
                            Kharre's SI coping tips
                                       
   This is a collection of extremely useful ideas about how to deal with
   the urge to self harm. They were originally posted to the
   bodies-under-siege list and are used by permission of the [1]author.
   All of them are great, but the section on [2]how to react to a loved
   one who self-injures is fantastic, probably the best advice I've seen
   that's directed toward family and friends of self-injurers.
   
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   [3]Questions to ask before you hurt yourself
   [4]Realistic acceptance
   [5]A letter to my SI
   [6]Things to help you through the bad times
   [7]Important tips for those who interact with someone who SIs
   
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   First: People SI for many different reasons. In my particular case I
   SI to deal with severe stress and pain, and to express emotions that
   overwhelm me. Also, when I first began trying to stop I found that
   there were two different motivators for my cutting. One was that I
   felt I needed to, but the other was because I wanted to.
   
When I feel I need to cut I ask myself the following questions:

    1. Why do I feel I need to hurt myself? What has brought me to this
       point?
    2. Have I been here before? What did I do to deal with it? How did I
       feel then?
    3. What I have done to ease this discomfort so far? What else can I
       do that won't hurt me?
    4. How do I feel right now?
    5. How will I feel when I am hurting myself?
    6. How will I feel after hurting myself? How will I feel tomorrow
       morning?
    7. Can I avoid this stressor, or deal with it better in the future?
    8. Do I need to hurt myself?
       
   The questions differ a little bit every time, but I will not cut if I
   cannot answer them. At first I would write them down, but now I run
   through them in my head. The most important questions on the list are
   #'s 4 to 6. In the beginning I would give myself little half-assed
   answers, but as each month passed my answers to myself became more
   detailed and I began to learn things about myself. I also found out
   that I can lessen or avoid stress, rather than running blindly into
   it. It also used to be that #8's answer was always 'yes', but now it
   is way more often a 'no'.
   
   What this exercise is doing is helping me learn how to identify my
   emotions and stressors, which is a very important part for me, because
   those are the things that drive me to SI.
   
Realistic Acceptance

   I did two things that ended up being VERY important.
   
   First, I accepted cutting as a good thing. It helped me deal with
   things I otherwise could not deal with. It gave me a fast and easy
   release valve anytime that I needed one. It allowed me to swim where I
   would have once drowned. (I primarily did this because SI is a
   never-ending circle. I would cut and then I would feel like I was bad.
   The guilt and shame was incredible, and I would cut again to ease the
   guilt - I was continuing the circle.)
   
   Second, I acknowledged it as a harmful behaviour. I do not say "I want
   to cut" anymore. I say "I want to hurt myself".
   
   Understand the difference?
   
   I sometimes want to cut, but I don't ever want to hurt. By replacing
   the rather impersonal word "cut" with "hurt" my mind was forced to
   acknowledge this as a harmful behaviour.
   
   We say "cut the Turkey", not "hurt the Turkey", and I was implying
   that I was an unfeeling thing to be carved up.
   
  I AM NOT JUST CUTTING MY FLESH - I AM HURTING MYSELF.
  
A letter to SI

   I wrote a letter that went something like this.... (I'll write another
   because I have found that it helps me to write these occasionally):
   
     Dear Cutting,
     Thank you for being such a great friend.
     Thank you for always being there for me.
     Thank you for helping me out when I couldn't continue on my own...
     
     I'm sorry, though, because I don't need you anymore, Cutting.
     I don't want this type of help that you give me. I don't want to
     hide in a dark bathroom anymore while people are outside laughing.
     I want to be one of the ones who laugh.
     I don't have the time to give to you anymore, and you are too
     greedy, you keep wanting more and more time.
     I am all grown up now, and yet you make me feel like a frightened
     little child. Swimming through tidal waves isn't good enough for me
     anymore, I want to learn how to fly.
     See, I have discovered that you're not just an anti-anxiety
     pill...I have discovered that you are also a very dangerous one.
     You are eating away my insides, taking away what little control
     that I have, and I can't afford to lose anything more that belongs
     to me.
     I don't need what you give me, because what you are taking away
     from me is even more important to me.
     
