My name is Dr Emma Gray, and I'm the Lead Clinical Psychologist at the British CBT & Counselling
Service.
And in this video, I am going to share with you a three-step plan to help you to deal
with self-harm.
Okay, so, in the last video, I talked a little bit more about what self-harm is.
But, basically, it's where we intentionally cause ourself harm when we're feeling distressed,
and this harm, in the short-term, brings about a reduction in those feelings of distress.
Now, self-harm is a serious and very complex problem, so it needs a comprehensive plan
of attack—or solution.
So these three steps look at the short-term, the medium-term, and the long-term.
Okay, let's start with the short-term.
So, in the short-term, you need to try and develop an alternative to your self-harm that
brings about a similar amount of relief without causing you any physical harm.
So, this needs to be a sensory experience that's potent enough to distract you from
the distress that you're experiencing but also gives you a sense of control over your
experiences.
So, some of the things that people have used; having a freezing cold shower, eating a very
hot chilli pepper, going for a run (and I don't mean a gentle jog around the park, I
mean running as fast as you can for as long as you can, almost until you collapse, or
until you collapse), holding your breath until your lungs feel like they're going to burst,
and also, people have tried hanging upside down.
So, you can hang upside down on your bed—let all the blood rush to your head.
Or if you’re a little bit more athletic you can try a headstand or bending over backwards.
And again, you hold it until all of the blood has rushed to your head—be careful when
you get back up because you will feel a little bit dizzy, but that's the point, it's about
creating an overwhelming sensory experience which distracts you from your distress.
Now, in the short-term, none of these strategies are going to be as "effective" as your self-harm
in reducing your distress, but if you keep practising them, over time, they will bring
about enough of a reduction in the negative feelings to enable you to resist the urge
to harm.
Now, this is only the first step, so this isn't a solution, it's the first step of the
solution.
Okay, so, the second step is kind of your medium-term plan, and here you need to work
out why you're self-harming—now you might already know, but it might not be immediately
obvious—you need to work it out, so you know what you're dealing with.
So, self-harm kind of falls into two categories.
The first category is to reduce any psychological distress you're feeling—so, anxiety, anger,
depression.
The second category is where you're using your self-harm to alert the people around
you to your need for help, in the absence of other ways of doing it—so, it's, I guess,
the traditional cry for help, if you like.
Now, if you're falling into that latter category, I've listed some organisations in the description
below that you can contact and they will help you to think about other ways of getting your
needs met that don't cause you harm.
Okay, now, if you think that your self-harm is a way of managing distress, we'll move
on to look at that.
So, here, the way to work out why it's happening; if ever we're doing something that we don't
like, we need to look at how we're feeling because it's our feelings that determine what
we do.
And then, we look at our thoughts; our thoughts determine our feelings; our feelings determine
our behaviour.
So, the next time you notice an urge to self-harm or you notice you are self-harming, try and
work backwards from the behaviour.
So, backwards from the self-harm, how was I feeling just before I noticed this urge,
or just before I started to harm?
So, was I feeling anxious?
Was I feeling angry?
Was I feeling incredibly lonely?
And then, backwards again, what was I thinking?
What were the thoughts that kicked off that feeling?
It might be obvious to you straight away—but it might not, and if it's not, just have a
guess at it.
Your guess, you're guessing about your feelings and your behaviour, so it's going to be pretty
accurate.
Quite a common thought that triggers self-harm is, 'I'm feeling very alone, no one cares
about me, no one understands me.'
Okay, once you've got hold of that thought, you then need to look at its accuracy.
So, you do this by weighing up the evidence that you have to support the thought and the
evidence against that thought.
So, it can be quite helpful to sort of write it down in two columns—evidence for, and
evidence against.
When you've done that, and you've kind of worked out whether or not this thought is
accurate—because it might be accurate—then look at how helpful this thought is.
So, the idea here is, if you're trying to escape from the top floor of a burning building,
it might be accurate to think, 'I could die doing this.'
But, it's not a very helpful focus, so check out how helpful that thought is.
Once you've done this piece of work, you want to use all the information that you've gathered
to develop an alternative thought, an alternative to that thought that triggers your self-harm
and write it down.
And try and do this after every episode of self-harm.
And if you do this, over time, these alternative thoughts will start to, I suppose, sit in
your mind a little more, and help to reduce the distress that you feel before the self-harm,
and ultimately reduce the urge to self-harm, and the self-harm.
Now, as you can probably tell listening to this explanation, it's not straightforward
to do this.
So, give it a go, but you may find that you need a bit of extra support in the form of
some sort of therapy or counselling.
Okay, the third step, so your longer-term plan to tackle your self-harm, is to future-proof
any changes that you manage to make, and you do this by working out what it is that's made
you vulnerable to self-harm in the first place.
This is likely to be something that's happened in your past, your past experiences that have
shaped the way that you think about the world, the way that you think about yourself, the
value you place on yourself, what you expect from other people, and the way you think about
the world in general, is it a fair place, a safe place?—these sorts of things.
And again, this isn't always that straightforward, so you may choose to get a bit of extra support,
or help, in the form of some professional therapy or counselling.
But quite a good starting point, a self-help starting point, is a book called, ‘Reinventing
Your Life’—and I've put the link in the description, for this book.
But it helps you to start thinking about how your past experiences have shaped how you
think about things now.
Okay, so, that's the end of this video.
If it was helpful, please like, subscribe, and share with your friends.
And I'll see you soon.