Self-injury awareness day: a coping plan for self-injury cravings

March 1 is self-injury awareness day. Generally speaking, people’s awareness of self-injury is pretty good but what’s lacking is action. People who engage in self-injury get so overwhelmed that they don’t know what to do. Having a coping plan that uses the technique of ‘urge surfing’ can help.

Remember the 3Ds: DelayDistractDecide.

The first step is to understand that cravings and urges to self-injury are expected (in the same way as you’d expect for someone with an addiction).

The longer you have been engaging in self-injury, and the more total times you’ve engaged in it, the stronger and more frequent the urges will be.

Identifying triggers is important. The urges to self-injury can be triggered by certain people, places, pictures, feelings, situations, memories, dreams and even objects (e.g., looking at scissors).

Urges are like waves- they rise and fall, rather than continue on a straight line. Urge surfing means that you recognize the urge is there, BUT you sit on top of the waves rather than giving in to them. Every wave starts small and builds to its highest point. Eventually, the wave will break and flow away. With patience and persistence, the urges may still come, but they’ll be smaller, last only a few minutes, and most importantly, you’ll be more confident that you can cope.

Cravings only lose their power if they are not strengthened (i.e., you resist the urge to self-injury). Each time you engage in self-injury, the urges will come back. While it may seem impossible, and you’ll struggle at first, the longer you can manage not to self-injury, the smaller those cravings will be.

Every time you use a strategy other than self-injury, the peak of the waves will reduce and will actually get further and further apart.

These techniques are adapted from Dialectical Behaviour Therapy (DBT) which assists individuals to label, understand, manage and cope with overwhelming emotions.