Stopping Yourself Wanting to Self-Injure

The Main Contents

The Self-Help Information in the Article

Part One
A Teenager Who Gets the Impression That her Parents Don't Care or Listen, and Gets Stressed Because They're Very Critical

Deciding to Try to Stop Self-Injuring

Here are some suggestions I hope will help.

I don't know enough about your relationship with your parents to give you many suggestions as to what you could do about that. But I can give you some suggestions about other things.

Recovery might be easier if you can think of someone else to confide in who can support you through it. You could probably do it on your own though if you have to.

Recovery will probably take time, so be patient with yourself. Any habit that's been with you for a while will probably take time to break.

It might help to write down all the reasons you can think of why you'd like to stop. If you can remind yourself of them later, they might motivate you to continue not to self-harm when you're tempted.

If You Self-Harm Again After You've Decided to Try to Stop

Don't feel like a failure if you give into temptation and do self-harm again. Most people probably relapse sometimes when they're trying to break any habit, especially when they're first beginning to try, since then the habit will be at its most familiar, so it'll come more naturally than any other way of coping with stress that you've just begun to try.

Instead of seeing a relapse as a failure and being discouraged, you can think about how long you managed not to self-harm for before you gave in. It may be that you can keep yourself from self-harming for longer and longer in between each relapse. If you notice that's happening, it'll definitely be worth congratulating yourself for. In fact, any time you have an urge to self-harm but don't, or realise you've gone for longer without self-harming than you have for a while, or even resisted a temptation for half an hour when you usually used to give into it straightaway, you're fully entitled to be pleased with yourself. In fact, you could even reward yourself by allowing yourself to have a bit of fun, or doing something that makes you feel good, or sometimes indulging in a little treat of some sort.

Whenever you have a relapse, whether it be just self-harming once when you'd been trying to recover, having a bad week where you self-harm a few times, or going for a period where you self-harm a lot again, don't be discouraged and think you've failed. It often takes several tries before someone can give up something for good.

Having a Recovery Calendar

One thing you might find encouraging is if you get a calendar, and for every day you don't self-harm, you stick a smiley face sticker on it, or draw a smiley face on it. That way, if you do self-injure one day, instead of feeling as if you got so far and then blew it, you could look at all the smiley faces on the days you didn't self-harm, so you can be encouraged instead, by thinking something like, "Well, this month, I self-injured on five days, but there were a whole twenty-five days when I didn't self-injure".

Having a Victory Box to Keep Notes of Successes In

Another thing that might encourage you is having a victory box. That's a box - maybe a shoe box, that you cut a slit in the top of, and put notes about your successes in. Every evening before you go to bed, you think about what you've done well that day. If you managed not to self-injure, write a note about how you managed it. For instance, write about what you said to yourself to persuade yourself not to, how you talked back to thoughts that were depressing you and stopped them bothering you, what exactly you did that stopped you wanting to self-injure, or at least helped you resist the temptation, and so on.

Also in your victory box, you can put notes about other successes you've had, such as doing well in a school test, doing well in a sporting event, performing well in a school concert or play, doing a good deed, or whatever else you did that went well that day.

Every day, have a look at all your victories, so you get more of an idea of what works to stop you self-harming that you can do more of, and what makes you feel good, and also so you can be pleased at what you've achieved.

Planning What to Do About the Things That Stress You Out, at Times When They're Not Bad Enough to Make You Want to Self-Injure

If there are stresses in your life sometimes that you know make you more vulnerable to feeling like harming yourself, think through, when you're feeling quite calm, what you can do instead. Then it'll be easier to do whatever you've decided to try when you're stressed, than it would be to think through what to do from scratch then.

If you write down some suggestions on cards or bits of paper, and keep them where you'll have them to hand when you need them, to remind yourself of things you can do, it'll be easier than trying to remember them when your head's full of what's stressing you out.

Challenging Upsetting Thoughts

If you start to have thoughts about yourself that make you more depressed, such as thinking you're a complete failure if you have a relapse, or thinking you must be weird or bad for wanting to self-harm, try to remind yourself of things that make you feel calmer, such as that self-harm is just a coping strategy some people use when they're stressed, and that relapse doesn't mean failure, just a temporary setback that you can learn from.

Some people have lots of upsetting thoughts when they're stressed or depressed, that they realise weren't true when they're more cheerful and relaxed. I've known a few depressed people who said they worry a lot, and when they're worried and more depressed, they know their thoughts get more and more exaggerated. They can tell they've done that afterwards when they're feeling calmer; but at the time, they don't realise they're doing it, so their thoughts just keep on getting more upsetting, and they just let them. The brain works like that. It's more and more difficult for people to think clearly the more upset they are.

If you think you might do that, it might help if you write the upsetting thoughts down when you feel calm, along with the alternative ways of looking at things that you know are the better ones when you're feeling calmer. Then you can remind yourself of them when you feel worse.

For instance, if when you're stressed and want to self-harm, you tend to think you're a pathetic person who just can't cope like other people can, but you know when you're feeling more cheerful that everyone finds it difficult to cope with a lot of stress, and that a lot of people who don't self-harm might do other things that aren't healthy either, you can right down both the depressing thought, and the more realistic one, on a piece of card or paper, with the conclusion that you're not as abnormal as you think you are when you're stressed.

And likewise with any other distressing thoughts you have about anything that you realise aren't really accurate when you're feeling more cheerful, but which seem very accurate indeed when you're stressed or depressed, because it's difficult to think of other ways of thinking then. If you have them written down, you can look at them when you're upset and thinking those depressing thoughts, and they might remind you that there are more realistic ways of looking at things.

Planning How you Could Improve Your Life

One thing you could do is to write a list of all the things that stress you out, and go through the list, looking for solutions, or discussing the things on the list with anyone you know who you know has a sensible attitude.

You might make goals for improving your life, or for how much less you want to self-harm in the near future.

Try to make them realistic though, so you can feel fairly sure they're achievable. So, for instance, you might think it would be nice if you could get into the best university in the country. Maybe that's possible. But don't set your heart on it so much that you're really disappointed and discouraged if it doesn't happen. Look into less ambitious ideas as well.

Less ambitious doesn't necessarily mean less good. You might be able to think of several little things that could make you feel quite a bit happier, once you get a few ideas to start off.

Changing Your Mood When you Want to Self-Harm by Changing Your Physical Sensations

Sometimes, people can lose an urge to self-injure if they do something to take their attention away from it, and give themselves a sensation that helps relieve the urge at the same time. For instance, some people self-injure to relieve tension. If you do that, perhaps relaxation techniques would help instead. Some people find that if they self-harm to distract themselves from the feeling of emotional pain, other sensations can do that instead. Here are some you could try out when you begin to get an urge to self-injure, to see if you're satisfied with doing other things instead:

• Splash water on your face. Perhaps cold water. It might be more fun if you use a water pistol or those things you can get to spray water on plants with.
• Have a warm or cold bath or shower. That'll change the sensations you're feeling, partly by changing your body's temperature.
• Make your whole body as tense as you can. Hold the tension for several seconds, and then slowly let the tension go. You might find the relief from tension is quite pleasurable, and you might well feel more relaxed afterwards.
• Change the temperature of the room you're in, or yourself, or go somewhere that's a different temperature. For instance, stick your head out of the window for a while on a cold winter's night, or turn the radiator right up for a while in the summer, or go for a walk outside in the cold, or sit in the hot sunshine for a while. Or something like that. Changing the temperature of your surroundings not only changes the way you're physically feeling, but it can also bring people out of dissociation.

Other Techniques That Might Take Away an Urge to Self-Injure, or Act as a Substitute

Stop any of these techniques if they make you want to self-injure more. But do them if they help:

• Instead of cutting, burning or bruising yourself, colour part of your body to look the way it would have looked if you had injured it. For instance, you could draw long red lines on your arms with red lipstick or something, instead of cutting. Make sure you're using something non-toxic and easy to wash off.
• Hold an ice cube in your hand for several seconds.
• Plunge your arm or hand into a bucket of very cold water, maybe with ice in it. The sensations will be quite like the ones you get when you self-harm, but it won't do you any damage.
• Likewise if you eat a raw onion.
• When you're feeling in a good mood, record a video or tape etc. of you talking about your good qualities, why you like yourself, and why you don't deserve to injure yourself. You could get family members and friends to speak on it as well if you feel comfortable asking them. Then, when you get an urge to self-harm, put it on, and it might make you feel better so the urge fades, and make you feel loved, as well as raising your self-esteem a bit.
• Phone, write to/email, or visit a friend or family member. Supportive human contact can make people feel much better if they're distressed. Think about the friends or family members you have who you think might be the most understanding and supportive, or just the ones who'd be most enjoyable to be around, who'd cheer you up a bit, and then decide who to contact each time.

There are lots of other things you could try. You might have already tried things that have worked for you. Think back to see if you can remember anything that has.

Delaying self-harming - the Fifteen Minute Rule

Some people find that if they decide to wait fifteen minutes or so after they've decided to self-harm, and tell themselves that if they still want to self-harm just as much at the end of it, they can, the urge to self-harm will go down during those fifteen minutes, so when the minutes are up, they won't feel like self-harming much any more.

Or if they do, they might see if they can go another fifteen minutes without doing it, knowing they have the freedom to do it if they want to at the end of that. And then they try and go another fifteen minutes after that if they want, knowing they're free to self-harm at the end of that if they decide to. And so on.

During those sets of fifteen minutes, they'll do something they either enjoy, or something that relaxes them, or something that they have to focus all their attention on, to distract themselves from their urges to self-harm, since then, the urges fade away more easily.

If you really feel you have to self-injure within that first fifteen minutes and give into the temptation, don't feel discouraged. In fact, you can still be pleased you resisted the temptation for a while, even if it was only a few minutes. You could try another way of distracting yourself from your self-harm urges the next time. It might be a matter of trial and error at first, but you'll probably get better and better at not self-harming over time.

Distracting Yourself From Your Urge to Self-Injure

It can help to go out of the room where you normally self-harm, since it might be easier to take your mind off it then.

You could put together a list of things that relax you or which you enjoy doing or which take up all your attention in a pleasant way, so you can choose some easily when you get the urge to self-harm.

For instance, you could maybe de-stress yourself by phoning a friend, watching a comedy video, going for a brisk walk, listening to any music you find helps soothe your emotions, having a warm bath, reading something interesting, or whatever helps. You could write down a list and keep adding to it whenever you think of more things that might help. If you keep it somewhere handy, you can remind yourself what's on it whenever you need to. If you've got friends who do non-harmful things to cheer themselves up or relax, perhaps they could give you more ideas for it.

Actually, one thing some people find helpful is listening to songs where the lyrics talk about hurt feelings, that describe feelings that are similar to theirs. It's as if it's nice to know there are songs that express the way they're feeling well, as if the songs are a bit like their voice, expressing themselves well, and that having the feelings expressed in songs can be satisfying so it can be soothing.

When you feel like self-harming, don't reject the idea of doing other things instead, thinking they couldn't possibly help. After all, you only need to try one for a little while, before you move on to another one. It's not as if they're meant to stop you self-harming altogether. They're just meant as short-term distractions that might tide you over till your impulse to self-harm dies down.

Don't be down-hearted if you end up harming yourself anyway. You could perhaps just write the distraction method you were using off as something that doesn't work, and try others next time. You could make a separate list of the methods you find most effective.

Or maybe distraction methods will work some times and not at other times. But they might become more and more effective the more you recover.

If some of the methods work well, you could start using them whenever you feel stressed, before it's built up to the level where you want to self-harm.

When you're feeling calmer, you might be in a better position to think about other more in-depth things that could help you with your recovery.

Combating the Urge to Self-Harm

When you're feeling quite relaxed, try to think of each thing that sets off your urges to self-harm, so you'll know when you're most vulnerable to them.

Write down a list of the things that set your self-harm urges off, so you don't have to worry about forgetting a few and having to think through what they are again. If you have a list of constant reminders of what they are, then when one begins to happen, you'll recognise it for what it is sooner than you might have done if you hadn't thought through what they are, and you might be able to divert your attention, or take steps to avoid certain situations, before your emotions get so strong you find it difficult to divert yourself from your urge to self-injure.

Or you can plan in advance things you can do when something happens that usually makes you start wanting to self-harm.

If you have an urge to self-harm most of the time, try to work out when your urges increase a bit and decrease a bit. Try and work out what's happening at those times. It might be possible to do more of the kinds of things you notice you've been doing when the urges decrease, and less of the kinds of things you notice you've been doing when they increase. Or you might be able to find ways of coping with the things that tend to be happening when the urges increase better, so you don't feel the need to self-harm.

