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Short-Term Strategies to Manage Self-Harm Urges and THE LIMITS by Nell Freudenberger


Cover of the book The Limits by Nell Freudenberger used as a teaching example for the therapy skill of short-term strategies to manage self-harm urges

Pia is a high school student living between divorced parents. It’s the height of Covid, and Pia has almost no support from friends or family. Mom lives in Tahiti. Dad and new step-mom live in New York. In Tahiti, Pia attends school online and has almost no socialization with people her age. Pia’s mother is a researcher whose busy work schedule allows for very little time with Pia. Pia attends a hybrid program in New York but struggles to make friends. Similarly, Pia’s father’s job leaves him without much extra time. So, Pia is left to spend time with people she doesn’t enjoy, like her peers and stepmom.  

 

Pia feels intensely and lacks positive coping skills. The adults in her life worry about her; she seems depressed, lies, and self-sabotages. Her mom and stepmom notice a large cut on her leg; one night, her dad finds her holding a knife. Pia is self-harming.

 

Self-harm is when a person deliberately injures their body via cutting, burning, scratching, unhealthy drugs, alcohol, or sexual practices.  People self-harm when faced with overwhelmingly negative feelings and a sense that they don’t have healthier options, frequently thinking that the self-harm will make them feel better. Conversely, self-harm leads to guilt, shame, and isolation.

 

Here are Short-term strategies to manage self-harm urges:  

 

Talk to Someone: Reach out to a friend, family member, teacher, crisis line, or mental health professional.

 

Self-Soothe Instead of Self-Harm: Try doing things that help you calm down. Examples include reading, deep breathing, yoga, playing with a pet, watching TV, or texting a friend.

 

Express Your Feelings: Give your feelings an outlet. Try journaling, writing poems, playing an instrument, singing, drawing, or painting about your feelings.  

 

Distract Yourself: Focus on something else while the urge to self-harm passes. Try cleaning, holding ice cubes, exercising, writing letters, and painting your nails.

 

Relieve Stress: Release energy by walking, running, ripping paper, using a fidget toy, completing errands or assignments, or safely throwing things (e.g., a tennis ball at a brick wall or a pillow at a bed).


 

 

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