Key takeaways:
The urge to self-harm or deliberately hurt yourself often arises with intense emotions or stressful situations where you feel completely overwhelmed and don’t know what else to do.
To address and shift the urge to self harm, you can try a number of strategies, like holding ice, going for a walk, taking a shower, calling a friend, coloring, or calling a crisis hotline.
If you’re dealing with self-harm urges, seek professional support. An experienced therapist can help you address underlying factors that contribute to self-harm urges.
Self-harm — or nonsuicidal self-injury (NSSI) — is when a person deliberately causes harm to themselves. This may include acts such as cutting, hitting, or burning oneself. People self-harm for various reasons. For some people, it can be a way to manage intense emotions. Other people use self-harm as a form of self-directed anger or punishment.
As scary as it may seem, self-harm is a common way people try to cope with difficult experiences. Up to about 45% of adolescents self-harm, and as many as 23% of adults may self-injure. The good news is, there are strategies you can use to cope with self-harm urges and prevent self-harm.
The urge to self-harm can feel intense. By the time you feel it, your best course of action is to use one or more coping strategies. These strategies or skills can help by quickly lowering intense emotions, distracting you, or connecting you with support.
Here are some of the best strategies to put into action when you have the urge to self-harm.
These coping skills can help lower intense emotions quickly by using your body and five senses:
Hold ice or something cold.
Suck on sour candy.
Go for a walk, run, or dance.
Take some deep breaths.
Focus on your senses: What can you see, hear, smell, feel, and taste right now?
Take a shower.
Follow a workout routine on YouTube.
Yell or scream.
Use essential oils.
Stomp around.
Make yourself a cup of hot chocolate or tea.
Snuggle under a warm blanket or with a stuffed animal.
Put on hand or body lotion.
Do yoga.
Sometimes, you can wait out the urge to self-harm by distracting yourself. Here are some activities that may help:
Play a video game.
Draw or color.
Read.
Listen to music.
Watch a comedy on TV or online.
Clean your home.
Pick a letter of the alphabet, and list every word you can think of that starts with that letter.
Choose a subject, and research the topic.
Organize your shelves.
Plan your next vacation — even if it’s a dream vacation. Think through where you want to go and everything you want to see.
Make a list of all the good things that happened today, even if they’re small.
Reaching out for support when you’re struggling can go a long way toward lowering self-harm urges. Here are some ways you can connect with others or even connect with your own emotions:
Text, call, or video chat with a friend.
Snuggle with a pet.
Go to a coffee shop.
Sit in a public park and people-watch.
Write in a journal.
Play a live action game with others.
Search Meetup or Volunteer Match for a group or organization you want to connect with in the next week.
Just like surfing a wave, you can “surf” the urge to self-harm until it passes. Urges (and intense emotions) act like a wave. They rise in intensity until they naturally fall back down. So how do you practice this when you have self-harm urges?
When you feel an intense emotion or the urge to self-harm, notice it, and label it as a feeling or urge.
Watch the thoughts, feelings, and urges rise, but don’t try to change them or repeat them in your mind. It will probably feel uncomfortable. You can remind yourself that it makes sense that having intense urges isn’t comfortable.
As the feelings and urges wash over you, use deep breathing to help manage the intensity without acting on the urge to self-harm. You can also use phrases like, “It’s OK to feel this way, and I don’t have to change it” or “Urges are temporary, and this will pass on its own.”
As you ride the wave, you’ll notice the intensity of the urges go down. If you are able to keep breathing and observe what’s happening without changing anything, most urges will lessen within 30 minutes.
Every person is unique, and different thoughts, feelings, or situations may be triggers. When self-harm thoughts or urges arise, consider what is triggering you. This may be another way to lower self-harm urges and prevent self-harm.
Examples of triggers include:
Feeling overwhelmed
Feeling as if your life is out of control
Having difficulty expressing what you feel
Feeling abandoned, rejected, or disconnected from your support system
Having relationship challenges
Having problems at work or school
Bullying
Experiencing reminders of past trauma, like flashbacks or intrusive memories
Try to brainstorm ways you might be able to address your self-harm triggers directly. In some cases, this might not be possible. But other times, you may be able to take steps to head off a trigger before it leads to self-harm urges.
For example, perhaps feeling lonely or disconnected from your friends triggers self-harm urges. You could try planning a regular meet-up with a friend the same night every week. This gives you social support you can count on and look forward to each week.
You can also reflect on what factors make you more vulnerable to self-harm urges. Examples of things that can increase your vulnerability to self-harm urges include:
Not getting enough sleep
Working long days
Not eating regular meals
Forgetting to take your medication
Addressing your triggers in this way won’t help at the moment when a strong self-harm urge strikes (you’ll need your coping skills for that). But over time, it may help you neutralize stressors before they cause self-harm urges.
If you experience self-harm urges or engage in self-harm, seek support from a mental health professional. They can help address the underlying factors that lead to self-harm. They can also help you find alternative ways to cope when you have self-harm urges.
Dialectical behavior therapy (DBT) may be especially helpful for managing self-harm. This type of therapy focuses on mindfulness and learning new ways to manage distress, regulate your emotions, and navigate relationships.
Look for DBT therapists or therapists who have experience working with people who self-harm. If you have an underlying mental health condition, your provider may also suggest an evaluation for medication.
Here are some online databases to start your search for a provider:
Gaylesta (LGBTQ therapists)
InnoPsych (BIPOC therapists)
Open Path Psychotherapy Collective (low-cost therapy)
It’s important to note that nonsuicidal self-injury is usually not a suicide attempt. However, those who self-harm may be at higher risk of suicidal thoughts and attempts. Take self-harm seriously, and get professional support.
Self-harm urges are often triggered by intense emotions or stressful situations. If you already have the urge to self-injure, try holding ice, going for a walk, or texting a friend. Once you identify the situations that trigger self-harm, try brainstorming new ways to manage triggers before the urges even start. Regardless of where you are in your journey, seek professional help for self-harm. A professional can help you address the underlying causes of self-harm and learn new ways to cope.
If you or someone you know is struggling with self-harm, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255, or text HOME to 741741 to reach the Crisis Text Line.
Cipriano, A., et al. (2017). Nonsuicidal self-injury: a systematic review. Frontiers in Psychology.
Dartmouth-Hitchcock Center for Addiction Recovery in Pregnancy and Parenting. (2021). Urge surfing.
Kilburn, E., et al. (2009). Distraction techniques and alternative coping strategies. Cornell Research Program on Self-Injury and Recovery.
Klonsky, E.D., et al. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian Journal of Psychiatry.
Linehan, M. M. (2015). Taking care of your mind by taking care of your body. DBT Skills Training Handouts and Worksheets, Second Edition.
Mitchell, A.J., et al. (2006). Self harm and attempted suicide in adults: 10 practical questions and answers for emergency department staff. Emergency Medicine Journal.
Therapist Aid. (2021). Urge surfing.
Turner, B.J., et al. (2014). Treating nonsuicidal self-injury: a systematic review of psychological and pharmacological interventions. Canadian Journal of Psychiatry.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.