Self-harm alternatives: distraction techniques

Experiencing urges to self-harm can feel overwhelming. But with the right support and guidance, learning to resist the urge to self-harm is possible. Recognising an urge does not mean you have to act on it. Understanding your triggers can help you prepare strategies to avoid or reduce harm by using safer self-harm alternatives.

There are various techniques that people find helpful when recovering from self-harm. Some of these techniques can help you to resist the urge to self-harm in the moment by distracting you, while others offer alternative, non-harmful ways to express or process your thoughts and feelings.

Self-harm distraction techniques

The 15-minute rule

Many people find the ‘15-minute rule’ helpful when managing urges to self-harm. When you feel the urge to self-harm, try to delay self-harming for 15 minutes, keeping yourself occupied during this time with distraction techniques.

Distraction techniques can be helpful. When the 15 minutes are up, if you still have the urge, you can continue the distraction for another 15 minutes. You then repeat this process until the urge has passed. If 15 minutes is too long, you can start with five minutes and work your way up to 15 minutes.

You might find it helpful to monitor how you’re feeling and which distraction techniques work best for you. If it’s not too overwhelming, keeping a diary or list of your preferred distraction methods can be helpful.

Find a distraction technique that works for you

Below are a number of techniques that you can try if you are looking for a distraction from the urge to avoid self-harm:

• Do physical activity such as walking, running, gardening/weeding, cleaning/tidying/decluttering, dancing, running
• Tear a sheet of paper into tiny pieces
• Listen or sing to music
• Breath in and out slowly, extending your exhale for longer
• Massage your hands or feet
• Clench and relax each of your muscles
• Write a song, poem, or letter to yourself to express your feelings
• Write lists
• Allow yourself to cry
• Tell a loved one how you feel
• Occupy your hands with a crafting activity, such as knitting or crocheting

Harm minimisation versus harm prevention

If you start self-harm treatment, you might find harm minimisation more helpful than prevention methods. Prevention focuses on stopping self-harm as early as possible. However, harm minimisation acknowledges that the urge to self-harm might continue throughout recovery and trys to avoid, delay, or reduce both the level of harm and the number of times you self-harm.

People who self-harm often do so as a way of coping with emotional distress. Stopping self-harm suddenly, without replacing self-harm coping behaviours for healthier coping mechanisms, can be difficult for some people. This is why using harm minimisation in the short term, ideally under the supervision of a mental health professional, can be helpful for some people. Harm minimisation involves using less harmful behaviours that can still offer some emotional relief, such as snapping a rubber band on the wrist instead of cutting.

Harm minimisation strategies should be carefully monitored by a qualified mental health professional. They should also be used together with other forms of therapy. In a study looking at self-harm reduction strategies from the perspective of young people, a small group of 14–15-year-olds said they benefited from harm minimisation because it provided:

• Autonomy or “doing something to help yourself” rather than relying on others
• Getting similar emotional relief with less physical harm

Harm minimisation is not suitable for everyone. Further research is necessary to see who might benefit most from harm minimisation strategies and what is the best way to use them.

Using self-harm alternatives safely

If you feel unable to resist the urge to self-harm, you may want to minimise harm or find safer alternatives to the way you usually self-harm. Below are techniques you can try depending on which situations you are in.

If you feel the need for a ‘release’ but want a safer alternative

• Snap an elastic band against your skin
• Squeeze ice cubes for a short time
• Eat spicy food
• Eat sour sweets
• Cut your fingernails
• Pinch your skin
• Run your hands under cold water or take a cold shower
• Draw on your body with red markers or paint (as an alternative to seeing blood)

If you cannot resist the self-harm urge and want to minimise harm to yourself

• If you feel you must self-harm, keep a first aid kit close to hand and clean and care for self-harm wounds
• Do not share any equipment you use to self-harm. Accepting other people’s equipment or sharing your own equipment with others increases the risk of hepatitis and HIV
• If you feel you must self-harm, sterilise any equipment you use to minimise the risk of infection
• Know when to seek medical help for severe injuries or infection
• If you feel you must pierce the skin, avoid cutting where major veins and arteries lie close to the surface of the skin
• Avoid alcohol and/or recreational drug use as it may be more harmful to you if you experience the urge to self-harm while drunk or high
• Avoid ingesting any toxic substances or tablets as there are no ‘safe overdoses’

Regularly practising coping techniques that replace your usual methods of self-harm with safer alternatives or eliminate harm altogether provides the greatest long-term benefits for your physical and emotional wellbeing.

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