An overview of recovery
Recovering from self-injury is both a journey and an experience with many stages. The reasons that a person begins self-injuring are complex and take time to develop. It thus makes sense that the recovery process can take time to unfold as well. It is important to remember that the road to recovery is not always smooth and it is common to encounter bumps along the way.
Sometimes it helps to remember that stress and slips are part of the recovery journey. A slip or relapse doesn’t mean that the person has failed or that he or she has moved back to square one. In fact, it can be helpful to view a slip-up as an opportunity for growth: a time to explore new coping skills; examine possible triggers and aspects of the self-injury experience that may have been operating at an unconscious level; or take time to review and enhance support networks.
Watch a video about the recovery process as experienced by people who have struggled with self-injury themselves or alongside someone they care about:
The recovery process
The idea that there are stages of change that people go through when they want to change something in their lives is intuitive. Human beings tend to resist change, particularly when it feels risky, so virtually all of us have some amount of resistance to moving farther along than we are. Knowing that change is a process, takes time, and that it can feel scary even when the benefits are also clear may help foster patience.
Recovery generally occurs in stages, although there can be some movement back and forth. Starting at the bottom of the model below the stages tend to look like this:
While this might appear to be a straightforward question, often it is not. Some people can identify very particular reasons for stopping while others just begin to feel like they’ve simply “grown out of” it. One of the most common reasons we hear for stopping is that it causes pain to loved ones. Other people report finding that once they begin using other, more positive ways to cope, they are no longer feel the urge to self-injure. Others report that escalating levels of shame, embarrassment, guilt, or sadness prompt them to seek help or stop on their own if they are able. Some want to stop simply because self-injury no longer “works” for them.
The reasons for wanting to stop can be as varied as the reasons for starting. Whatever the reason, being able to articulate these reasons to oneself is useful when the urge to self-injure inevitably comes up. Knowing that triggers are likely and having a plan for dealing with these as they arise is also helpful.
The first step in stopping self-injury or anything other negative habit or behavior is getting really honest with oneself and, often, others. One of the most common reasons that people do not stop self-injuring, even when in therapy or when they have multiple supports in place, is because they really do not want to stop yet. This is not always conscious, though, and it can take a lot of courage and honesty to admit that recovery is not happening because one does not really want it to happen rather than because something else is going wrong.
Since self-injury can become a comfortable routine with clear benefits to the user (e.g. one feels better – at least for awhile), it can be surprisingly hard to walk away from unless there is something else to help with life’s rough spots. See the Stages of Change Practical Matters to learn more about how change happens and to figure out where you might be in the process.
What to expect:
Change can be scary and hard. Most often these feelings arise from the simple discomfort most of us feel with not knowing what to expect. We can become rather discombobulated and uncomfortable when our expectations do not match what happens; indeed, this discomfort is one of the main reasons for slips. Here are a few of the general things you can expect:
- Non-linear progress (slips are normal!)
- Mood swings
- Resistance in yourself and possibly others
- More time than you thought it might
- Strong emotions that may occur at seemingly random times (e.g. fear, anger, frustration, grief, relief, hope)
Recovery is about more that just stopping the behavior – it requires a changes in thought, emotion, and behaviors. Since many of these thought and feeling patterns become neurologically habitual (meaning that the brain has essentially been trained to link specific thoughts, emotions, and behavioral reactions), learning other, healthier patterns takes time and effort.
It is important for supportive others to know that there is no set formula for recovery and that the absence of the behavior is only one part of the recovery picture.
Helping yourself stop
Learning to help yourself stop injuring can be difficult at first, but it is a skill that is well worth the effort it takes. It is normal for people to struggle or have doubts about their ability to support themselves outside of self-injury when it has been such a quick and easy fix for negative feelings (or lack of feeling). Feelings of low self-worth and/or a lack of confidence that often go along with self-injury may have left you feeling incapable of stopping. In fact, however, it is precisely because you have faced intense emotional experiences and life situations that you may also be uniquely positioned to live a rich and authentic life. You are also well positioned to help others in similar situations understand and move through the experience.