Things that help me to avoid hurting myself

     * I jump on the computer and find someone to email. We talk about
       everything and anything, and I try to avoid mentioning
       self-injury.
     * I do productive things that keep me busy and active. I clean the
       back porch, a closet, or mop the floors.
     * I walk a lot, and think.
     * I write about self-injury. (Like now.) I write about my failures
       and successes both and it helps, if anything, just to keep me
       busy.
     * A great tip a friend gave me:
       TREAT YOURSELF NICE, EVEN IF YOU FEEL YOU DON'T DESERVE IT!
       Once someone told me that her therp had suggested doing something
       nice for herself after SI'ing. So I tried it. I cut one night, and
       then afterwards I took a bubble bath, and took a cup of hot
       chocolate and a good book to bed early. It really did help.
       And then one day.....I thought......If doing something nice for
       myself after self-injuring makes me feel better, then maybe it
       would help if I did something nice as a treat for NOT cutting.
       It makes sense to baby ourselves when we feel bad after hurting
       ourselves, so doesn't it also make sense that it would help to do
       it before we cut when we are feeling our worst?
       So when the cutting urge is strong, I try doing something I like.
       Visiting my mom, painting, reading, bubble bath in the dark with
       music playing. My gift to myself for not cutting. It doesn't work
       all the time, but it does work a lot.
     * Make an emergency box. Suggestions on what to include:
          + Crayons, or paint, and paper.
          + Little toys (happy meal toys) that you like.
          + A puzzle.
          + A word game book.
          + Your favourite book.
          + A tape of your favourite songs.
          + Pictures of friends.
          + Letters that are special to you (or cards).
          + A book or tape of inspirational messages.
          + A list of phone numbers and addresses of friends. (Make phone
            calls, or write letters.)
          + Stories about your special memories.
       Only open your emergency box in an emergency, or it loses it
       special-ness. About once every two or three months entirely change
       the contents. Have an SO or a friend, or your child pick something
       special to put into the box while you're not looking so that there
       will be a surprise for you when you do have to open it.
     * Are you sure you're going to self-injure?
       Has it taken over your thoughts like it does with so many of us?
       Can you picture it in your mind?
       Can you see yourself self-injuring? Imagine every step of the way?
       When I want to cut I can see it all in my mind. Many of us can.
       You have to get it OUT!!!!
       So start writing!!!!
       Write it all out. Be very descriptive, describe every little step.
       Only do this when you feel you are SURE you will be hurting
       yourself, otherwise you may trigger yourself into doing it when
       you don't want to. Go back and read it again.
       Get another piece of paper, and write it all over again, only this
       time leave out the vivid physical description, and instead write
       only about emotions. Begins sentences with: "I feel....", "I want
       to feel.....", "I don't feel.....", "when I _____, I feel...".
       This may release the tension (having someone else actually read it
       sometimes helps, if you need to you can send it my way, or take it
       into your therp's office). It may just emotionally exhaust you so
       that you don't have the energy to hurt yourself.
       And if it doesn't work you have a written record of your emotions
       that you can look back on later that really could help you get a
       better insight into your self-injury.
       
   The key is to learn how to identify your emotions, triggers, and
   stressors, so that you can learn how to better deal with them in the
   future, or how to avoid or lessen them.
   
   Allow yourself to hurt and to be angry and to feel guilt, but also
   remember that you have to learn how to deal with these things and how
   to ease them.
   
  Important:
  
   Every one of us is different. We all SI for different reasons and in
   different ways. If none of these suggestions work for you, then don't
   give up. Change them. Try something totally different, or do the same
   things in unusual ways. Individualise your coping methods. Tailor them
   so they fit you snuggly and comfortable.
   
   Maybe instead of writing you can use a tape recorder.
   
   Or instead of doing something nice for yourself, do something for
   someone else. There are many ways for us to heal, and not everything
   that works for someone else works for us.
   
   Don't give up. Keep trying, and remember to try each thing you think
   of more than once, because it takes time to get used to new habits and
   get rid of the old.
   
   And no one is perfect, but if you can go three days, or eight, or
   thirty without SI'ing, then remember that you may have SI'ed, but you
   went without it for a time. Every bit of progress is great, but too
   often we don't recognise it as a forward motion. The fact that you
   went 8 days without SI'ing is much more important than the fact that
   you did end up hurting yourself.
   