The Thoughts You Have Before You Self-Injure

Think about what kinds of thoughts you typically have in the hours and minutes before you self-harm. For some people, they're thoughts like, "I'm no good. I don't know why anyone likes me. I hate myself. I can't cope." Whatever they are for you, it might help to write them down when you're feeling calm and more cheerful, and think them through, so you're more likely to notice them when they start to happen again. If they're written down, you can go through them, analysing them to decide whether they're really true. They might be exaggerations. Once someone gets stuck in a cycle of pessimistic thinking, their thoughts can get more and more upsetting the more emotional they get, because the more emotional people get, the less clearly they can think. You might have noticed, not just with yourself, but with angry parents and so on. But if you've worked out that the thoughts you often have when you get upset are exaggerations, they'll hopefully be less likely to upset you the next time they happen.

Or when you get an urge to self-injure, you could write down the thoughts you're having, and then go through them one by one, working out if they're absolutely true. By the time you've thought critically about all of them, you might not feel like self-harming any more.

Thoughts can get quite inaccurate when people get too emotional to think them through, as if they're just records that play automatically, rather than carefully thought through things. The more you do think them through, the more you might realise that though you assume they must be true, they aren't.

An Example of Someone Having Inaccurate Thoughts When He's Upset

For instance, it's possible that a boy who's doing so well at school that he gets straight A's in all his tests and exams, who swims for his school in competitions, who gets big parts in a local theatre group he performs with, and who has a part-time job and a girlfriend, might still get so depressed sometimes because he's never got over his parents divorcing and he partly blames himself, even if it wasn't his fault at all, that he often goes into a gloomy mood when he's on his own, where he thinks thoughts that make him feel worse and worse, like,

"I can't do anything right. I should be better than I am. I'm such a loser. No one wants to be with me. I'll never feel any better."

His thoughts might make him feel more and more distressed, till the only way he feels able to cope with them is to self-injure.

Maybe that's what happens with you? How many of those thoughts of his would you say were accurate? Could your own thoughts get just as inaccurate before you self-harm? For instance, could you perhaps start thinking no one likes you when you can see when you're more cheerful that some people do? Could you start thinking your parents never spend any time with you whatsoever, when really, though things could certainly be improved, they do spend at least some time with you?

Try thinking about the thoughts you typically have before you injure yourself, and think about how accurate they really are. Then when you catch yourself actually having them again, you'll hopefully know they're not as true as you might have assumed they were before.

If you can change those thoughts, chances are you'll stop getting so distressed you want to self-harm. At least, it won't happen nearly so often.

One problem is that if you don't examine your thoughts for accuracy and reject thoughts that aren't true, some of those thoughts can actually come true. For instance, if that boy who self-injures often thinks his life will never get better, so he gets more and more depressed about it, he might get so convinced that his life's a mess and it isn't worth even trying to make it better that he might stop trying, so it never does get better. He might stop bothering to go out to his theatre group; he might give up bothering to work for good grades; he might stop socialising with people and so eventually lose his friends and his girlfriend; and he might just stay in feeling miserable. Then he'll be more and more sure his thoughts are right. And in fact they will be becoming truer. His life won't get better if he behaves like that. In fact, it will have become a whole lot worse, just making him more depressed, all because of his gloomy discouraging thoughts. Only when he starts to try to achieve things and enjoy himself again will his life start to get better.

So it's useful to think through the thoughts that make you want to self-harm to see how accurate they are, before that ever happens to you, if possible. It's typical for depressing or anxious thoughts to often be exaggerations, or misinterpretations of things, like the boy's were at first.

You could think of yourself as a detective, examining the evidence to see how true your thoughts are. If you think one's inaccurate, you could write down the reasons why, as if you're making a report on your findings.

You could do that with every thought you decide is inaccurate. Then you could read through the notes you've made whenever you start to get those thoughts for real. It might stop you getting so distressed by them that you want to self-injure.

If Your Depressing Thoughts Are True

If you decide that any depressing thoughts you're having are absolutely true, try to think through what you can do about it. For instance, if a relative of yours is making your life much harder to bear because they abuse you when they see you, and you keep distressing yourself by thinking about how awful it is, try instead to think about what you could do to try to see less of him or her, if possible, or how you could try to stop them being abusive, if you think you might be able to.

Or if it's verbal abuse, like a father who keeps yelling about you not getting good grades at school or something, you could try to surprise him into acting differently by behaving differently than normal when he starts.

Stopping Upsetting Thoughts

Another thing you could try if you decide your thoughts get exaggerated and inaccurate when you start getting distressed, is to shout stop to yourself, or even out loud, whenever you notice you're having depressing thoughts. Then try to focus your concentration on something else.

Or another thing you could try is writing down negative thoughts, and trying to think of any positive things that mean they aren't as bad as you think.

For instance, one person might challenge his negative thoughts in this way, thinking a depressing thought first and then answering it in his mind:

• I'm so stupid for wanting to hurt myself.
  No. Harming myself doesn't mean I'm stupid; it's just the best way I know how to cope sometimes. I'll learn new ways of coping soon.
• I have to keep my self-harm a secret. Everyone will think I'm a sick freak if they find out.
  No. I don't know what people will think yet. Some people might be understanding. More people might understand if I explain to them what makes me want to do this, instead of just showing them my scars. And if I really want to talk about it, I could always phone a help-line to discuss it, before telling any friends I decide to tell.
• I only self-harm because I know I can't cope with life.
  Really? Actually, I'm coping quite well with a lot of things. And I could probably find ways to cope with at least some of the others if I set my mind to looking for ways of dealing with them.
• I can't do anything right. I mean, I came last in that swimming race!
  Come on; coming last in one race doesn't mean I can't do anything right. It doesn't even mean I'm no good at swimming. All it means is that I came last in one race. I'll train a bit more.
• I'm a failure. Dad was asking me what I could recommend that might stop him and Mum divorcing, and I couldn't come up with anything, and then they did get divorced. It's my fault.
  It's not my fault. I was only ten when he was asking me what I advised him to do! How was I supposed to know! A big grown-up like him should have known better than to ask, and he should have realised that he should have known a whole lot more about how the world works, and possible solutions he could try, than I was likely to know about at my age! It was silly of him to have expected a ten-year-old to sort out his problems for him! Still, at least there are some good things about him, and it's nice to go out to places with him sometimes when I see him nowadays.
• Everyone thinks I'm a freak. There were at least five people laughing at my tastes in music after school today.
  So, five people laughed. Given that thousands of people have bought the records I like, I hardly think those five are in the majority when I take everyone into account; and even if most people in the world don't like that music, all that really means is that people have different tastes in music. It's silly of people to laugh at other people or to think they're freaks just because they like different music.

So you could write down some of the negative thoughts you typically have, with more accurate and reassuring ways of looking at those situations. Then look back at what you've written whenever you start to have those thoughts again, to reassure yourself.

Working on Changing Emotions

The reason people have emotions is so the brain can alert them to something it thinks they ought to be taking notice of. For instance, if a person's in danger, they'll feel fear, which is a brain signal meant to make people treat the situation with urgency so they'll do something to get out of it.

If it's impossible for them to get out of the situation that's making them feel fear or some other strong emotion, or they try to just ignore the emotions they're having, perhaps because family members have scolded them for having them, the emotions will likely get worse, as if the brain's like someone not being listened to who resorts to shouting.

The thing is that sometimes people get strong emotions when they don't need the brain to produce them to alert them to a problem any more. For instance, if when their dad raised his voice, they knew there was about to be trouble, they might have got fearful. That was their brain sending them an accurate danger signal, with the idea that it would help them quickly get out of the way if they could. But their brain might send them the fearfulness signal when their boyfriend raises his voice as well, because their brain associates raised voices with trouble; but really, their boyfriend might never cause any trouble beyond a bit of heated discussion when he raises his own voice. So the brain's sending a fearfulness signal that might lead to strong emotions when it doesn't need to. It's just associating the boyfriend's raised voice with the father's raised voice that did mean trouble, so it thinks it needs to send the fear signal when it doesn't really.

So if you have emotional reactions to things you don't understand, and that you don't want, one thing that might help is if you try to work out what your brain might be associating the things that seem to be triggering the emotions off with.

When you understand why your brain's causing them, it's possible to train it to react differently.

Also, sometimes, a whole range of emotions come together strongly to make the feeling they're giving people overwhelming; but before they get as strong as that, it may be possible to identify each emotion and work on it separately.

Tips on Dealing With Anger and Frustration

Anger in particular can be associated with especially bad self-harm, because it makes people want to do something aggressive.

Self-criticism can be one thing that leads to more and more anger. As self-critical thoughts go round and around in a person's head, they can get more and more angry, until they feel so bad they want to harm themselves in self-hatred. But it might be that the self-critical thoughts aren't even deserved.

Even if you did something you can rightly criticize yourself for, the more you get worked up about something, the less clearly you'll be able to think, till you can blow things right out of proportion without even realising you're doing it. That's just the way the brain works.

Vigorous exercise can help relieve angry feelings because it uses up aggressive energy.

In fact, there are several things you could try. Here are a few suggestions. See which ones you like the sound of. You might be able to think of others as well:

• Dance out the emotion in your room, maybe to fairly loud music;
• Go for a run;
• Go for a bike ride;
• Throw a ball or a soft toy against a wall repeatedly;
• Write a letter to the person who's made you angry, expressing all your feelings and the reasons they've made you angry; but don't necessarily post it.
• Listen to a tape of something that mirrors how you're feeling, like a thunder storm, or a song with lyrics you really identify with.
• Play a good video game;
• Do a drawing or painting in angry colours, or colours that represent whatever other emotions you're feeling at the time. Paint or draw the kind of scenes that fit your emotions, whether that be scenes of people, or just patterns, such as lines painted in angry colours.

Feeling Down

Often, when people are feeling depressed to start with, a small thing can make them feel much worse than it normally would, because it's another thing on top of all the rest of the things that are bothering them. Also, the more emotional a person gets, the harder it is to think clearly and solve problems, because the brain's so full of emotion that there isn't much room for much thinking to go on. So even little things can seem like big things that mean your whole day's ruined or your life's hopeless. Also, you might remember several other times when you've felt this bad, but because your emotions are stopping you thinking of good things, you might forget times when you enjoyed yourself. So you might think life's always as bad as it is at that moment.

Something that might reduce your urge to self-harm is if when you're feeling down, you try to remember that the brain doesn't function as well as it does normally when you're feeling upset, stopping you from being able to get things in perspective and solve problems well. So it can make you think things are more hopeless than they really are.

Maybe if you write that down and keep it handy, you can read it to remind yourself when you start thinking things are hopeless. As soon as your emotions calm down, you'll start getting things into perspective again.

In the meantime, perhaps the best thing you can do is to look after yourself, to do things that'll help you calm down so you'll be able to start thinking more clearly again. Think about how you'd treat a friend who was feeling sad and depressed. What would you do for them? Do the same for yourself, as far as you can.

You might not feel like doing anything nice for yourself, because when you're upset, you might feel so pessimistic you might think nothing could possibly work, or that you need to punish yourself. But again, those ways of thinking are caused by the strong emotions in the brain blocking out your ability to think clearly. If you try caring for yourself, you may well find you manage to soothe yourself, and then you start to feel less hopeless about things.

So before you next feel down, you could make a list of activities to do that are simply designed to make you feel better, and keep the list handy, so you can easily pick one when you start feeling down.

Things other people have put on lists like that have included things like:

• Any kind of craft, that makes you feel you're achieving/creating something good, and that takes your mind off bothersome thoughts because you have to focus your attention on what you're doing. Some people find embroidery helpful because you have to focus so much attention on doing it carefully, although you can chat to others or have the television on while you do it. But any craft you enjoy would be good. It could even be things like making cards with pretty pictures on them on the computer.
• Painting;
• Learning up about something that seems interesting.

There might be lots of other things you could try.

Anxiety

Anxiety can make people think they're not in control of a situation that they really can control. For instance, it might make someone worry and worry about a conversation they're going to have with their boss, and feel sure they won't be able to cope with it, when it turns out they didn't need to worry at all. Anxiety can make people think they're less capable than they are. So a person might self-harm to feel as if they're in control of something, when they really have more control over things than they think, and they can get more control over them if they do other things instead, like relaxing so they have a clearer mind so they're better at thinking things through and deciding what to do.

