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My self-harm urges are way out of control.

This is a trigger warning question: My self-harm urges are way out of control. My therapist and psychiatrist are aware of this, but l'd like to hear what a mental health professional has to say and what I can do? I'm feeling really sad.

 

I'm really sorry that you're struggling with this. It's not an easy struggle, of course this makes you sad - and I'm really glad you felt safe enough to reach out.

Here are a few things I want to share to hopefully help you or point you in the right direction.

First, I want you to understand that self-harm is simply a maladaptive coping skill. It's used to feel because you're afraid of feeling. What does that mean? It sounds like a contradiction, but it's really not. It's used to feel physical pain because you're afraid of feeling emotional pain. This understanding is crucial because it removes a lot of the shame and stigma. Shame and stigma only further trigger self-harm urges because they fuel even more painful thoughts

Second, to heal from and recover from self-harm urges, you need to begin to feel and process your emotions consistently and proactively.

It's great that you're in therapy and seeing a psychiatrist, but you also need dally practices to unload your thoughts and feelings so they don't pile up and become so emotionally charged.

Journaling, meditating, and speaking with supportive people in your life are all beneficial.

Engage in activities you love, like walking or exercising, and commit to doing them regularly.

Some activities will directly help process your feelings, while others should make you feel good/ take the edge off the discomfort of being in touch with painful feelings.

Third, understand the thought-feelings-behavior triangle, also known as the CBT triangle. A thought triggers a feeling, which triggers a behavior.

Side note - The triangle works in all directions so Sometimes, engaging in an action can trigger a feeling and thoughts as well. When you have a strong urge to self-harm, your (negative) thoughts and feelings are very activated.

To overcome that urge, identify your thoughts and recognize they re just thoughts, not facts. Don't buy into them.

Additionally, work on the other edge of the triangle - Choosing different behaviors that are self-soothing and supportive, like calling a friend or engaging in physical self-care. Some people use ice or a hot/cold shower or body lotion. You do you.

Understanding this triangle is crucial because it empowers you to realize that only you can fight the urges bec only you can change your behaviors 

Lastly, you mentioned wanting to hear from a mental health professional even though you're already in therapy and seeing a psychiatrist.

Your choice of wording made me wonder if maybe you don't consider your pros enough equipped to help you. So I just wanted to underscore that it's important that you respect and value your therapist and psychiatrist, that most their insights resonate with you so that you can lean on them. If you don't fully trust your support team, it will be challenging to heal. You deserve to be working with professionals you can lean on and trust.

I hope some of this helps. I'm rooting for you, I believe in you, and I'm sending you so much love and healing.

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About the author

Fay Brezel, LMHC

Therapist, Licensed Mental Health Counselor, LMHC

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure.

  • 🎯 Direct
  • 💙 Warm
  • 💪 Challenging
  • 💡 Solution-oriented

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