   The three things that help me not to cut the most:
    1. Wearing long sleeves. See, I rub at my scars a lot, and sometimes
       looking at them makes me want to cut. I have problems bathing when
       I am in a cutting mood, because it means I have to see the cuts. I
       have found that keeping them covered, even at night, helps me
       avoid cutting.
    2. Writing about self injury helps me. Either writing about it, or
       writing out coping methods (like now). It doesn't really bring any
       special awareness, but it does keep me busy, especially mentally.
    3. Pure luck.
       
Things that friends and family can do to understand self-injury better, and to
help a self-injurer

   "Hi, how are you today? Did you cut last night?"
          Please, please. I reserve this question for my husband and
          counselor only, and I don't want to hear it from anyone else.
          The truth is, if you already know your friend SI's, then if
          your friend ever wanted to talk about it s/he would try to
          approach you about it. If you sense that your friend needs to
          talk then ask questions. Through asking questions we can learn,
          grow, and maybe understand.
          "How are you today?"
          "How was your night?"
          "How are you feeling?"
          Don't treat the self-injury as anything special. It is a part
          of your friend, just like your nail biting habit is a part of
          you, and s/he already has a million people trying to tell them
          how awful self-injury is. On the other hand, you don't want to
          encourage it either.
          What do you do about the neighbour's habit of chewing her lip?
          Your Uncle Bill's habit of tugging his moustache?
          You ignore, sometimes you kindly say "don't do that". You don't
          preach on them, though.
          
   Here is the number one tip if you have a friend or family member who
          self-injures:
          Emotions.
          There it is. Always remember it. Emotions.
          
   Me: "I blew it. I hadn't cut in 14 days, and I cut really bad last
          night."
          Someone: "That's okay. Next time won't be so bad."
          NO. We are creatures of sub-consciousness, and the above
          comment leads us to believe that there will be a next time, and
          it terribly undermines the fact that I went 14 days without
          cutting.
          
   Me: "I blew it. I went 14 days, but cut last night."
          Someone: "How bad did you cut? Are you okay? Does it need
          stitches?
          While it is okay to be concerned I would wait on questions like
          this. Wait until s/he feels comfortable enough with you to
          start telling details about self-injury and their emotions.
          Talking about the act itself will sometimes undermine the
          feelings behind the act, and very often it causes me, as a
          self-injurer, to dwell on it. When I think a lot about my cuts
          I'll cut again. Keep your friend's mind off of it for a while.
          If you are truly concerned then go ahead and ask after you find
          out if your friend is okay emotionally.
          
   Don't ever ask to see the wounds.
          They may look awful to you and you may force your friend into
          an unneeded hospital trip. If you do see it and it looks
          terribly bad I would suggest bypassing the emergency room and
          making an appointment with a family doctor, or someone
          friendly.
          The truth is, your friend probably knows when a trip to the
          medical world is required, and if you're close enough and
          open-minded enough about the self-injury, then s/he may ask you
          what you think about it anyhow.
          I would suggest steering your friend to an anonymous clinic, or
          a small family practise for treament. I would also suggest that
          until you and your friend better know the doctor/nurse to avoid
          most questions.
          Your friend does not have to tell them what happened. Most
          SI'ers feel cornered, pressured to tell, so they do and end up
          under 24 hour surveillance in a psych hospital. Be there to
          help avoid the questions, or to back up whatever story your
          friend tells.
          IMPORTANT: If your friend is in therapy with someone they
          trust, then call the therp before you head to the doctor's
          office and let your friend talk a bit, and ask the therp what
          the medical doctor should be told.
          But I digress...We were talking about talking.
          