It's easier to relax if you relax regularly, beginning when you're not all that anxious, rather than waiting till you are. And when you're relaxed, it'll often take more to get you anxious than it would have done to get you more anxious if you were anxious already.

Some relaxation techniques take practice before you're really good at relaxing with them. But anyway, you could try out different methods and see which ones you like. You could keep a written note of which ones you found helpful and which ones you didn't like.

Maybe you could ask friends and family what they do to relax, and try some of the things they do.

Perhaps you could think back and see if you can think of things that've helped you in the past, whether that be soothing music, watching a favourite video, doing specific relaxation exercises like slow controlled breathing, or whatever.

Soothing Yourself by Thinking of Something Relaxing and Enjoyable

One way you could try relaxing when you're stressed is to close your eyes, breathe very slowly for a little while, and imagine you're somewhere nice for a while. Day-dream about it in detail. It could be somewhere you've been on a holiday you really enjoyed that you could imagine being in again. Or somewhere you went for a day out that you really liked. Imagine what things around you look like, what sounds you can hear, and even any fragrances in the air and what temperature it is, for instance if the sun's shining brightly down warming you up, and you can smell the scent of flowers in the air, or sea air.

It might take a while to build up your day-dream till it's detailed. But if you find it comforting, rehearse day-dreaming about the place several times a day so you're good at imagining being there. Then you'll find it easier to imagine yourself being there for a while when you're stressed and want to relax.

Another thing you could do is to think back to some of the most successful moments in your life, moments when you know you did something well, and perhaps were praised for it. Then imagine you're watching yourself succeeding at it on a DVD. Day-dream about that several times a day as well if you think of something good, in as much detail as you can, till you can go into a day-dream about it and relax yourself when something makes you feel stressed.

Meditating

Some people find meditation very relaxing.

It can be a bit challenging at the same time though, because it involves trying to gently push all thoughts out of the mind, and that's difficult to do. Still, people aren't really expected or even meant to do it perfectly. The idea is that you try, so you don't get so absorbed in upsetting thoughts they begin to distress you.

The way you meditate is to help yourself get distressing thoughts out of the mind by having a go at focusing all your attention on one thing, which has nothing to do with them. Here's one way of meditating: What you could do is to sit somewhere comfortable, put a hand on your stomach, and then try breathing very slowly, deeply and evenly. You'll feel the stomach inflate like a balloon as you breathe in, and deflate again as you breathe out. If you're breathing evenly, your stomach will be inflating and deflating in a nice steady rhythm. So you can concentrate on whether it is, and if it isn't, you can focus your efforts on breathing more evenly.

Focusing all your attention on something like that is relaxing, both because breathing slowly relaxes the body, and because if you're concentrating on that, you won't be thinking distressing thoughts. If any other thoughts do come into your mind, don't get annoyed with yourself or anything; just gently put the thoughts out of your mind and focus your attention on your breathing and your stomach going up and down, and whether it shows you your breathing's slow and even or not again.

You can also concentrate on inhaling and exhaling, or on the sensations your breath causes as it flows in and out of your nose or mouth. Remember to keep your breathing slow. Gulping too much air in at once can cause light-headedness.

Before you put each unwanted thought out of your mind, label it. For instance, if you think, "I wonder what's for dinner", think something like, "Oh, I'm having a thought about what's for dinner", before pushing that thought out of your mind. If you have a thought that says, "I can't do anything right", instead of it leading to other depressing thoughts, just think something like, "Oh, here's a thought that says I can't do anything right", before gently putting it out of your mind and focusing your attention on your breathing again. You can do the same with any feelings you have.

Try making time to practise this meditation for about fifteen minutes every day. As you get more skilled at letting go of your thoughts, letting go of them in everyday situations might become easier as well, so they won't upset you so much. Also, your meditation sessions will probably become more relaxing, since letting go of upsetting thoughts will be easier the more practised you are.

A Food Meditation

Here's another idea for a meditation: Something else you could focus your attention on, trying to keep your concentration there while you label and then gently push away other thoughts that come into your mind, could be a little piece of food. For instance, it could be a single raisin.

Sit somewhere comfortable, and then put it in your cupped hand. Then spend a few minutes carefully studying its texture and shape, and the shadowing around it. Concentrate on it in detail. Then, slowly pick it up and feel its texture in your other hand. After a few minutes, put the raisin in your mouth, and focus your attention on what it feels like for your tongue and teeth to touch it, and whether your mouth's producing more saliva because of it. After a little while, slowly bite into and chew the raisin, paying attention to what it tastes like, and what it feels like to bite and chew it.

When you've swallowed it, imagine it going on its journey down your throat and into your stomach.

Expressing and Soothing Emotions Through Creativity

You might get a lot of satisfaction, as well as being able to express your emotions, if you find things to do you enjoy, like making things, or painting, or drawing - some kind of expressive artwork. Or maybe you'd like to write poetry or stories. Or perhaps you'd like to compose new music. Or maybe you like singing or dancing.

Maybe there are activities you could persuade your family to get involved in with you. Or maybe you could show your family what you've achieved.

If you can find a nice quiet private place to do whatever creative thing you decide to do, all the better.

You could experiment with doing different things till you find something you like a lot.

Pampering Yourself

You could try doing other things to soothe your emotions as well. One thing some people find works is having a relaxed warm bath, with scented bath oils, and maybe other things that make the atmosphere nicer. If you can do something to pamper and soothe yourself every day, it'll be one way to make yourself less stressed.

Aerobic Exercise

Exercise can work off nervous tension and give people a bit of a buzz that makes them feel better. Also, if it's a group exercise where you're meeting other people, that can make it more enjoyable so it can cheer you up a bit.

If you can do some kind of exercise every day, something you know you enjoy, then it will hopefully mean your mood often improves. It could be walking, running, cycling, swimming, dancing or something else.

Some people have found yoga and martial arts helpful. They can help you focus on breathing in a more relaxing way and can supposedly help your powers of concentration. They could be worth a try.

Thinking of Difficulties as Learning Experiences

Many of the difficulties in our lives can teach us wisdom. Quite a lot of them are caused by the ways we interpret things, not the things in themselves. For instance, someone who isn't making friends might think they're useless or that other people don't like them or aren't very nice. So they might be upset. But what they could do instead is to think of the fact that they haven't got any friends as an opportunity to grow wiser. They can ask themselves how they could do things differently to get more friends. They might decide to befriend different people, or work harder at befriending the ones they're already hoping to make friends with, and so on.

One thing that can help is if you make a little note of everything you notice that helps improve things, and everything that you notice isn't helping. You can perhaps pretend you're watching yourself from a bubble you're sitting in high above.

For instance, someone trying to make new friends could think about what's just happened, every time they have an encounter with someone they'd like to be their friend, and they could make notes of any worthwhile thoughts they have about what they did well, and what they think they could do differently in future, and put the little notes in their pocket, and read them before they go to bed.

Every few days, they could look at all the little notes, think about what they were doing well so they could do more of it, and also think about the things they were doing that were actually defeating their purpose, such as if they decided one day that there was no hope and slunk away; and they could decide to do less of that.

So, for example, if they find that listening more to friends makes them more popular, they'll know to do that again. If they find that dressing to look cool doesn't improve their friendships, they'll know they needn't bother with that too much. And so on.

They might soon find they're making progress in what they want.

Telling People You Self-Injure

You might want to tell people you self-injure, perhaps because if you lie about how you got your injuries it makes you feel guilty and causes awkwardness in the relationship, or because you want support, or for some other reason. If you do tell people though, or they find out, it might be best if you try to explain in as much detail as you can why you do it, or explain in some way they'll understand. The trouble is that some people can be disgusted by self-injury, or think you've got some severe mental illness, or decide you're scary to be around, or something like that. Those kinds of attitudes come from not knowing much about it. Things like self-injury can seem scary for people who don't understand them.

So you might think your wounds say you're in pain and you need support, while people who know you caused them yourself might think they mean you're some kind of scary freak. Even friends might back away because they feel a bit scared and don't know what to do. But the more they understand about why you harm yourself, the more supportive they'll probably be. That's why the more you can explain about what makes you want to hurt yourself, the better.

Also, if you can talk about things you're learning to do instead, then they might not be so worried. For instance, if someone who finds self-harm soothes their emotions tells their friends, and then tells them about all the other ways they're learning to soothe their emotions, what they say won't seem so scary, because their friends will be reassured that at least they're getting over it; and some of what they say might even help their friends with their own problems.

Stopping Scars Looking so Bad

Eating a good diet can help wounds heal. That's one thing.

At the time when you self-harm, there are a few things you can do, so if the wound's going to scar, the scar won't look as bad as it would have done otherwise.

Cleaning the wound when you've first made it will reduce the possibility of it becoming infected and getting worse, so it'll reduce the possibility of a really bad scar forming.

It helps reduce scarring if the edges of a cut are held together as well. At the hospital, that would be done with stitches, or with surgical glue. Stitches need to be put in within the first 24 hours, or the edges of the cut will have started to heal on their own, and probably won't join together so neatly. Surgical glue might be better than stitches in a way, because it avoids the possibility of a scar forming where the stitches were. It holds the wound together and then dissolves as the wound heals. There might be lumps in the wound while it's healing, but that's just the glue, which should dissolve.

Knowing When to Go to the Hospital

You might be unsure as to when a wound's bad enough to go to hospital. But if you're in doubt, it's best to go. There are some guidelines that can help you make the decision. Seriously think about going to hospital if:

• There is quite a bit of blood loss; a wound won't hold closed because of where it is and keeps opening up again; or a wound won't stop bleeding after ten minutes of putting pressure on it with a clean dressing.
• A wound is deeper than just a surface cut, so the cut might have damaged tendons or more significant blood vessels.
• The wound includes damage to the mouth, face, hand or genitals.

It might be as well to check a wound over the next few days for signs of infection, such as swelling, redness or pus.

If the wound's a burn, the best immediate thing to do for it is to run it under cool water, or put it in cool water, possibly for between ten to thirty minutes. That'll stop the burn doing further damage. It's best if you can get it in water within minutes of having made the wound.

Don't pop blisters yourself, since they're the body's way of shielding the affected area from things that might cause further damage while it heals the wound.

Don't put any creams on the burn, but do put a sterile dressing on it. Some creams are grease-based, and grease keeps heat in.

If it's painful, you can take a painkiller; but if it's very painful, or the burn seems to be getting worse, get medical help as soon as you can.

Burns should be covered up; so if you haven't got any sterile dressings, at least use something, and then get medical help as soon as you can. Very large or deep burns should always be medically seen to, as should burns on the face, joints or hands.

Stopping Worrying About What People Will Think of Your Scars

Having scars left over from self-harm can be awkward, because they can last a lifetime. So they can lead to a lot of worrying over time about how to handle people's questions about them or other reactions. And they can be permanent reminders of how upset you were when you self-harmed, so they can keep you stuck thinking about it. They're a sign to everyone that you've self-harmed, so it's as if they're publicising something to total strangers that you'd probably rather keep quiet and only tell close friends and family.

Some people's reactions might make you feel less confident, or angry or anxious, just at the time when you're trying to learn to calm emotions to stop them getting bad enough to make you want to self-harm.

Talking to others about it should become easier if you're prepared to accept self-harm as a part of who you have been at one time in your life, rather than thinking of it as something to be ashamed of. If you no longer self-harm, you'll at least be able to be pleased you made a success of getting over it. But it represents a way you coped at a time in your life when you were having difficulties; that's all. It's not as if it defines you as a person.

Dealing with other people's reactions can be awkward; but sometimes, people can worry for years about what people will say in the future when they finally have the courage not to cover up their scars; and then when they do, they find out that people's reactions aren't anywhere near as bad as they thought they would be, with some people just not noticing, some not saying anything, and some just not being too bothered about it.

There will be exceptions, so it's worthwhile planning what to say to people who ask questions. It might often be possible to dismiss the enquiries in a couple of short sentences, and take their attention away from you personally, by firmly saying something like,

"Some people self-harm when they're feeling very upset, to distract themselves. People who self-harm aren't doing anything all that abnormal; they're just taking things to greater levels than most people do. For instance, one reason people self-injure is to distract themselves from emotional pain. If a person who doesn't self-injure is sitting in the dentist's chair and they're in a bit of physical pain, they might clench their fists really tight to distract themselves from it. If they were in more pain, they might want to do worse things to themselves. Emotional pain's the same. Self-harm's just the way some people cope with it."

