For those who self-harm‌ Self-harm is a coping method. You may do it because it helps you in some way. Thinking about the ways in which self-harm has helped you in the past can sometimes help you realize that you did what you had to to get through an unbearable situation. Of course, there are other ways to deal with emotional pain, but sometimes self-harm is the only thing you’ve found that can help. Self-harm doesn't make you a bad person, it is a way of coping with pain, fear and anxiety. These feelings are challenging for everyone and each person has a different way of dealing with them. Dieting, excessive exercise, smoking or going to work sick are all examples of self-harming behaviors. You have no reason to feel ashamed. You, like everyone else, are simply doing what you think will help you get through the moment.
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About the guide: This guide is intended for those who self-harm and other supportive persons. The goal of this guide is to provide information and strategies to safely self-harm The goal of this guide is NOT to tell you what to do. The goal of this guide is for you to take care of yourself as best you can.
Harm Reduction Harm reduction means that there are ways to care for yourself even though you may not want to stop a behaviour. The idea is to reduce as much harm as possible while continuing to engage in the behavior, if you choose. Even though you self-harm you may not want to cause permanent damage or risk unintentional suicide. There are a lot of harm reducing practices you can do when you self-harm or engage in self-harming behaviors.
CUTTING Supplies:
Gauze or paper towel Bandages (including elastic bandages) Isopropyl alcohol (rubbing alcohol) Soap Alcohol wipes Clean blades, non-serrated, preferably single-edge.
Steps to Cutting Safely 1. Wash your hands thoroughly. 2. Clean the blade with soap and water. 3. Disinfect the blade with rubbing alcohol. *Do not share blades with others. Even after sterilization, diseases like Hepatitis can still be transmitted. 4. Wipe the skin where you intend to cut with alcohol wipes. 5. Make a shallow cut on the surface of the skin horizontally, not vertically. 6. Blot the area gently with gauze or a paper towel to soak up some of the blood 7. Once the cuts stop bleeding, wash with soap and water. *If bleeding does not stop, skip to the next section.
8. Clean the wounds with isopropyl alcohol. 9. Apply bandages over the wound(s). Keep bandages on and allow time to heal.
The emotional pain you feel is directed at your body, but your body cannot always cope with or accommodate the injuries you inflict upon it. Your body can only take so much abuse so it’s important to know what its’ limits are.
If you can’t stop the bleeding… 1. Try pressing cloths or paper towels (maxi pads make good bandages) directly on top of the wound 2. On top of the cloth or paper towel, wrap a larger cloth or towel around the entire area and tie it tightly. The intention of this is to apply pressure to the wound. 3. Keep the wound elevated and wait 10 minutes. If the wound is on your arm, hold above your head. If the wound is on your leg, lie down on the ground and elevate your legs. 4. Do not look before the 10min is over! If the blood soaks through before the time is up, put another cloth on top of it.
5. If after 10 minutes, it is still bleeding- re-wrap and seek medical attention.
SHOCK: Sometimes, severe cuts or other injuries can cause your body to go into shock. Shock can be life threatening so if you think you are going into shock, please call an ambulance. Shock tends to make itself worse, so it is critical to get medical attention quickly!
Signs that you are in shock…
confusion, restlessness & irritability dizziness, faintness & nausea pale, clammy, moist skin hypothermia cold & mottled skin, especially in extremities rapid breathing rapid, weak pulse
What to do if you are in shock… 1. Lie down 2. Control external bleeding (see steps above) 3. Try to maintain body temperature. If you notice yourself feeling cold, try to cover yourself with a blanket or something similar. 4. Do not eat or drink, even if you may feel thirsty. 5. Do not raise your head. 6. If possible, try to keep your legs elevated about 12 inches. 7. Seek medical attention!
Infection: Wound sometimes get infected. Infected cuts are a big risk. This applies to small cuts, as much as, larger wounds. Here are some ways to easily avoid infection-
What to do to prevent infection… 1. Always wash your hands before touching the wound 2. Change wound dressings or bandages daily 3. Wash the wound each time you apply dressings or bandages 4. Be patient and allow time for the wound to heal
Signs that a wound may be infected…
Redness or swelling Drainage & pus Local fever (the cut will feel hotter than areas around it) Increased or sustained pain Bad odour Not healing
If you’re cut gets infected… 1. Apply antibiotic ointment to the wound (ie. Polysporin) 2. Re-apply ointment two or three times a day 3. If there is no improvement, seek medical attention. If an infected wound goes untreated, it may end up becoming a full-body infection, which needs immediate medical attention.