An important thing to remember is that your capacity for growth and change is only limited by your own thoughts and beliefs; nothing more. This is not a small thing — beliefs are very powerful, particularly if they have been reinforced by other people around you. it is also true, though that most of us go through periods of believing that we are unworthy or unable to motivate and help ourselves without realizing that this belief is just a thought; not a truth. When we can open to the possibility that this belief is not an absolute truth and that there are other possible ways to explain hard experiences, we all begin to see other possibilities for our future.
It is common human experience to doubt or downplay strengths and to resort to negative thoughts and feelings about oneself or others. Most often this is motivated by the desire to cover up feelings of grief, fear, shame, rage or other intense and deep feelings that one is having trouble facing. This can happen automatically and quickly — so automatically that it feels impossible to stop. Although it may be overwhelming at first, a critical first step is to simply watch the pattern of thoughts and emotions. The better we understand our own automatic process and assumptions the more choices each of us have.
Some additional things a person can do to support his/her own recovery process are:
- Journaling about thoughts, feelings, and experiences noticed as a part of understanding automatic patterns;
- Noticing and keeping track of positive experiences, feelings, and thoughts;
- Practicing daily gratitude for the small and big changes and moments;
- Doing things that increase “feel good” vibes like dancing, listing to music, reading, playing an instrument, being outside, etc.
- Maintaining communication with healthy and supportive friends and family members
Supporting someone you love
Watching someone one cares about move down the path to self-injury recovery can be a really hard. It is important to remember that relapse is a typical part of recovery and that blame, anger or pity towards one’s loved one may only trigger further feelings of shame. If you are a parent or loved one of someone who injures please see the Resources for Parents materials for specific information on how to support your loved one and yourself in their recovery process.
Deciding to talk to someone
Deciding to reach out about past or present experience with self-injury can be a scary. However, it is also an important step full of opportunities for positive growth. There are many factors at play in deciding to reach out. Most important, perhaps, is consideration of who to tell. Choosing someone likely to be supportive and/or who can assist in linking to other resources, like a good therapist, are key things to consider. Since disclosing that you have self-injured can trigger fearful or even angry reactions, knowing that this is possible ahead of time is wise. People who care about you may react this way because it can be really hard to learn that a loved one is suffering and hurting; it can make people feel really powerless. Taking time to think about where sharing will happen and what will be shared can also be helpful. Doing your best to choose a calm time and, ideally, a relatively private and/or safe feeling space can make a big difference. For more on specific talking to someone about self-injury see the “Finding Your Voice” fact sheet.
Seeking professional help can be an important step in recovery from self-injury. Participating in therapy can be useful in recognizing and acknowledging the importance of self-injury in a person’s life, uncovering patterns of behaviors, identifying and recognizing triggers, learning coping skills, managing stress and learning to recognize and work with strengths. Finding the right therapist can sometimes be a difficult process, however. Most important is that the person find someone he/she connects with and, ideally, who can provide both support as well as challenge boundaries when needed. Finding someone who has experience working with individuals who self-injure is helpful but not critical.
Before a person goes to a therapist, it can be good to take some time to ask friends and family members for a recommendation, peruse the potential therapist’s website or introduction page, speak with them on the phone, or look up reviews about them on the internet. Deciding on a therapist simply because someone else recommends them, however, can be a mistake.
Keep in mind that the first couple of sessions of therapy will likely feel a little awkward or cause feelings of anxiety. This is a normal reaction to change and to discussing sensitive topics with someone one doesn’t know well. One should also expect that the therapist may bring up or ask questions that others in their life tend to avoid. With some time, feelings of anxiety should abate. Therapy is a relationship, and like most good relationships, it often improves over time. However, therapists don’t just “click” with all people; that is why it’s important to seek the right “fit.” It can also be helpful to discuss a therapist’s preferences and approaches to treating self-injury. Common treatments for self-injury include CBT, DBT, and other modalities with mindfulness-based components. For more on therapy see Therapy: What to expect, and Therapy Myths.
There are several great websites we recommend for those interested in treatment. Click here for a list of these resources and other helpful websites.