There might be people who want to know more, but they'll probably be the minority. As with worry in general, you might find any worrying you did about what might happen actually made you feel a lot worse than what actually happened did.

If someone does say something unpleasant, try to step back from it and really think about whether it's true. Some people say things out of total ignorance. Remember that if someone says something and it starts to trigger off the old critical thoughts you used to have about yourself, like that you must be mad or a failure, remember how thoughts can become very mistaken when emotions are strong so the brain's swamped with emotional signals and can't think through things properly. They can make you think things are much worse than they are.

You don't really have to take seriously the comments of a stranger who knows nothing about your life, and perhaps nothing about self-harm beyond what they might have read in some tabloid. If it's someone who knows you who's making the comments, it might help them understand things better if you perhaps leave them a book about self-harm. But if you feel unhappy and would rather not talk to them about it, then it might be better to just try to put the comment behind you.

Some scars fade over time anyway so they grow less noticeable.

Part Two
Parents of a Self-Harmer Needing Advice

Someone's just posted on a forum saying she's recently found out that her daughter self-harms, and doesn't know what to do. There are a few other parents saying similar things.

I've read a bit about what parents can try. I think I'll say:

One Thing You Can Perhaps Be Encouraged About

If your children told you themselves, you can be encouraged by that, because it often takes a lot of courage for people to tell someone they're self-harming, and it may well be a sign that they trust you enough to tell you.

I've heard it advised that you can best keep that trusting attitude they may have towards you if you show caring concern and don't be judgmental.

If you feel disgust at their wounds, don't try to cover it up, because they might notice, and think you're disgusted at them. Just let them know it's their wounds that are making you feel squeamish, but that doesn't reflect on your feelings about them personally.

What You Can Do If You Made Mistakes When You First Discovered They Were Self-Injuring

If you made mistakes when you first found out, you can probably repair the damage, so don't worry too much about it. You can't blame yourself if you reacted badly at first. The news probably came as quite a shock, so your reactions were most likely to have been automatic, not calmly thought through.

It'll be best if you try to be as understanding and encouraging as you can now. Don't be too demanding, for instance expecting recovery to take place immediately. These things tend to take time.

But at least you don't have the responsibility of making sure recovery happens all on your own. You can try getting professional help, perhaps going to see your doctor, and looking up information about self-harm and what to do, from national organisations set up to help self-harmers.

If things went so badly the first time they mentioned their self-harm to you that communication between you has broken down altogether, and they perhaps now shout at you to go away and don't want to talk to you at all, remember they're perhaps frightened of not being able to control their emotions by any other way than self-harm, and perhaps scared of what might happen to them if they don't stop, and perhaps frightened of what else you might say to them that might upset them, especially if you try to make them stop immediately, or condemn them for their behaviour.

Sometimes, a letter or email to them can help. It means you can sit down and really think through what you want to say without being interrupted by them, so it's less likely to turn into an argument, and you can come across as calm and supportive.

If you write a letter or note, put it somewhere where they'll see it, and perhaps tell them you'll be happy to talk to them if they want to talk.

Explain in the note or email that you didn't handle things well when they first told you they were self-harming. Don't be afraid to admit you were wrong. It'll give them more confidence that you'll be understanding in future. Offer a sympathetic ear if they want to talk, but don't try to force them to. Say they can write a note back to you if they'd prefer that than answering face-to-face. That'll mean they can reply in their own time, without there being so much risk of the conversation getting emotional.

Once you've built up confidence in each other again, then you'll probably be able to talk face-to-face comfortably again.

Showing You Care

Even while they might not want to talk to you, though, they might appreciate it if you care for any fresh wounds of theirs you see, by, for instance, providing a sterile gauze bandage or plaster if the wounds are fairly minor and clean, or taking them to hospital if you think they need stitches. You can take the opportunity to show you care.

Let them know you'll be willing to provide a shoulder to cry on if and when they're ready to talk.

You could offer to go and see the doctor to try and get therapy for them if they'd like, but don't try to force them into it.

Wait till they're calm before asking for explanations about why they injured themselves though. They might be feeling too emotional to want to talk just after they've hurt themselves.

For People Who Think Their Child Might Be Self-Harming But They Haven't Mentioned It

The same thing would also go for people who suspect their child of self-harming, but the subject hasn't been brought up yet, and they want to bring it up themselves. Tips for them might include:

Give some thought to the timing of when you bring the subject up: Bring it up somewhere quiet where you've both got time to talk without interruptions. You could tell them that if it isn't convenient to talk then, they can pick a time.

Try to be as tactful and understanding as you can. One way of saying things could be something like,

"It's really difficult for me to say this, and I could be wrong, but I've noticed some scars on your arms, and I can't help wondering if you've been hurting yourself."

They might not admit to it. On the one hand, they might be relieved and glad you've noticed, and want to confide in you. But on the other, they might feel ashamed and vulnerable, and wonder what your reaction will be, so they might deny it, or blame the injuries on some accident or other.

Don't take it personally if they do deny it and yet you're convinced you're right. It might not mean they don't trust you, but just that the shock of having what might have been a guilty secret brought out into the open might make them defensive.

You can reassure them you'll be willing to be there for them to listen if they do decide they want to talk about it at some point. Once they've had time to reflect on what you said, they might decide they do want to confide in you after all.

Common Mistakes Carers Make When They Find Out Someone's Self-Harming

It's natural to want to do what you can to try to protect the self-harmer from themselves, like taking away all the things they use to harm themselves, or having them supervised all the time. The trouble is that not feeling in control of their circumstances is one thing that can cause the frustration and distress that contributes to the emotional build-up that makes people want to self-harm. Also, if anything else makes them stressed, they'll still want to use that method of coping till they've learned other ways of handling their emotions so they can deal with them without wanting to self-harm. So chances are they will. And if they've had their usual self-harming implements taken away, chances are they'll just find another way of harming themselves, possibly something more dangerous, unless you've spoken to them and they feel confident they can cope by doing alternative things.

So a good thing to do is to get their permission to take away anything that could be particularly dangerous, like anything that looks particularly lethal, or anything that's rusty or dirty that would be more likely to cause infection. But it's probably best not to take everything, unless, again, they've told you they feel confident they can do non-harmful things instead, for instance if you give them a supply of raw onions, and they seem happy to eat those instead of harming themselves.

What they need to recover is to learn to stop distressing thoughts building up till they cause such strong emotions that they need an outlet and turn to self-harm, and to learn healthier ways of expressing their thoughts, and to change the circumstances in their lives that cause them distress, perhaps with help.

If you show too much disapproval of their self-harm or try to stop them by taking everything they could use away, they might start self-harming in secret again, maybe on parts of their body you won't look at, pretending to you that they're recovering when they're not. It's best that you know what's going on in their life.

Another mistake people make is to expect too much too soon, setting goals for their children's recovery that are so high as to be unrealistic, such as that they should stop self-harming immediately, before they've learned other strategies for coping with overwhelming emotions. They might want to stop immediately themselves. But the next time those emotions come on again, they might not know how to cope with them in any other way than by self-harming. And if they seriously think they'll let you down if they do self-injure, they might start feeling like a failure, which might make their distressing emotions even stronger, so they might be more likely to self-harm.

What can work better than focusing on the self-harm itself is trying to think up ways with them of coping with their emotions in alternative ways, or ways they can distract themselves from their emotions when they want to self-harm, till they fade. There are lots of things self-harmers have found helpful as distraction or self-soothing methods that have stopped them self-harming sometimes.

Encourage them and be pleased for them whenever you notice even little steps forward. And when they do relapse into self-harm, encourage them that relapses are normal and you'll support them to get their recovery on track again, and that it doesn't mean all the effort they made before was wasted.

Telling the self-harmer to keep the self-harm a secret from family and friends can put an extra emotional burden on them, because they might think you're ashamed of it. So although you might want to, because you'd be ashamed for anyone to find out, it's best not to be too rigid about the idea.

If your child confided in someone outside the family long before they ever told you they were self-harming, don't take it personally, and try not to feel too hurt. It won't necessarily mean they've rejected you as a confidante. Lots of people find it easier to talk to people outside the family about emotional problems they're having. They can say what they want to without worrying about family reactions; and also, sometimes, it gives them more control over when the issue's brought up. For instance, if they talk about it to a school counsellor once a week, they know exactly when they're going to talk about it and they can prepare. But they know that if they tell someone in the family, the person might want to talk about it at all kinds of times, sometimes when they themselves would rather not talk about it.

Another reason self-harmers might prefer to talk to someone outside the family about it is because they might worry about how upset you'll be if they tell you. Don't try to hide your feelings when they do tell you things, to try to protect them from the burden of knowing you're upset, but try to focus on reassuring them by telling them about how you intend to be there for them and support them, and about what you and they might be able to do to help their recovery, rather than on how it's made you feel.

Don't Rush to Blame Yourself or the Self-Harmer For Their Self-Harm

Don't think you must be entirely to blame for your child's self-harming and keep going over and over in your mind all the things you think you might have done to cause it. It'll probably be a whole range of things that built up to cause an emotional burden so overwhelming that your child decided they needed to cope with it by harming themselves. Maybe the most important things are things that happened when you weren't there and they didn't tell you about them. Perhaps things at school. Even if one of the most important things that made them want to self-harm was something you did, it won't help to get really down-hearted about it and full of self-blame. The important thing is how to change things so things can get better. It's best to focus on how to make the future better, rather than what went wrong in the past. What went wrong before might need to be thought through a bit, but only to the extent that it can help you decide how things need to change for the better.

It may be that people you know will think your child's self-harm must be your fault. Try not to let them depress you. Remember there are probably several things that led up to it, many of them possibly nothing to do with you.

But don't blame the self-harmer either. Being too critical could make them feel bad about themselves and so want to self-injure more. Some parents try to shame the self-harmer into giving up, by saying things like, "Can't you see the damage it's doing to this family? Surely you must realise you're being selfish!" or, "You've got everything going for you; a loving family, a good school, your own computer and television; grow up and get a grip on yourself". If the self-harmer could have sorted out what's making them so upset without any kind of help, they would have done it before. Telling them things that might make them feel more inadequate than they do will probably just make their problem worse.

That doesn't mean you have to sacrifice honesty to be nice. It just means trying to be understanding.

Just Listening to Your Child Sometimes

Sometimes what they might find most helpful is if you just listen, without interrupting, without judging them, and without even giving advice. Sometimes, they might want to talk till they feel thoroughly heard. In fact, doing that might sometimes be just what they need to calm themselves down so they don't resort to self-harming that time around.

Seeking Outside Help

Don't be afraid to seek the support of someone you can confide in, so you don't feel as if you're dealing with the self-harm alone. A friend could come up with new ideas for you and your child to try in their recovery, or help you think things through out loud by being a good listener. Then you can perhaps help your child better.

And don't be afraid to seek professional help for the family if you think you could do with it.

Spending More Time With Your Children

Many psychological researchers have found that one important thing in helping teenagers develop self-confidence and self-worth is spending quality time with parents, in a relationship where they're made to feel as if they matter, and know they can turn to their parents for help. It may be that you haven't spent much quality time with your children, perhaps because you've had to work to make ends meet. If you find it is possible, though, to spend more time with your children, doing things you both enjoy together, talking through any problems they have with them if they confide in you, and just being there if they need you, then you might find it pays off. Sometimes, that kind of care is more valuable than material luxuries. If someone who's self-injuring starts to feel listened to,

Even having dinner together around a table where you get the opportunity to talk to each other can be valuable quality time together where teenagers can be made to feel cared about, and will have the opportunity to talk about anything that's bothering them if they want to.

Developing new regular routines where you spend time with your children doing something you all enjoy can help strengthen family bonds and make children feel happier and more secure as well.

Leaving Time for Them to Relax, as Well as Encouraging Them to Do Worthwhile Things With Their Time

On the other hand, while it's helpful to some extent to schedule in activities for teenagers to do, and to push them to spend time on schoolwork in the hopes that they'll be the best they can be, it's very important that they have time to relax. Feeling too pressured to do well or to fill their time can place stresses on them that can contribute to them wanting to relieve the tension by self-harming. So try to get some kind of balance.

When parents start listening to and being supportive of their teenage children, their self-harm sometimes stops.

Respecting the Point of View of Your Teenager

Also, if you've been especially strict with them, or especially unwilling to give their point of view any credence, ask yourself whether that's because that's the way things really have to be, or is it because you've absorbed messages in the past that taught you you have to be like that, when you don't really. Being willing to talk through things and make compromises with teenagers can make them feel much less pressured and resentful, so they might not have so much of a build-up of emotions, so they might not self-harm so much.

