sensation (other than pain) without harming yourself:

  • Hold ice in your hands, against your arm, or in your mouth (Be careful, if you hold it too long, you can give yourself frostbite)
  • Run your hands under freezing cold water
  • Snap a rubber band or hair band against your wrist (Another one to be wary of, I’ve bruised myself doing this)
  • Clap your hands until it stings
  • Wax your legs
  • Drink freezing cold water
  • Splash your face with cold water
  • Put PVA/Elmer’s glue on your hands then peel it off (This one is good for the sensation of picking scabs)
  • Massage where you want to hurt yourself
  • Take a hot shower/bath
  • Jump up and down to get some sensation in your feet
  • Write or paint on yourself
  • Arm wrestle with a member of your family
  • Take a cold bath
  • Bite into a hot pepper or chew a piece of ginger root
  • Rub liniment under your nose
  • Put tiger balm on the places you want to cut. (Tiger balm is a muscle relaxant cream that induces a tingly sensation. You can find it in most health food stores and vitamin stores.)

Alternatives that will distract you or take up time:

  • Say “I’ll self harm in fifteen minutes if I still want to” and keep going for periods of fifteen minutes until the urge fades
  • Color your hair
  • Count up to ten getting louder until you are screaming
  • Sing on the karaoke machine
  • Complete something you’ve been putting off
  • Take up a new hobby
  • Make a cup of tea
  • Tell and laugh at jokes
  • Play solitaire
  • Count up to 500 or 1000
  • Surf the net
  • Make as many words out of your full name as possible
  • Count ceiling tiles or lights
  • Search ridiculous things on the web
  • Color coordinate your wardrobe
  • Play with toys, such as a slinky
  • Go to the park and play on the swings
  • Call up an old friend
  • Go “people watching”
  • Carry safe, rather than sharp, things in your pockets
  • Do school work
  • Play a musical instrument
  • Watch TV or a movie
  • Paint your nails
  • Alphabetize your CDs or books
  • Cook
  • Make origami to occupy your hands
  • Doodle on sheets of paper
  • Dress up or try on old clothes
  • Play computer games or painting programs, such as photoshop
  • Write out lyrics to your favorite song
  • Play a sport
  • Read a book/magazine
  • Do a crossword
  • Draw a comic strip
  • Make a chain link out of paper counting the hours or days you’ve been self harm free using pretty colored paper
  • Knit, sew, or make a necklace
  • Make ‘scoobies’ – braid pieces of plastic or lace, to keep your hands busy
  • Buy a plant and take care of it
  • Hunt for things on eBay or Amazon
  • Browse forums
  • Go shopping
  • Memorize a poem with meaning
  • Learn to swear in another language
  • Look up words in a dictionary
  • Play hide-and-seek with your siblings
  • Go outside and watch the clouds roll by
  • Plan a party
  • Find out if any concerts will be in your area
  • Make your own dance routine
  • Trace your hand on a piece of paper; on your thumb, write something you like to look at; on your index finger, write something you like to touch; on your middle finger, write your favorite scent; on your ring finger, write something you like the taste of; on your pinky finger, write something you like to listen to; on your palm, write something you like about yourself
  • Plan regular activities for your most difficult time of day
  • Finish homework before it’s due
  • Take a break from mental processing
  • Notice black and white thinking
  • Get out on your own, get away from the stress
  • Go on YouTube
  • Make a scrapbook
  • Color in a picture or coloring book.
  • Make a phone list of people you can call for support. Allow yourself to use it.
  • Pay attention to your breathing (breath slowly, in through your nose and out through your mouth)
  • Pay attention to the rhythmic motions of your body (walking, stretching, etc.)
  • Learn HALT signals (hungry, angry, lonely, tired)
  • Choose a random object, like a paper clip, and try to list 30 different uses for it
  • Pick a subject and research it on the web – alternatively, pick something to research and then keep clicking on links, trying to get as far away from the original topic as you can.
  • Take a small step towards a goal you have.
  • Re-organize your room
  • Name all of your soft toys
  • Play the A-Z game (Pick a category i.e.. Animals, and think of an animal for every letter of the alphabet)
  • Have a lush warm bubble bath with candles!
  • Do some knitting
  • Do some house hold chores
  • Go to the zoo and name all of the animals
  • Blow bubbles

Alternatives for when you’re feeling guilty, sad, or lonely:

  • Congratulate yourself on each minute you go without self harming
  • Draw or paint
  • Look at the sky
  • Instead of punishing yourself by self harming, punish yourself by not self harming
  • Call a friend and ask for company
  • Buy a cuddly toy
  • Give someone a hug with a smile
  • Put a face mask on
  • Watch a favorite TV show or movie
  • Eat something ridiculously sweet
  • Remember a happy moment and relive it for a while in your head
  • Treat yourself to some chocolate
  • Try to imagine the future and plan things you want to do
  • Look at things that are special to you
  • Compliment someone else
  • Make sculptures
  • Watch fish
  • Youtube funny videos!
  • Let yourself cry
  • Play with a pet
  • Have or give a massage
  • Imagine yourself living in a perfect home and describe it in your mind
  • If you’re religious, read the bible or pray
  • Light a candle and watch the flame (but please be careful)
  • Go chat in the chat room
  • Allow yourself to cry; crying is a healthy release of emotion
  • Accept a gift from a friend
  • Carry tokens to remind you of peaceful comforting things/people
  • Take a hot bath with bath oil or bubbles
  • Curl up under a comforter with hot cocoa and a good book
  • Make affirmation tapes inside you that are good, kind, gentle (Sometimes you can do this by writing down the negative thoughts and then physically re-writing them into positive messages)
  • Make a tray of special treats and tuck yourself into bed with it and watch TV or read
  • Write words in the sand for them to be washed away