Warning signs for a full-body infection…
Fever (over 100°F or 37°C) Nausea Aching
BURNING Burns are painful; burns can leave permanent scarring in much the same way as cutting might and these can be extremely serious injuries. It’s important you understand how to look after your skin after a burn – just applying a bandage may actually do more harm than good.
What to do if you’ve burned yourself…
Remove all clothing / jewelry from the affected area Cool the area with lukewarm water Cover the burn with plastic wrap Ibuprofen can be used to help with pain
Seek medical attention if…
The burn is larger than your hand The affected area is white or charred (blackened) The burn blister becomes infected (filled with yellow or green pus) It is a chemical or electrical burn
RESOURCES Distress Centres Free, confidential and anonymous crisis intervention and emotional support hotline available 24 hours, 7 days a week. Phone: 416-408-HELP (4357) Youthline Free, confidential peer support for LGBTQ youth, telephone and text support available Sunday to Friday, 4:00PM to 9:30 PM Phone: 1-800-268-9688 Text: 647-649-4275
LEARNING TO LIVE WITH SCARS Learning to live with your scars can be a critical part of your well-being. There are many ways that people cope with scars. It’s important to know that there is no ‘right’ way to cope with scarring. Each person is going to feel differently so it’s important that you do what feels right for you! It’s okay not to like your scars - liking them is very different from accepting them. Your scars may be important as they can serve as reminders of a time in your life that was difficult. Your scars may remind you of your strength to persevere and cope with hard times and emotions. Some people are proud of their scars and the person they have become as a result of their struggles. Other people don’t feel proud of them, but simply come to accept that their scars represent a part of their life story. Regardless of how you feel about your scars, please know that it is OK not to be OK and it is OK if you are still struggling! Your scars do not make you who you are. Your scars do not define you as a person. Your scars do not make you any less lovable in any regard. What you choose to tell people who notice your scars is up to you. There is no right or wrong answer; it comes down to whatever you feel comfortable telling people. Self-harm is nothing to be ashamed about - it's more common than you think. You don't have to tell people, but you also don't have to avoid it.
KNOW YOUR RIGHTS! It is important to know your rights especially when accessing emergency services. 1. The right to caring, humane medical treatment. People who self-harm must receive the same level and quality of care that a person presenting with an identical but accidental injury would receive. 2. The right to participate fully in decisions about emergency psychiatric treatment (As long as nobody's life is in immediate danger). 3. The right to body privacy. Visual examinations to determine the extent and frequency of self-harm must be performed only when absolutely necessary and done in a way that maintains your dignity. 4. The right to disclose to whom you choose only what you choose. No care provider should disclose to others that injuries are self-inflicted without obtaining your permission. 5. The right not to be automatically considered a dangerous person simply because of self-inflicted injury. No one should be put in restraints or locked in a treatment room in an emergency room solely because injuries are self-inflicted.
RESOURCES Justice for Children & Youth Free confidential legal advice for youth under 18 and homeless youth under 25 in Ontario. Phone: 1-866-999-5329 Empowerment Council: Systemic Advocates in Addiction and Mental Health For patient advocacy assistancePhone: 416-535-8501 ext. 36837
ALTERNATIVES TO HARMING If you decide you want to try something different, you could try some of the following which produce sensations similar to the feelings related to your self-harm.
Angry, Frustrated or Restless? -Slash an empty soda bottle, piece of cardboard, old t-shirt. -Stomp on aluminum cans for recycling until they’re flat -Use a pillow to hit a wall -Throw ice against something hard enough to shatter it (the wall in your bathroom is a good place to do this) -Go for a walk, jog or run
Sad, Depressed or Unhappy? -Do something slow and soothing like taking a bath -Light some incense -Smooth lotion into the parts of your body you want to hurt -Call or visit a friend
Craving Sensation or Feeling Unreal? -Squeeze ice cubs hard -Put a finger into a frozen food (like ice cream) -Slap a tabletop hard -Snap yourself with a rubber band -Take a cold bath
Wanting to see blood? -Draw on yourself in red felt tip marker, paint or makeup -Make ice using red food coloring and draw on areas you want to cut with the red-colored ice
Want to see scars or pick scabs? -Get a henna tattoo kit. Put the henna on as a paste and leave it overnight. The next day, you can pick it off as you would a scab and it leaves an orange-red mark behind.