Talking Time

Apparently, teenagers who self-harm often think their parents don't listen to them. If you think that might be true in your family, or if you often have family arguments that get heated, one method that can calm them down, or that can help each family member feel listened to, is having times where each family member expresses their opinions and their needs in turn.

To help with that, you can buy a plastic flower, or get a twig and decorate it, and whichever person's holding it at any one time speaks, and the rest sit and listen, without interrupting. It can sometimes be done where you sit around a table with a candle in the middle, and you pass the flower or twig, or whatever it is, around, and each person says what they want the others to hear in turn, while the others look at the candle.

Or it can be done where the person holding it expresses their opinion, and then they hand it to the person who they were talking to, and that person answers, and then hands it back for the other person to say more.

It means people don't all start talking over each other.

One thing that can calm arguments down even more, although it takes some self-control to do, is that when the first person in an argument has finished talking, instead of coming right back with a reply, the one their comments were aimed at repeats them back to them, not necessarily word for word, but repeating back the gist of what they said, and asking if they've understood what the other person was trying to get across. Then, the person who spoke first might say yes, or they might explain a bit more.

Then the other person responds.

When they have, the person who spoke first repeats back what the other person said to them, asking if they understood it correctly.

That means both sides have then expressed an opinion, and had it paraphrased back to them by the other.

And it carries on like that. It stops arguments developing out of people responding in anger without having really thought about what the other one said and so misunderstanding it.

Thinking Back to What Was Good About the Family Relationship in the Past

One thing that might help you remember old things you did together that brought you closer to each other as a family is a kind of memory exercise, where the self-harming teenager imagines they're in a time machine and can go back to a time in the past when their relationship with you and other family members was closer. They describe what they enjoyed, in as much detail as possible. Then you all think about what parts of it you might be able to re-create.

For instance, if you used to go for walks together and they remember that as something they enjoyed because it was a time when the family had fun together, maybe you could make time for them again.

Or if they treasure a memory of doing something that made them feel as if the family was close that it would be impractical to do nowadays, such as a memory of sitting on someone's lap, maybe you could ask what it was about that memory that makes it special, and think about what you could do to re-create whatever it was. For example, if the memory's precious because they felt loved, you could maybe ask them what would make them feel loved again.

Part Three
A Woman Whose Problems Have Made her Want to Self-Injure

Dealing With Relapses on the Way to Recovery From Self-Harm

It seems you've got a lot of reasons to self-harm. But you'll probably be able to think of alternative ways of coping with those things, or of decent non-harmful substitutes for self-harming that have some of the effects. I've got some suggestions.

You could think of stopping self-harm as being like shutting the door on your painful past, and starting anew with hope for a better future. If you do self-injure again though, you won't have to think of it as getting stuck in the past again. You can just think of it as a temporary journey there that you can shut the door on and move on from again when you want.

At times when you're tempted to self-injure, it might help you not to if you try and work out what triggered your emotions to make you want to self-harm again. All it will mean is that something still needs to change in your life, whether that be a circumstance you're in, or the way you think about past circumstances, or the effects that reminders of them have on your emotions. Relapse is a signal your brain's sending you to work out what's bothering you so much that it's making you want to self-injure, so you can work on changing things as much as you can.

Changing things like that can't all be immediate though. It's bound to take a bit of time.

Distracting Yourself From Your Urges to Self-Injure

A technique some people find helpful in the short term is to do something to distract themselves from thoughts of self-injuring when they want to, but to promise themselves that if after fifteen minutes, the distraction technique they're using hasn't worked, and they want to self-harm just as much as they did before, they can give themselves permission to if they want, or try something else for another fifteen minutes, and if after that, they still want to, they can feel perfectly free to.

There are quite a lot of distraction techniques people say they've found helpful. Some people find their urge to self-harm goes away when they start using them. Some people find some distraction techniques more helpful than others. So if you try one and it doesn't work, it's worth trying others.

Some techniques that soothe some people make others feel worse. For instance, some people find their urge to self-harm goes away if they draw red lines on their skin with lipstick where they would have self-injured to represent blood, if they like to see blood flowing because it symbolises the crying they want to do but can't in the normal way, or something. Some people have found that very helpful. But some people find that if they draw red lines on themselves, it just tempts them to self-harm where the lines are. So it's worth finding what works best for you personally.

If you try one thing and it doesn't work, don't be discouraged. It just means it's worth moving on to trying something else.

Distraction techniques are really just a short-term solution to try while you work on changing the things in your life that are actually making you want to self-harm.

Things to Try Instead of Self-Harming

See which of these distraction techniques and similar things you like the sound of. Some of them are meant as things you can do for fun. Some are meant to soothe the emotions. Some are meant to be ways of getting anger and other emotion out of the system. Some are meant to give you a sense of creating something worthwhile you can be pleased with. Some are meant to help you feel less isolated. And so on. You might want to choose different ones each time, depending on what you think you need most at any one time.

• Play some sad songs and sing along with them, with feeling;
• Think of a word that describes how you're feeling, (like lonely, sad, anxious, vulnerable, horrible, worthless, or whatever), and then write it over and over again till it fills up a piece of paper. After a while, the word might start to look silly, so it might end up giving you a smile or a laugh;
• Have a go at singing what you're feeling, loud if you're feeling angry;
• Do some craftwork, making something you'll have to concentrate on and that'll give you a sense of achievement when you've done it. It could be making something that'll be of some practical use. Or it could be doing something pretty, like embroidering or something;
• Have a warm bath or shower;
• Go outside for a walk and look at the details of anything from nature around you;
• Sit somewhere where you can watch something soothing, like in front of a fish tank;
• Play with a pet;
• Cuddle a teddy bear;
• Spend a few minutes doing slow steady breathing, breathing in as slowly as you can and then breathing out slowly;
• Do any other relaxation techniques you like;
• Blow soap bubbles;
• Read a comic;
• Buy yourself a treat;
• Put on the silliest clothes or clothes combinations you can think of;
• Go out where you'll be around other people, for instance going shopping, or visiting a friend;
• Hold ice cubes in your hands for a few seconds, or eat something with a strong flavour, like raw onion, ginger root, a slice of lemon, a chilli pepper, and so on, or have a cold shower;
• Punch a bed or a pillow to get anger out, or hit it with something like a tennis racket;
• Tearing up old newspapers and magazines can also help get anger out;
• scratch draw a picture on a thick piece of wood, or use a screw driver and stab at the piece of wood. (that can be another way to release emotions without harming yourself);
• Do things in another room from the one where your self-harming things are kept, to reduce the temptation to use them;
• Learn to confront other people so you let them know how you feel instead of keeping your emotions inside;
• Carry comforting things in your pockets or bag or whatever you take around with you, like a picture of someone you trust, or a pet, or one of those little squeezy stress balls, or something that reminds you of something you associate with happiness, like a seashell that reminds you of nice trips to the seaside, or whatever. Put your hand on it when you begin to feel stressed, to remind yourself of what it reminds you of;
• Try things that keep both your hands and your brain occupied at the same time. Perhaps try a jigsaw puzzle, or some online equivalent;
• Take up a sport you enjoy. Vigorous exercise can help relieve tension, and make you feel more alive;
• Writing and journaling might help. Perhaps you could make up short stories, or write essays on things you find interesting. Some people even enjoy writing poetry. Or you might find it soothing to write about your feelings. Some people get upset doing that for too long, so it's best to stop when you stop finding it helpful, but you could see if doing it for at least a few minutes helps anyway;
• Get some big bits of paper and make collages out of little pictures from magazines, or other things that might look pretty, sticking them on the big bits of paper in various ways. Or you could decorate the front of diaries you write in or anything like that. Or you could have notebooks or scrapbooks for making collages of pretty or interesting things in;
• Remind yourself where you are, to bring yourself back to the present if you're too caught up in emotions or in a bit of a trance. Get a pen and paper, and write down everything you can see around you, anything you can hear, and anything you're touching with any part of your body. So, for instance, what you write might go something like:
  I'm sitting on my bed.
  My legs are touching my blanket.
  The ceiling is white.
  The walls are blue.
  It's 7:00 PM.

  And so on.

• Play with play-dough or clay, perhaps making a big sculpture, and then doing whatever you want to it to release anger, or trying to do something really creative.
• Draw a picture of the one making you angry, perhaps adding features to caricature them, like claws on the ends of their fingers, or whatever else you think you might like drawing;
• instead of harming yourself, try massaging the area you want to harm with massage oils or creams, reminding yourself that you're a worthwhile person who deserves to treat yourself and your body with love and respect;
• Or if you really want to punish yourself, do a dirty or boring job no one else wants to do, like cleaning something dirty and yucky, emptying rubbish bins, and so on;
• Do some housework, like cleaning - that might help when you want to self-harm for other reasons, not just self-punishment, and you'll be pleased you got it done;
• Repeatedly recite a poem or something you like;
• Play some kind of musical instrument. Even if you don't really know how to play it, picking out tunes is a way to concentrate, and playing might be soothing or absorbing, so it might help you get rid of the urge to harm yourself;
• Scribble on paper. Clutch the pen in your fist. It's a way to get emotion out of the system. Put a few sheets together, or use card, so it doesn't tear;
• Use the thing you usually use to injure yourself on something else. For instance, if you use a razor blade, you could rip it across an old towel or something. Sometimes, seeing what can be done with such an object can make people think twice about using it on themselves, and cutting something else also gives a person the feeling that they're cutting something, which might be a satisfactory substitute for cutting themselves;
• Get yourself a rag doll. Imagine it represents yourself. When you want to cut yourself, cut that instead. Then care for it, sewing up its wounds;
• Some people who want to feel pain when they self-harm like to keep a rubber band around their wrist, so instead of cutting, they just snap it on themselves;
• Make a list of all the reasons you want to stop self-harming, and read it every time you feel like injuring yourself, to remind you. Put on it that you don't deserve to be hurt. You're important and you deserve to cherish yourself.

You could think up several things of your own that might work for you.

Since self-harm can have a powerful effect, replacement strategies might not work as well if you try using them to gain the same effect you get from self-harm. But they will hopefully at least take the edge off your urge to self-harm so you can resist it more easily. And some strategies might be more effective as replacements than others. Try them out and see which ones work best.

Remember you're not alone in your struggle against self-harm. Lots of people have gone through the same thing.

You could perhaps write lists of healthy things you'd like to do when you feel like self-harming, in order of preference. Then try them in turn when you get an urge to self-harm.

If you give in to the urge to self-harm, afterwards, try to work out what triggered it off, and then plan for things you could do differently next time, so it's less likely to catch you off guard. Or you might be able to recognise the signs of it coming on, and do things to deflect it before it gets strong enough to make you want to self-injure.

For instance, if you realise that criticism triggers off thoughts in you about what a worthless person you are, and the more thoughts like that you have, the more upset you get until you want to self-injure, then you can try working out things to do at the start, when you first get criticised, to stop things building up like that.

Changing Any Routines You Have That Lead Up to you Self-Harming to Help you Get Out of the Habit

Some people have routines, like rituals they always do in a certain way, before they self-harm, which are part of the satisfaction of the self-harm and what gets them in the right mood. For instance, they might lay towels out tidily along with first-aid equipment, to give them the satisfaction of knowing they can go straight from harming themselves to caring for themselves. Or they might light a candle and stare into the flame for a while while rocking back and forward, to take the edge off their stressed emotions. And so on. So self-harm becomes more of a comfort and more enticing.

If you have a routine, where you do specific things before you self-harm to build up to it, or you have specific times of day when you self-harm, it might help to deliberately get into new routines by doing something else at those times, and get away from things that remind you of your routine of building up to a self-harming session. That's because even being reminded of it might give you an urge to start it off. Perhaps you could move the things you use so they're out of sight at the times of day you'd usually use them as part of a self-harming ritual, if you're going to be in the house at the time. You might get into comfortable new routines instead.

For instance, visiting people, or getting absorbed in something you're interested in, at the times you know you're most likely to self-harm, can stop the urge coming on.

If you put new steps into your routine, it might help as well. For instance, someone who has a routine of coming in from work and going straight to get their self-harming things might find it gets them out of the routine if they deliberately do something different every day as soon as they walk in the door, like perhaps putting on a tape of relaxing music and making a cup of tea. Or it could be something like putting anything to do with work down and then going out for a walk a couple of times around the block. Whatever they enjoy. Soon, making a cup of tea and putting on relaxing music, or whatever else they do when they get in, might have become a new routine that replaces the self-harming one altogether.

