selfharmUnfortunately, the coexistence of eating disorders and self-harm is not uncommon – about 25% of people with eating disorders also self-harm in other ways (Sansone and Levitt 2002:205). In my personal experience, when feelings of anxiety, shame or guilt overwhelm me, or my capacity to engage in ED behaviours are somehow inhibited, then the urge to harm myself in other ways intensifies. At various times throughout my journey, self-harm also served as a form of punishment and as an expression of self-hatred towards my body. Whilst acting on the urge to self-harm provides immediate relief from the distressing feelings, thoughts, and images, the relief is temporary and short-lived. The consequences of engaging in such behaviours create further problems and prevent me from learning more effective strategies for dealing with the initial or underlying issues. In the intensity of the moment however, it can be challenging to sit with the urge to engage in ED or self-harming behaviours, and so I created this list of alternatives that I can access in those moments. I keep this list in the front of my diary and when needed, try different ideas until the urges have subsided.

selfharm3Most of the activities fall into one of the following four strategies:

  1. Delay – e.g. hold off on acting on the urge until I have spoken with someone or tried xyz,
  2. Distract – e.g. go to the park, play a game,
  3. Divert – e.g. engage in an activity that has a similar effect to self-harm but without causing injury such as holding an ice cube or snapping a rubber band against my wrist,
  4. Deep Breathing or other relaxation methods.

Self-harm is often used to express pain and intense emotions; calm or self-soothe; to deal with a sense of feeling disconnected or numb; or to release tension or vent anger.  Therefore, to make the list of alternatives to self-harm a little more accessible, I’ve attempted to categorise the various ideas/activities into the possible perceived benefits of self-harm, i.e. what is motivating you to self-harm, and what is an activity that can provide a similar outlet or expression of that.

Alternatives to express pain and intense emotions…

  • Paint, draw, or scribble on a big piece of paper with red ink or paint
  • Express my feelings in a journal
  • Make a notebook of song lyrics that I relate to
  • Compose a poem or song to say what I feel
  • Allow myself to cry-crying is a healthy release of emotion
  • Write down any negative feelings and then rip the paper up
  • Listen to music that expresses what I’m feeling

Alternatives to calm and soothe yourself… (for more ideas, see ‘Self-Nurture‘)

  • Take a bath or hot shower
  • Make a cup of tea
  • Pet or cuddle with a dog or cat
  • Paint my nails
  • Wrap myself in a warm blanket
  • Go outside and watch or look up at the stars
  • Massage my neck, hands, and feet
  • Listen to calming music
  • Carry a small stone in my pocket (See Journey Jewels in the Recovery Resources Package) and tightly hold onto it
  • Read a book
  • Splash my face with cold water
  • Hug a pillow or soft toy
  • Light some candles
  • Choose an object in the room. Examine it carefully and then write as detailed a description of it as I can. Include everything: size, weight, texture, shape, colour, possible uses, feel, etc.
  • “See, hear and feel” – 5 things, then 4, then 3 and countdown to one which will make me focus on my surroundings and will calm me down
  • The Calm Jar (Fill a mason jar or similar with coloured water and glitter. When feeling upset or angry I can shake it to disturb the glitter and focus on that until the glitter settles.)

selfharm2Alternatives to help with feeling disconnected and numb…

  • Hold an ice cube in my hands, against my arm, or in my mouth
  • Snap a rubber band against my wrist
  • Call/text a friend (I don’t have to talk about self-harm)
  • Take a cold shower
  • Chew something with a very strong taste, like chili peppers, peppermint, or a grapefruit peel.
  • Go online to a self-help website, chat room, or message board (use this with caution as it may be more triggering than supportive)
  • Run my hands under freezing cold water

Alternatives to release tension or vent anger…

  • Scribble vigorously on a piece of paper
  • Have a pillow fight with the wall
  • Shoot rubber bands across the room
  • Rip paper into itty-bitty pieces
  • Punch a cushion or mattress or scream into my pillow
  • Squeeze a stress ball or squish Play-Doh or clay
  • Make some noise (play an instrument, bang on pots and pans)
  • Learn to swear in another language
  • Pop bubble wrap
  • Pop balloons
  • Build a fort of pillows and then destroy it
  • Go for a walk
  • Exercise vigorously—run, dance, jump rope, or hit a punching bag
  • Silent scream

Miscellaneous Distraction ideas…

  • Play a game (Subway Surf is one of my favs!)
  • Search for ridiculous things on the web
  • Play a musical instrument
  • Watch a movie or TV show
  • Look up words in a dictionary and expand my vocabulary
  • Come up with funny snap chats to send to my friends or sister
  • Listen to music and sing along loudly
  • Visit
  • Go to the park and play on the swings…swing really high and feel the breeze on my face and the funny turns in my belly
  • Revise my list of motivations for continuing to moving forward
  • Write a letter or card to encourage someone else
  • Write an article for the Recovery Resources website (and email it through to me!!!)
  • Learn a new skill – e.g. how to build a website or an app, how to crochet, etc
  • Remember that I don’t have to hurt myself just because I’m thinking about self harm
  • Recognise and acknowledge the choices I have NOW
  • Think about what I would say to a friend or my niece if they were struggling with the same things and try to be a good friend to myself.
  • Re-organise my room or a cupboard in the house
  • Play with modelling clay or Play-Dough
  • Pray or Read the Bible
  • Work on a jigsaw puzzle
  • Go for a bike ride
  • Work out my 5×5 Rubik’s cube
  • Hunt for random stuff on EBay
  • Throw the netball around
  • Read through my Inspo Box
  • YouTube funny videos
  • Sort some files on my computer
  • Sort through a drawer of my paperwork
  • and learn new signs (Australian Sign Language)
  • Go visit my nieces and nephews

If you need further support to reduce self-harm behaviours or develop more appropriate and healthier coping strategies, please speak with your treating team; check out the ‘Get Help’ section; or access one of the following online supports: ReachOut; Sane; LifeLine; or Headspace.

*Sansone RA, Levitt JL. Self-harm behaviors among those with eating disorders: An overview. Eating Disorders 2002; 10(3):205-13.