How To Use DBT Skills To Prevent Self-Injury

by | Mar 2, 2022 | Dialectical Behavioral Therapy (DBT), Therapy

Trigger warning: Some of the information in this article might be disturbing and bring up negative feelings. Reader discretion is advised.

The global pandemic continues to rage on, with over 435 million cases worldwide and almost 6 million lives lost. With illness and death hitting so close to home for many, research shows that signs of mental illness and strain have increased in people from all age groups. Unfortunately, the presence of different mental health conditions can lead down the path of self-injury as a way to cope with stress, loneliness and negative thoughts and feelings. 

For those dealing with self-injury urges, Dialectical Behavioral Therapy (DBT) can prove to be a useful and effective coping strategy. Even if you aren’t ready to begin seeing a therapist, you can learn DBT skills on your own. When you’re ready to begin treatment for self-injury, your therapist can help you to strengthen your skills.  

For the past twenty years, March 1 has been internationally recognized as Self-Injury Awareness Day and is represented by an orange ribbon that signifies hope. In the United States alone, yearly self-injury numbers among women and girls are as high as one in five; and one in seven among men and boys with almost 2 million reported cases. 

What Is Self-Injury?

Self-injury falls under the group of actions considered self-harm behaviors and occurs when a person deliberately hurts or harms themself. Acts of self-injury can include skin cutting, head banging, ingesting harmful substances, repeatedly punching self or objects, deliberately breaking bones and other forms of self mutilation. This kind of coping mechanism is usually more common in adolescents and young adults with 50% of reported cases starting at fourteen years old. Though it is rare, acts of self-injury can be present in children as well. It’s important to note that self-injury does not always end in suicide nor is it a definite indicator that a person has suicidal tendencies. 

There are different reasons for self-injury, none of which you should be ashamed of if you’ve ever chosen to injure yourself. Self-injury can come about as a way to express or deal with difficult emotions, cope with low self esteem, as a result of mental illness or as a way to have some kind of control over one’s own body when it feels like control is not present in any other area of life. In order to be diagnosed as a person who self-injures, it’s recommended that you speak to a therapist or mental health professional and share your experience. 

The different mental health conditions that can contribute to thoughts of self-injury include (but are not limited to) personality disorders, post-traumatic stress disorder (PTSD), bipolar disorder, depression, anxiety and schizophrenia. If you suspect you are living with any of these conditions and want to learn more or find out if they are linked to your tendency to self-injure, you can contact us to schedule a consultation. 

DBT Is An Effective Tool for Preventing Self-Injury

There are several different ways to manage the negative feelings that lead you to think about harming yourself. Dialectical Behavior Therapy or DBT is a kind of therapy done collaboratively to bring about positive changes in the life of the affected person. Essentially, DBT combines a number of different core strategies and actions to help you manage difficult emotions and improve your coping skills, relationships and quality of life. This kind of therapy can be done individually (in person or over the phone) or in a group. Effective DBT can bring about acceptance and change in behavior, cognition and skills.

If you opt to undergo DBT, you may need to dedicate time to learning and improving upon skills like mindfulness, distress intolerance, emotion regulation and interpersonal evaluation. All of those can be used when the urge to self-harm arises. Each component of DBT has a variety of methods to help with grounding. 

• Mindfulness – In order to practice mindfulness, it’s best to use the 6 main mindfulness skills. These are observation, description, participation, non-judgment, single-tasking and focusing on effectiveness. When you take the time to observe, this means you are taking in what’s happening around you and trying to find the root of your trigger. After you have done so, it’s time to move on to describing what you are experiencing. These two actions can happen at the same time and are key parts of the mindfulness process. Participation will have you being present and fully immersed in the activity you are doing to calm yourself, whatever it may be. Reducing judgmental thoughts is also key in the mindfulness process, as releasing the idea of good and bad emotions can help you to see your feelings as they are instead of assigning a meaning to them before you’ve figured them out. Single-tasking or the ‘one mind technique’ is focusing on one thing at a time instead of overstimulating your mind and thoughts. Finally, focusing on effectiveness means that you should stick to the techniques and actions that work for you when you are in distress.

• Distress Tolerance – This part of the therapy teaches you how to cope in times of stress through acceptance. If you’re easily overwhelmed, you might feel that you need to run away from the issue when negative feelings start to come up. While there are times when removing yourself from the situation that distresses you is the best way forward, there are other times when there is no other choice but to go through the experience. For example, if you are stuck in traffic and there is no other way to your destination, distress tolerance can help you to understand that this was not your fault and insert feelings of patience. By going through the motions with acceptance and grace, you can eventually learn how to manage intense or overwhelming feelings. 

• Emotion Regulation – The practice of emotion regulation aims to help you understand your emotions, reduce emotional vulnerability and reduce suffering due to emotional distress so you can have more good and positive experiences. Non-judgment and acceptance play major roles here. In order to regulate your emotions, you will need to accept that negative ones are natural but they don’t have to consume you or control the situation you are in. Once you are able to understand and label your emotions, you are on your way to being able to regulate them. Actively letting go of negative thoughts and taking action to create positive ones is also a big part of emotion regulation. 

• Interpersonal Evaluation – The skills learned here helps a person to become more assertive in relationships through introspection and self-awareness. By learning what your needs are through self-evalution, you mayclear and honest communucation, you may be better able to let the people around you know what you need while working on reducing whatever emotion that would have pushed you to harm yourself in the first place. 

Dialectical Behavioral Therapy is a very effective therapy treatment that is well researched and evidence-based. DBT can help not only with self-injury, but also with improving your way of being in relationships and can help you learn ways to soothe yourself when you feel distressed. The therapists at Flourish Psychology are trained in Dialectical Behavioral Therapy and other treatment modalities. We can help you see that you’re stronger than your self-injury urges and teach you tools to use such as mindfulness, nonjudgmental thinking, and acceptance. Contact us to schedule a consultation.