But if they just treat it as an extra step in their self-harming routine at first, again, when they've done it, perhaps the urge to self-harm will have faded, just as it might when using the distraction techniques. They could choose things from their list of distraction techniques to build into their self-harming routines to slow them down as well, so the urge to self-harm might fade on the way.

If they find it's getting stronger instead though because of the frustration of it being delayed, then they can reassure themselves that they're not being forced to go slower, and that in reality, they can stop to self-injure right there and then if they want.

Have a good think about extra things you could put into your self-harming routines to change them and slow them down, or places you could go at the times you'd normally start getting urges to self-harm, where you won't be able to carry them out, and where you'll be so interested in other things that you might not even get the urges.

You could make a list of places you could go, or things you could do, and keep it handy, so whenever something happens that you know can lead to you getting an urge to self-harm, such as you having a bad day at work, you can look at the list, and think of something to do before the urge comes on.

Sometimes, that could be turning your attention to thinking through ways of solving the problems you're having.

For instance, if someone's being bullied at school, they could think through what they could do, perhaps asking themselves if there's a teacher who seems more trustworthy than the others they could go and tell, and think through when and where to tell them, and what to say. Or they could perhaps go onto the Internet to look at websites run by anti-bullying organisations, to try to find some good advice on what to do.

But if you put yourself in an environment where you can't easily self-injure and where you'll be absorbed in things you like doing or which you think are worthwhile and helpful, before your self-harming urges actually come on, you might be able to avoid even wanting to self-harm that day.

For instance, being with friends, going for a brisk walk when the weather's nice, or whatever you enjoy doing, might work.

Doing Things to Substitute for Self-Harm

For people who do their self-harm routines when they feel out of control of a situation so they want to do something they can at least feel in control of, and who find the routine calms them just as much as the self-harm itself, other things that make them feel in control of something might work just as well. For instance, tidying a room or a cupboard, cleaning, or even washing up, can help give a sense of restoring order, so they might help.

If the self-harm routine fulfils other needs you have, you might be able to think along the same lines, about what else would fulfil those same needs so you could do that instead.

For people whose enjoyment of their self-harming routine is to do with the strict step-by-step nature of it, they could maybe find other things that need to be done in a step-by-step way, like making a cake or doing a jigsaw puzzle.

Just as self-harm can have the advantage of distracting you from your emotions because it focuses your whole attention on the wounds, something else that takes up your whole attention might be equally effective in distracting you from strong emotions, like playing a computer game, perhaps, or learning to play tunes on a musical instrument, or whatever you can think of that takes brain power.

Again, these are just short-term techniques. Healing the emotions is the way to go really. But since that'll take time, in the short term, while you're working on that, absorbing yourself in something else might cut down the risks of self-harm for now.

If You Think You Just Must Self-Harm

If you feel you just must self-harm, please try to reduce the risk of you doing serious damage by making sure whatever you hurt yourself with is clean and sterile, and not too big or sharp. Try to get rid of anything you have that could be particularly dangerous. If you've overdosed before, make sure you haven't got large amounts of drugs that you might take on impulse, that you could regret taking later when it's too late.

If you feel it would help, shut everything you use to hurt yourself away, so it'll be more difficult to get to. For instance, perhaps you could put it in a box in the corner of the garage behind a load of things you'll have to move out of the way if you want it. That way, if you get an urge to hurt yourself, you know your things are available, but it'll take time and effort to get them, so they're not easily enough available that you can just harm yourself on impulse before you've really thought about it, so the urge might have time to fade away while you're getting them.

Make sure your wounds are tended well. For instance, clean them, close them and dress them well, to prevent them becoming infected. If you need to get medical help, for instance if you've overdosed, seek it straightaway. If you don't think you will seek it yourself, you could maybe agree beforehand on a codeword you could phone and say to a friend or text them, that will be a signal for them to get medical help for you.

Dealing With Self-Criticism

You might often have a stream of self-criticism going through your head, perhaps criticisms that other people made of you that weren't fair, but they said them so often you came to believe them, and now you keep repeating them to yourself. I'd bet it won't help if you see things on television or in magazines etc. that make you feel critical of yourself, like super-slim models, and so on. You might only half notice the stream of criticism going through your head; but if it's there, it'll get you down, and make you think you're a much less worthwhile person than you are.

One thing that might help is if you first sit still for a while and try to think of all the critical thoughts that typically go through your brain, and write each one down as you think of it. Then you could examine each one to find out whether it's really true.

Critical Words

Thoughts you might have that are especially unlikely to be true are exaggerations, containing phrases like, "I never"; "I'm a complete"; "I always"; "I'm just a"; "I'm no good at", and so on.

Whenever you catch yourself thinking like that from now on, you could change the thoughts a bit to make them sound less harsh. For instance, instead of using words like should, must, ought to, have got to, and so on, you could try catching your harsh thoughts and being easier on yourself by using words like "could", "would like to", "will if I can", "would be nice to", and so on.

If you can't think of the critical thoughts you often have when you're sitting down trying to, think back to the last time you were depressed, ashamed or angry with yourself, and try to remember the kinds of thoughts you were having about yourself then.

If you can't think of anything, you could perhaps ask a friend or any close family member you have if they could tell you what kinds of things they hear you saying about yourself, or to point out to you the next time they hear you criticising yourself. But most of your self-criticism will probably just go on silently in your head.

Thinking About Where the Critical Thoughts First Came From

When you've thought of some of the critical thoughts you have about yourself, it might then help to ponder for a little while on what the purpose of the critical thoughts was in the beginning, and where they first came from. Do they sound like things your parents used to say to you, or a baby-sitter, or a teacher, or kids at school, for instance? If you know they came from other people to start with, and you know you don't have to believe everything those people said, the critical thoughts might lose some of their power.

The critical thoughts might even have been there to protect you in the beginning, for instance if you were abused as a young child, and the knowledge that someone who was supposed to be providing and caring for you could do that just out of nastiness, would make you feel so frightened and insecure that thinking you must have done something to deserve it at least spared you that.

But to carry on thinking like that will just make you dislike yourself so you haven't got the confidence to move forward and make the most you can of your life. If, for example, your dad kept telling you you'd never achieve anything in life, you might have come to believe it, perhaps because he said it so often you thought it must be true, and to think it must be true was less frightening than to think that he, the adult who was supposed to know best and make sure you were cared for, actually had such bad judgment that he would say something over and over again that just wasn't true, not even realising it wasn't true, or just being nasty. Since then, you might have come to feel sure it's true that you'll never achieve anything in life, because your experiences since seem to have proved it. But they might have done that because thinking you won't achieve anything in life means you haven't got the confidence to try to; and also, every mistake you make, or every time you do badly in something, you take it as confirmation that you'll never achieve anything in life, whereas a more confident person would just think of it as one thing they did badly, or one mistake they made, and put it down to experience and try to do better next time. But it stops you being confident enough to try again.

Or your critical thoughts might be a defence, that was originally built up because you thought other people were going to criticise you, so you would criticise yourself first, so it wouldn't feel so bad when other people did, because they'd only be saying what you yourself had said.

Or perhaps you thought that if others heard you criticize yourself, they wouldn't bother. Or maybe you thought that if you agreed with them when they criticised you, they wouldn't argue with you so much.

While techniques like that might have helped you at one time, now you're better able to justify yourself and stand up to criticism from others, it'll make you feel better to do that than to belittle yourself.

Or perhaps if you realise that your critical voices are really covering up fear of criticism from others, you can plan things to do to help yourself cope with criticism from other people, such as learning assertiveness techniques.

Dismissing Critical Thoughts

Your critical thoughts, that might have served a good purpose at one time, might now be just getting in your way.

So you could gratefully tell your critical thoughts that they did a good job once, but now you don't need them any more.

You might have to keep patiently reminding them that they can go away now, every time you catch yourself having them for a while. Or you could again examine them for how true they are, every time you notice yourself having one.

Asking Yourself What Triggers Off the Critical Thoughts Each Time

Another thing you could do when you notice yourself criticising yourself is to ask yourself what triggered off the criticism. For instance, was it a phone call from someone who used to criticise you a lot, like a parent, that brought back memories of what they said, so it started you on a train of critical thoughts? Was it a reminder of something you did wrong that made you feel discouraged, and from there, you started thinking more and more exaggerated critical thoughts about how you never do anything right? It could have been a number of things. If you try to remember what happened just before you started criticising yourself, you might be able to work out what sparked off the thoughts. Then, you could think about whether it needed to.

Also, next time the thing that triggers off your critical thoughts happens, you can be on watch for the start of the critical thought train, so you can stop it in its tracks, perhaps by distracting yourself by doing something else, perhaps by thinking of the things you've done well in life, or perhaps by recognising what's going on, realising that any thoughts you're likely to have will get exaggerated if you let them, and disputing the ones you're having, such as saying to yourself things like, "No, I'm not a complete failure. I might have believed what my parents told me when I was little, but I know better now", or whatever thoughts are most relevant to you personally.

There might be several things that spark off onslaughts of self-critical thoughts in you. It might help to write each one down, whenever you realise it's happening, so you can tailor your response to each individual one.

For instance, someone who found they were criticising themselves a lot after their mother had visited them might write down that her visits are a trigger for their critical thoughts to come on, and then pay special attention when she visits after that to reminding themselves that they don't need to take their critical thoughts seriously, because they've only come on because the visit just triggered off memories of the upsetting things she used to say, and that her criticism of them when they were a child was silly and exaggerated, not reasonable, so they don't have to start criticising themselves as if it was all true, and even if some of it was, they don't have to criticise themselves in the same way now.

Making Yourself Feel Better About Yourself By Giving Yourself Positive Messages

Or when you notice you've started criticising yourself, imagine what a good friend might say to you. Perhaps they'd say that the things you were thinking weren't true. Perhaps they'd say that yes, you can make mistakes and do silly things, and there are things you aren't good at, but that that's the same for everyone, so you don't need to be too hard on yourself. Perhaps they'd tell you what they like about you. Perhaps they'd say that if you're feeling down, you deserve to do something caring for yourself. And if a friend would say things like that to you, why not be kinder to yourself?

One thing you can do is to write down loving messages about yourself to replace the critical ones, and maybe contradict them. Then you can stick them up around your house or carry some with you, so when you start being swamped by critical thoughts, you can read them. They could be things, perhaps, like, "I know I'm a good person really, and I deserve to look after myself", or, "I may have made some mistakes, but I'm not a complete failure, and from now on, I'm going to try to get the best out of life as far as I can". They could be all kinds of things that contradict your critical messages.

If you have a supportive friend, you could ask them what kinds of nice messages they think it would be good for you to have around your house or carry around with you. If you can remember any nice things they said about you that you knew were true, perhaps you could write them down and keep them.

You could even make a tape of the nice messages, and often listen to them while you're doing something else.

Also, if you feel particularly cheerful at any time, try and discipline yourself to write down what you're thinking and what's going on, so maybe you can do what you're doing then more often to lift your mood. If you write it down, you won't just forget what put you in a good mood, because you'll have something to remind you.

Criticism Isn't All Bad; it Depends How It's Done

Criticising yourself isn't always a bad thing. It depends how it's done. If it's the kind of criticism that helps you work out how to do things better in the future, then it's naturally a good thing. Or if you tell yourself you do stupid things sometimes and that you're not much good at some particular thing, that's OK, as long as you recognise that everyone does stupid things sometimes, and everyone has things they're not that good at, so you know you don't have to think you need to be specially condemned for anything. There's a big difference between telling yourself you do stupid things sometimes, and telling yourself you're a stupid person. Any intelligent person can do stupid things sometimes. But a stupid person is, by definition, stupid all the time. So try not to exaggerate in your thinking.

It could help if you forgive yourself for any past mistakes you have made. Everyone makes mistakes. Even if yours were worse than most, you won't do any good now by just making yourself feel miserable and worthless because of them. Thinking them through to see what you could learn from them, and making amends if you need to, is a good thing. But just condemning yourself for them will just discourage you. There were probably things going on that mean you weren't so much to blame as you think. In any case, deciding to forgive yourself and move on can make a big difference to how powerful the critical thoughts are.