Alternatives for when you’re feeling panicky or scared:

  • “See, hear and feel”-5 things, then 4, then 3 and countdown to one which will make you focus on your surroundings and will calm you down
  • Listen to soothing music; have a CD with motivational songs that you can listen to
  • Meditate or do yoga
  • Name all of your soft toys
  • Hug a pillow or soft toy
  • Hyper focus on something
  • Do a “reality check list” – write down all the things you can list about where you are now (e.g. It is the 9th November 2004, I’m in a room and everything is going to be alright)
  • With permission, give someone a hug
  • Drink herbal tea
  • Crunch ice
  • Hug a tree
  • Go for a walk if it’s safe to do so
  • Feel your pulse to prove you’re alive
  • Go outside and attempt to catch butterflies or lizards
  • Put your feet firmly on the floor
  • Accept where you are in the process. Beating yourself up, only makes it worse
  • Touch something familiar/safe
  • Leave the room
  • Lay on your back in bed comfortably (eyes closed), and breathe in for 4, hold for 2, out for 4, hold for 2. Make sure to fill your belly up with air, not your chest. If your shoulders are going up, keep working on it. When you’re comfortable breathing, put your hand on your belly and rub up and down in time with your breathing. If your mind wanders to other things, move it back to focusing ONLY on the synchronized movement of your hand and breathing.
  • Give yourself permission to…. (Keep it safe)
  • Create a safe place for yourself and take yourself there
  • Lay on the grass and watch the clouds. You can try to make pictures with them too.
  • Light a candle and watch the flame

Alternatives that will hopefully make you think twice about harming yourself:

  • Think about how you don’t want scars
  • Treat yourself nicely
  • Remember that you don’t have to hurt yourself just because you’re thinking about self harm
  • Create a safe place to go
  • Acknowledge that self harm is harmful behavior: say “I want to hurt myself” rather than “I want to cut”
  • Repeat to yourself “I don’t deserve to be hurt” even if you don’t believe it
  • Remember that you always have the choice not to cut: it’s up to you what you do
  • Think about how you may feel guilty after self harming
  • Remind yourself that the urge to self harm is impulsive: you will only feel like cutting for short bursts of time
  • Avoid temptation
  • Get your friends to make you friendship bracelets: wear them around your wrists to remind you of them when you want to cut
  • Be with other people
  • Make your own list of things to do instead of self harm
  • Make a list of your positive character traits
  • Be nice to your family, who in return, will hopefully be nice to you
  • Put a Band-Aid on the area where you’d like to self harm
  • Recognize and acknowledge the choices you have NOW
  • Pay attention to the changes needed to make you feel safe
  • Notice “choices” versus “dilemmas”
  • Lose the “should-could-have to” words. Try… “What if”
  • Kiss the places you want to SH or kiss the places you have healing wounds. It can be a reminder that you care about myself and that you don’t want this
  • Choose your way of thinking, try to resist following old thinking patterns
  • The Butterfly Project- draw a butterfly on the place(s) that you would self harm and if the butterfly fades without self-harming, it means it has lived and flown away, giving a sense of achievement. Whereas if you do self-harm with the butterfly there; you will have to wash it off. If that does happen, you can start again by drawing a new one on. You can name the butterfly after someone you love, or have a loved one draw it for you. (I’ve tried this before, but it sets me up to feel guilty)
  • Write the name of a loved one [a friend, family member, or anyone else who cares about you] and write their name where you want to self harm. When you go to self harm remember how much they care and wouldn’t want you to harm yourself.
  • Think about what you would say to a friend who was struggling with the same things you are and try to be a good friend to yourself.
  • Make a bracelet out duct tape, and put a line on it every day (Or any period of time) you go without self harm. When it’s full of lines, take it off and make a chain out of all the bracelets and hang it up somewhere where you can be reminded of your great progress.

Alternatives that give the illusion of seeing something similar to blood:

  • Draw on yourself with a red pen or body paint
  • Cover yourself with plasters where you want to cut
  • Give yourself a henna or fake tattoo
  • Make “wounds” with makeup, like lipstick
  • Take a small bottle of liquid red food coloring and warm it slightly by dropping it into a cup of hot water for a few minutes. Uncap the bottle and press its tip against the place you want to cut. Draw the bottle in a cutting motion while squeezing it slightly to let the food color trickle out.
  • Draw on the areas you want to cut using ice that you’ve made by dropping six or seven drops of red food color into each of the ice-cube tray wells.
  • Paint yourself with red tempera paint.
  • ‘Cut’ your skin with nail polish (it feels cold, but it’s hard to get off)
  • Use red food coloring on your skin (I’ve used this one and it really looks like blood. I like it.)

Alternatives to help you sort through your feelings:

  • Phone a friend and talk to them
  • Make a collage of how you feel
  • Negotiate with yourself
  • Identify what is hurting so bad that you need to express it in this way
  • Write your feelings in a diary
  • Free write (Write down whatever you’re thinking at that moment, even if it doesn’t make sense)
  • Make lists of everything such as blessings in your life
  • Make a notebook of song lyrics that you relate to
  • Call a hotline
  • Write a letter to someone telling them how you feel (but you don’t have to send it if you decide not to)
  • Start a grateful journal where every day you write down three: good things that happened/ things that you accomplished/ are grateful for/ made you smile. Make sure the journal is strictly for positive things. Then when you feel down you can go back and look at it.