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Scared. Disgusted. Confused. Worried. Frustrated. These are some of the words that I have heard from those caring for and about those who live with non-suicidal self-injurious behaviors, commonly known as self-harm. Oftentimes these caregivers will confuse self-harm with a suicide attempt; believing that their loved one was intending to die. They become emotionally exhausted from attending to the frequent feelings of urgency to address injuries and the emotional dysregulation surrounding the behavior.

The truth is, self-harm is only sometimes associated with suicidal ideation. Of course, knowing this does not make self-harm feel any less scary or baffling to caregivers.  It can be challenging to assess where this behavior is coming from and what purpose it is serving in an individual’s life. To better understand this pattern of behavior we often look at self-harm, not as the problem, but instead, as the solution to a problem. Looking at self-harm in this way can provide the opportunity to explore what other factors have motivated this concerning behavior. Additionally, looking for these motivators can help bring understanding to a pattern that can be difficult to understand.

Self-harm can serve many purposes for those who engage in it. For some, it can be a way to make their incomprehensible emotional pain make sense. They can make the abstract world of emotions, concrete through a physical wound. This often is the case for those who struggle with verbal communication or getting their ideas across effectively. For others, self-harm is a way to express their need for assistance from the outside world. And for still others, self-harm is actually a tool to prevent them from engaging in suicidal behaviors.

In many ways, self-harm behaviors can be seen as closely related to addictive behaviors. When an individual uses drugs and alcohol to soothe difficult emotions or to help express themselves, their other coping/communication skills become underused and a bit rusty. The same process happens with self-harm. When this behavior is solely relied upon in times of distress, other options that may be more sustainable and less problematic no longer get used.

When working to leave behind self-harm behaviors its important to learn about skills such as urge surfing which is based on the idea that no emotion last forever – rather, emotions come and go in waves. These emotional waves can be surfed with the use of a range of skills and so, too, can the urge to engage in self-harm. Of course, building a life worth living through therapeutic lifestyle choices and engaging in problem-solving for the issues that drive self-harm behaviors are also keys on the road to recovery!

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