Moving On From Critical Thoughts

Some people find it helpful to do something to symbolise getting rid of critical thoughts, for instance writing down all the harmful things they can think of that they think about themselves, and then tearing up the piece of paper and throwing it away. Or some people like to imagine something, such as imagining that all the critical thoughts merge together in a red light that they push out of their body. You might like that idea, or you might be able to think of something you like the idea of yourself.

If you're caring towards yourself, it'll put you in a better mood, so you'll be nicer to be around. So even if your critical voices are saying you don't deserve it, if you do caring things for yourself, you'll know it'll benefit other people as well as yourself. And if you think you're a bad person, being caring towards yourself can make you nicer because it puts you in a better mood; so funnily enough, being nicer to yourself is one way you can combat critical thoughts about not being good enough.

If you give other people compliments, you might find it cheers up the atmosphere around you, and you get more compliments back. Even if you don't, looking out for the good in people can make you feel more optimistic and cheerful.

It might take time to get out of the habit of criticising yourself in a negative way, and praising yourself instead. Don't criticise yourself for not managing it straightaway. Habits take time to break. Be patient with yourself. You'll probably get better and better at doing it as time goes on.

Building Self-Esteem

To get some idea of the kinds of things you'd like to aspire to when you're raising your self-esteem, and to give yourself more of an idea of your own good qualities, one thing you can do is to sit down for a while and think about what you admire in people you know, and then ask yourself which of those qualities you have yourself, or which you could have if you worked on it.

When you're thinking of the good qualities some of the people you know have - friends, any family members you get on with, and so on, try not to get distracted and start thinking critical thoughts about yourself, but think about the characteristics they have that make them enjoyable or nice to be around, for instance:

• Being good listeners;
• Being helpful;
• Being kind;
• Being genuine;
• Being easy-going;
• Being reliable;
• Being cheerful.

And so on.

Think about those and other qualities you value in a person. Write a list of as many as you can think of. For instance, some of the things you might list might be concern for others, honesty, sincerity, a sense of humour, and so on.

When you've listed as many as you can think of, look over your list, and tick any qualities that you have yourself.

You might not be able to see good qualities in yourself because of your low self-esteem, so it might make it easier if you imagine you're someone on the outside looking in like a friend. Think of friends you have, and try to think of any compliments they've given you, and of anything they might like about you.

You could ask a good friend for their opinion of what good qualities you have as well.

You could write a list of your good qualities, and put it somewhere where you'll see it often, to remind yourself. Then you can add to it if you think of more, or if you develop more, such as being able to stand up for yourself after you do a bit of assertiveness training, such as if you learn to say no without feeling guilty about it.

Finding Pleasurable Activities to Do

One thing that keeps low self-esteem going is feeling depressed, since when people feel depressed, they tend to forget any positive things about themselves and about the world around them, and get mired in pessimism. People tend not to feel like doing things they used to enjoy, or new things they probably would enjoy, when they're depressed, so they tend to isolate themselves, where they brood on their problems and feel worse and worse.

But often, if they make an effort of will and go and do something enjoyable despite the fact they don't feel like it, their mood can begin to lift. It might only be gradual at first, but the more they do things they enjoy, the more their mood can get better.

Also, if they're out doing things they know they do well, and becoming more confident around people because they find themselves around people they get on with well, that can boost their self-esteem and help to lift their depression.

Don't feel as if you have to try too much at once. Anything that feels too daunting will probably just make you want to give up and not do anything. Take things a step at a time if you'd prefer.

But think about what you enjoy doing. And who do you like to spend time with? What do you find worthwhile?

Make a list of activities you find pleasurable.

Do make pleasurable activities a priority, since they might give your mood quite a boost. If you're not used to doing nice things for yourself, you might have to schedule specific times in your diary to go and do some nice things, even if they're only small things.

If you can't think of anything you think you'd enjoy, think back to things you used to enjoy, and start by trying some of those again, if you can.

Always look for opportunities to do things that are important to you.

Think about all the positive changes you can think of that you'd like to make in your life, and think about the first steps you can take towards getting them going. Write them down so you don't forget your thoughts but can keep reminding yourself.

Also, set a date at some point in the future when you can look back and examine what you've achieved so far.

Try to Find People you Like

If there are any people in your life who seem to value you, respect you, and think of you as a capable person who can manage your own life, try to be with them more, (naturally without imposing on them). You could make a list of people who make you feel good and see you as being worth something, and try to spend more time with them. Being with people who think of you as important and recognise your strengths will boost your image of yourself.

Equally, make a list of people who make you feel bad about yourself because they don't seem to value you, and try not to spend time with them.

Do Caring Things For Yourself

Set aside a bit of time to think about things you do for yourself that make you feel good, and write a list in your diary or a notebook, to remind yourself to do them. They could be things like taking a bubble bath, buying flowers, or walking around a neighbourhood where there are flowers you can look at and sniff, going for a swim, or whatever.

Make a special point of doing something you enjoy at least once a day.

If you've been used to neglecting yourself, or you don't feel you deserve to do nice things for yourself, taking time out specially to do them might feel uncomfortable at first. But you'll probably get used to it.

Schedule in special times in your diary at first to do nice things for yourself, or make a commitment to do nice things with a friend at certain times, so you don't think about doing them but never get around to it.

Make a List of Your Positive Achievements and Experiences

Whenever you notice or remember something good you've achieved, even if it's something small like handling a phone call well that you were anxious about, write it down in a list. If you look out for little things you achieve, you might notice a lot of them over time, and if you add them to your list of daily achievements, it might get quite long. Then you might start thinking of yourself as a more capable person.

When you receive compliments, you can add those to the list as well, because you must be doing something right to get those, if they're sincere.

It's easy to downplay or forget your successes if you're not used to recognising them. So try making a deliberate effort to notice them. Then over time, you'll probably develop a more positive view of yourself.

Also, if anything nice happens to you, or if you remember anything pleasant from the past, write that down as well, so you might end up feeling more optimistic about life.

When you write your list of achievements, compliments and other positive things, also comment on what they show about you. For instance, someone's list might be a bit like this:

I helped my friend Lisa with a computer problem this morning and got it fixed. That means I know a bit about computers and am willing to help out a friend.

Barbara said she enjoys the amusing comments I make sometimes. This proves I have a sense of humour and can be entertaining.

I finished a big project for my coursework last week that I put a lot of effort into, and I've been praised by my tutor for it. This proves I can be hardworking, that I'm intelligent enough to be able to put a good piece of work together, and that I can achieve quite a bit when I get motivated.

I was playing a game with my sister's children today, and when she called them away because it was time to go home, they protested about having to stop playing. This proves I can be good at playing games with children and entertaining them, and that I'm the kind of person they can grow fond of.

I'm embarrassed writing this stuff, which proves I'm not big-headed.

And so on.

You might even carry around a little notebook just to put positive things in. Take it with you every day, so you've got it to hand when someone compliments you, or you do something you recognise as positive, so you can write it down before you forget it.

You might think writing things down is boring at first and not feel like doing it. But if you do, as your list grows longer, and you look back over it often, you'll probably realise it was worthwhile, because it makes you feel more of a capable and likeable person, so your self-esteem will rise.

In fact, you could make a point of looking over it every week, and then thinking about what you've learned about yourself, and writing a quick summary of the main qualities you've learned you have.

If you're feeling depressed or unwell, it might be difficult for you to think of the positive things about yourself and things around you. So if you can, ask a friend or family member you get on with what they think.

If you're feeling very bad about yourself, think of a task you can put your effort into achieving straightaway, no matter how small, that might give you a sense of accomplishment when you've done it. Feeling you've achieved at least something will boost your self-image.

How Mistaken Beliefs Can Affect People Badly in Practical Ways

Childhood experiences can make a child form long-lasting beliefs about themselves and the world around them that last long into adulthood or all their lives. Children who've been abused might draw conclusions from that that shape the whole of their outlook on life all their lives, and those beliefs can ruin their lives and relationships, or cause problems with the way they relate to other people. For instance, someone who came to believe the world must be a dangerous place because of the way they were treated might be scared to go out.

Or imagine there are three women, who have each arranged to meet a new friend in a cafe. One of them, Jane, has come to believe, because of the amount of abusive criticism she received from her parents as a child, that people find it hard to love her because she isn't a nice person, and she thinks that means that sooner or later, they'll abandon her. Another one, Clare, has had abusive childhood experiences that made her think the world is a dangerous place and no one is safe or can be trusted. Melissa, on the other hand, has grown up to believe that most people are fairly decent, and that things don't go badly wrong all that often.

The friend of each of the women doesn't arrive on time. Each woman has a different reaction, depending on what her beliefs about herself and the world are.

Jane thinks her friend must have decided she isn't worth coming to meet after all, so she gets upset and leaves. Clare gets scared something bad might have happened to her friend, feels panicky, and buys herself a drink to calm her nerves. Melissa assumes there must be a good reason for her new friend being late, and decides to look to see if she has her phone number if she doesn't arrive soon, to find out what's going on.

What it means for their emotions is that Jane is distressed and hurt, Clare feels very anxious, while Melissa keeps calm and is able to clearly think about what to do.

The beliefs of the two women who got upset weren't entirely wrong - they were just exaggerated. The world is a dangerous place sometimes, and everyone has faults. The trouble is that they over-estimate how bad things are without realising they're doing it.

Once someone realises they're in the habit of doing that, it is possible for them to change their outlook on life. It'll probably take practice. Habits are often hard to break. But with perseverance, it's possible to get into new and better habits of thinking.

Having mistaken beliefs can trap people into having bad lives. For instance, someone who was often told as a child that they'd never achieve anything in life might have come to believe it, so they never bother trying anything, so they never do achieve anything, and because they never do, they carry on thinking of themselves as someone who never achieves anything, thinking the criticism they received as a child must have been right.

Or someone who kept being criticised might think they must be unlovable, so they might not accept any compliments they're given because they assume they aren't true, and might quickly forget them, and they might not spend much time enjoying themselves with other people, because they assume other people will be bound to reject them, and even something that only hints at rejection might seem like a blow to them because they're so sensitive to it. Because they don't seem interested, other people don't speak to them much. Then they think that proves they've been rejected and they're unlovable. But if they had different beliefs, they might respond differently to people, and so discover that a lot of people liked them a lot more than they thought.

What can Stop Emotional Problems Caused by Bad Experiences From Going Away

People can still be affected years after they've had bad experiences.

One reason is because the beliefs those experiences caused them to have about the world, the future and themselves are still influencing the way they behave.
Another reason is that people's moods influence the way they think. For instance, if someone's feeling down, they're more likely to think pessimistic thoughts.
And another reason is that people's behaviour can keep their beliefs going.

For instance, one woman might have difficulties getting into relationships or keeping them, because she was betrayed by someone and was really upset by it, and now, even years later, she doesn't trust anyone, so she avoids getting close to anyone, for fear she'll be hurt again. Because she never lets herself get close to anyone, she never has a chance to disprove her belief that everyone's untrustworthy. So she carries on believing it, and it carries on causing her not to get into relationships, and she doesn't like not having a relationship.

Another person has low self-esteem, because he was abused years before, and it left him with the impression that he must be bad, because he thinks he must have done something to deserve it. Because he believes that so strongly, he dismisses any compliments he gets, or anything he does that proves he's a decent person really. But when he does something wrong, or feels guilty about something he does, or gets criticised, he takes special notice, because it confirms his opinion that he's bad. So he keeps on believing it, and his self-esteem stays low.

Someone else might get depressed easily, after having been neglected as a child. When people are depressed, they'll have an unrealistically negative view of everything. So he thinks his situation and the future are hopeless, and he thinks he's worthless. Because he thinks things like that, it depresses him. So his mood keeps his thoughts going, and his thoughts keep his depressed mood going.

Another person's scared of leaving the house on her own. She'd never felt very confident, and seemed to grow less confident as she got older. So she started preferring not to go out, either with friends or on her own. Because of this, friends stopped bothering to ask her to go anywhere with them. So she went out less and less. Because of this, she got less and less used to going out, so she grew less and less confident about going out.

Biology can contribute to keeping problems going as well. For instance, someone who suffered verbal cruelty when she was a child might have learned to cope by binge eating and drinking for comfort. Because eating and drinking did have an effect on her brain chemistry that made her feel better, she resorted to doing that whenever she had a problem, instead of working on sorting the problem out. She might still be doing that years later. So her problems don't go away.