   Me: "I haven't cut in 14 days, and I cut last night."
          Someone: "You know you could kill yourself! You don't want to
          die, do you? What if the blade slipped, or you cut too
          deep....It could get infected and you could get gangrene."
          I don't know if I can even touch this. These are all statements
          that I have heard.
          Hmmmm...
          Here are my answers to these questions/statements:
          
         1. I know I could kill myself. I am as careful as I can be, and
            yet I know that accidents do happen. That's why I'm trying to
            quit.
         2. I don't want to die. I self-injure to stay alive, to deal
            with the unbearable. If I wanted to die, then I wouldn't be
            here now.
         3. If the blade slipped or I cut too deep I would call my doctor
            and go in to see her, or ask her to come see me. If my doctor
            was gone I would call my counselor. If she was gone I would
            call mom. If she were gone I would go into the hospital. If
            your friend doesn't have a reliable support system, then help
            her/him set one up.
         4. I have been cutting for 9 years and only have had one
            infection. It healed overnight after reopening and cleaning.
            The chance of another infection is still there, and know
            what? I KNOW. I know accidents happen, I am not a moron and
            you don't have to treat me like one.
            
          Scare tactics really do work, people. They scare us. They make
          us feel stupid for doing what we do to ourselves. They us feel
          ashamed and guilty. And when we feel scared and guilty and
          ashamed many of us self-injure and continue the cycle. Scare
          tactics work....Don't use them.
          
   Me: "After 14 days, I cut last night."
          Someone: "That's bad. Why don't you just stop. That's so sick.
          Eew! That's gross!"
          Should I even touch this?
          No. If this is something you would say, then please go back and
          read parts one and two of this post, because you need to learn
          a bit about self-injury.
          
   Try this:
          Me: "After 14 days, I cut again."
          Someone: "14 days? You went for two weeks? How did you get that
          far without?"
          It is probably best to ignore the physical act. Focus on
          emotions.
          Oh, did anything specific happen that made you feel you had to
          hurt yourself?
          How are you feeling?
          How did you feel last night?
          If you want, you can call me if you feel that way again.
          
   On the other hand, if your friend tells you she/he has avoided
          SI'ing...
          Have you been doing anything specific when you feel you need to
          SI?
          Is there anything I can do to help you out?
          It must be very hard on you...
          
          Remember that the act itself isn't as important as your
          friend's emotions.
          Remember to try to figure out what your friend feels caused the
          SI that day, so s/he can think it over and maybe figure out a
          way to avoid it or lessen it next time.
          Remember to care and to be gentle.
          Remember your friend isn't doing this to hurt you.
          
  Special section: From self-injurers
  
          The best things that family/friends have said about my
          self-injury:
          
          + "I don't understand, but I'm willing to listen."
            It's very important to us that those around us keep an open
            mind and ask about that which they don't understand. If we
            have entrusted you with this "secret," then we also trust you
            enough to talk about it. Offer to be there and offer to
            listen.
          + "I love you anyway."
          + "How can I help?"
            This is the key question. Every one of us is different. Don't
            try to second-guess what your friend needs from you. Ask.
          + "This is hard for me to know you're doing this to yourself."
            
          The worst things they have said:
          
          + "My former roommate told me to move out when she found out.
            She thought I was a freak."
          + "[My doctor] told me he would quit treating me if I didn't
            quit. So I never discussed it with him again."
          + "If you do that you have just lost a friend."
          + "Don't talk to me about this stuff...I think it's gross..."
            All of these statements serve only to make us feel bad,
            ashamed, and guilty. These statements tell us that the
            speaker doesn't understand and isn't willing to listen. In
            just a few words someone who could have been a supporter and
            who could have helped us get better has effectively shut the
            door in our face. These statements say the same thing:
            "You're not good enough to deserve me."
          + "...that I'm only doing it for attention, and therefore it's
            invalid."
          + All of those who I have talked to also hated the scare
            tactics and threats:
            "If you continue doing this I will (enter threat here)..."
            
          What SI'ers wish that others in their life would do:
          Continue being supportive.
          
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References

   1. http://www.focus-asia.com/home/Nikki
   2. file://localhost/usr/home/llama/Web/psych/kharre.html#fam
   3. file://localhost/usr/home/llama/Web/psych/kharre.html#quest
   4. file://localhost/usr/home/llama/Web/psych/kharre.html#accept
   5. file://localhost/usr/home/llama/Web/psych/kharre.html#letter
   6. file://localhost/usr/home/llama/Web/psych/kharre.html#things
   7. file://localhost/usr/home/llama/Web/psych/kharre.html#fam
   8. file://localhost/usr/home/llama/Web/psych/injury.html