A person's current circumstances can keep the faulty beliefs going that make their life more miserable as well. For instance, a man might have grown up being bullied by his father who keeps telling him he's no good. He got bullied at school as well. He grew up feeling very shy and timid, believing he was useless and boring. He did get a job, but he still lives with his parents. He has a few good friends, and they invite him out, and assure him he's good company and they enjoy being with him. The friendliness of his friends makes him question his beliefs about being boring and no good. But when he goes home again, his father starts browbeating him again, while his mother just stands by not saying a thing, as she's always done. So he goes back to thinking he must be no good. No matter how often being with his friends makes him start questioning that belief, when he goes home, his experiences always make him start believing it firmly again. So he remains a timid, anxious man.

Thinking Through Your Own Attitudes to the World, Yourself and the Future, and How You Could Change Them

If you think about your own thoughts and beliefs, moods, behaviour, brain chemistry, and circumstances, you might be able to see similar cycles at work, and discover the reasons why some problems are still causing you difficulties years after you had the bad experiences that caused them.

It might take quite a bit of thinking to work it all out though, so don't worry if you can't at first. Pieces might fall into place over time.

Sometimes, just changing one thing in the thoughts/beliefs-mood-behaviour-brain chemistry-circumstances cycle leads to changes in all the others.

For instance, if someone who's isolated and lonely and not achieving much in life because they're depressed so they don't feel like going out much learns to change just their thoughts, so instead of continually telling themselves everything's hopeless and they're worthless, they think more balanced thoughts, their depression might ease, they'll feel like going out more and doing more things, so they'll achieve more in life, and their depression will lift more.

Or if they change the circumstances making them depressed, for instance if they were living with a husband who was abusive and they left him, that also might lift their depression, so their thoughts will change to less negative ones.

And so on.

But there can be a problem if negative thoughts have become such a habit that they're still ruining your life years after you left an abusive situation. They can cause the feelings that make you depressed and anxious and angry and so on. Then those feelings will put you in the mood to think more miserable thoughts, till you feel worse and worse. So changing your thought patterns can help change your feelings quite a bit.

Distressing Thoughts That go Round and Round in the Head

Emotions are just natural things built into the system; when they first come on, they're designed to grab our attention so we focus on a problem that needs to be solved or something else, and deal with it. They're the brain's way of making us pay attention to something. A thought might trigger off an emotion, or the emotion might come on without you realising you've even thought anything that would trigger it off, because the brain automatically matches situations you're in to situations you've been in before, so it thinks it knows what kind of emotions you feel in them, and triggers one off automatically when you're in that situation again.

But anyway, emotions are good things in moderation. For instance, if you're walking across a road, and a car goes through a red light and comes towards you, you might feel fear, and that might motivate you to run fast to get away. Or if someone you think is a friend comes towards you, you might feel more cheerful and smile, and want to greet them happily.

Those things are all very well, but misjudgements can be made if you feel fear because you've misjudged a situation and a car's not coming towards you after all, or you feel joy because you think the person coming towards you is a friend when they're actually hostile towards you, so you aren't ready to protect yourself.

It's just as bad a misjudgement when someone thinks everything's hopeless when it isn't really, or that they're worthless when they're not really. Emotions that aren't there for a good reason can be just as strong as they are when there's a good reason for them to happen, and all for nothing.

One thing that can make emotions much more difficult to manage and much more powerful than they might be at first is that they can trigger off upsetting thoughts that can go round and round in the brain, making a person ever-more upset, so their emotions get stronger and stronger. They might think and think about bad experiences they've had in the past that the emotion's reminded them of, beliefs they hold about their own failings, upsetting things people have said to them, and so on. Also, the more you repeat something to yourself, the more you can become convinced it's true, especially if you're upset at the time. So if you keep telling yourself you're a failure, for example, you'll believe it more and more, and get more and more upset by the idea. The more upset you are, the less clearly you can think, so the less likely you are to challenge the thought and ask yourself how accurate it really is.

It's possible to re-train the brain so your emotions are less likely to automatically trigger off the thoughts that go round and round in the head till they make the emotions too strong to handle though.

One thing that can help is recognising the thoughts for what they are as soon as they start, before they've got into full swing going round and round in the brain. There are several types of mistaken thoughts that can deceive people into believing things are worse than they are, and the more emotional a person gets, the less clearly they can step back from them and see them for what they really are. If you can recognise them as soon as they start, you might be able to stop them in their tracks, before they get that far.

One reason it's good to stop thoughts like that in their tracks is because they can cause people to make bad judgments about things. The more emotional a person is, the more persuasive and extreme thoughts can be. For instance, if someone's feeling really cheerful and optimistic, they might be over-confident and think they can achieve something they can't. So they might try it without preparing for it, and when they fail, they might be really disappointed. Or if a person's feeling really negative, they might think they're not capable of achieving anything, when that's not true either, but it might stop them trying, so they never find out they can do some things well. The balance is usually somewhere in the middle.

Different Types of Thoughts That Can Make People Make Bad Judgments

Have a think through these, to see which ones you're prone to. Once you've had a good think about how accurate any thoughts you have like that really are, it might be easier to recognise mistakes in thinking and correct them when they happen in future:

Dwelling Entirely on the Negative

One type of thought it's common for people to get if they tend to have a pessimistic outlook on life is one where they forget all the good things that have happened and keep focusing on anything bad that's happened, till they think the whole of their life must be bad. You might do that if you're very self-critical, thinking of all the things you did wrong or that didn't go well, until you're really depressed, even if most of the day did go well, and you're just remembering the small bits that didn't.

Or you might do that if something went wrong, and it was possible that you might be able to sort it out, but you can't see any positive solutions to the problem because you're feeling too emotional, but instead only what's gone wrong. Some psychologists call that processing your thoughts through a negative filter, as if the positive thoughts just can't get into your head.

It's the same if you get several compliments one week, but you get a few criticisms, and all you can remember are the criticisms.

An example of looking through a negative filter might be:

"I handed a piece of work in with a typing error today. I'm no good at this work!"

Predicting the Future

Related to that is a tendency to behave as if you can predict the future, imagining everything's going to go wrong, and worrying and worrying about bad things that might happen, when in fact it may be that most of the things you're worrying about won't happen at all, or that you'll be able to cope with them if they do much better than you think.

Disregarding the Positive

Another style of thinking is where people play down any positive or successful things they've done, and blow bad things out of proportion as if they're worse than they were. So, for example, when they've done something well, they might say they were just lucky, or that anyone could have done it, or that they passed a test because a teacher took pity on them, or that kind of thing. But if they do something badly, they entirely blame themselves, and think they must be a stupid person who always gets things wrong, or a bad person who always annoys everyone, or that kind of thing.

A person thinking like that can both exaggerate the negative and disregard the positive, when they're thinking about the same event sometimes. For instance, they could think:

"I can't stop thinking about the way I messed up that exam. Yes, I got a grade of 92%, but I made such a fool of myself messing up those quadratic equations!"

You've got enough to cope with without having that lot loaded onto you as well.

All or Nothing Thinking

Another type of mistaken thinking it's easy for some people to get into is one some psychologists call "all or nothing thinking", where you can find yourself thinking that if everything hasn't gone perfectly, then the whole thing's a disaster. For instance, if you cooked a meal and something got burned, you might think the whole evening was ruined. You might criticize yourself and criticize yourself for days for ruining it, when really, people hardly cared that one thing got burned. So you can feel far more of a failure than you need to, and put yourself under pressure to do things to a much higher standard than you really need to. Fear of failure can cause a lot of distress. That's especially because you might be able to think of little mistakes you make all the time, blow them out of proportion, forget about the things you did well, and feel as if you're always failing. All or nothing thinking makes you think that if something wasn't a total success, it was a failure.

A few examples of all or nothing thoughts are:

"I can't do anything right.
I can't trust anyone.
I'm a total failure."

People who think as if there's success and there's failure and nothing in between often find recovery from self-injury difficult, because they might set their standards too high, and become really disheartened at the slightest relapse. For instance, if you decide that from now on, you'll never self-harm again, you might feel like a failure if you give in to the urge to harm yourself one day. But if you take one day at a time, knowing you might have bad days, and that there's nothing wrong with that because most people recovering from self-injury do, you'll be more accepting of them when they happen, and less discouraged.

Catastrophising

A related style of thinking is called Catastrophising, where people think that because one thing's gone wrong, everything's bound to go wrong. Someone who was hoping everything would go perfectly can focus in on little things that didn't go quite to plan, and sink into gloom, worrying that the whole day's going to be a disaster.

For instance, you might run out of milk in the morning, and start worrying about what else might go wrong - that maybe your train will be late, people will talk about you behind your back, the boss will warn you you're in danger of losing your job, that you might be nervous and make a mistake in your work, and that then you might really get fired and be unemployed forever. So you might suddenly start to feel really depressed.

If you write down your train of thought, you might feel amused when you think that all that was sparked off just by running out of milk.

But if you let your thoughts take over at the time, they can make you feel really depressed. Stopping them in their tracks as soon as you can, before they get overwhelming, and analysing whether one thought follows logically on from the last one, or how likely those things really are to happen, can help.

Over-Generalising

A similar style of thinking is called over-generalisation. It's when something goes wrong, and you think it means that thing is always going to go wrong all your life. Here are a few examples of that kind of thinking:

"I failed that job interview; I'll never get a job.
This relationship's going badly; I'll never find a partner.
She let me down; no one can be trusted."

Mind Reading and Fortune Telling

Some psychologists call another style of harmful thinking "negative mind reading". It's where people feel sure other people must think they're stupid or incompetent or some other bad thing, and that they might be laughing at them or talking about them behind their back, but the person hasn't got any hard evidence that that's actually happening. And they never think other people must be thinking nice things about them. They think the worst all the time. They don't tend to try to find out for sure that people are thinking bad things about them; they just assume they're right in thinking they are.

Because they think other people must be thinking bad things about them, they can avoid them, so they can end up isolated from others, which means they don't get reassured that their worries were wrong, and they're not getting a decent social life, so they can get even more depressed, alone with all their upsetting thoughts.

Fortune telling is thinking as if you know what's going to happen in the future when you haven't got any evidence it will. For instance:

"I'm going to fail the job interview this afternoon. As soon as I walk in the door, the interviewer will decide he doesn't like me. I'm going to make a mess of it, I'm sure."

Taking Things Personally

That refers to thinking that if something happens that you don't like, it must have been your fault, or that it's somehow meant to be a slight on you. For instance, if you meet a friend and they rush off without saying hello to you, you might assume it's because they don't like you as much as you thought they did, when really, they're in a great hurry because they're late for a bus. An example of the kind of thing someone might think could be:

"The evening didn't go too well. There were lots of uncomfortable pauses in the conversation. It was probably because they were thinking about how badly I was dressed."

Blaming or Criticising Yourself For Things That Weren't Your Fault, or Thinking You Caused Things You Didn't

Examples might be things like:

"I can't catch up with my work. It must be because I'm stupid and lazy.
I'm not feeling well. It must be my own stupid fault for not taking care of myself well enough."

Calling Yourself Names, and Criticising Yourself More Harshly Than You'd Criticise Others

Calling yourself names like idiot, or criticising yourself more harshly than you would criticise a friend who was in the same circumstances as you, isn't good for you. The most likely thing it will do is to depress you and make your self-esteem low. Try not to treat or talk to yourself in worse ways than you'd treat a good friend.

Examples of name-calling or overly-harsh criticism might include:

" I'm a complete fool. How could I do that - I'm an idiot! I'm so stupid!"

Having Unrealistically High Expectations of Yourself, and Sometimes of Others

That means putting too much pressure on yourself to succeed at something or to do something you feel obliged to do, thinking that if it isn't perfect, it'll be no good. Or sometimes putting too many demands on others. If you think like that, you might use a lot of words in your thinking like "should", "must" and "ought".

Examples could be:

"If it isn't the best it can be, it doesn't count.
I need to get everything right.
I must get full marks.
I should please everyone.
I mustn't make a mistake.
I should never be untidy."

Hind-Sight Bias

That's where you look back at an event, thinking it would have turned out much better if only you'd done a certain thing, and blaming yourself for not having done it, when actually, it wasn't so obvious you could have done it at the time, or it might even be that you couldn't possibly have known that doing such a thing would have prevented something bad happening at the time. Examples might include:

"If only I'd taken the train that day instead of driving the car, that accident would never have happened.
If only I'd known he was an abuser, I'd have locked the door. I'm so stupid for not doing that."

Thinking Thoughts Like Those Are True Just Because You Feel as if They Are

Psychologists call that "emotional reasoning". Your thoughts are making you feel bad; and because you feel bad, you think it means your thoughts must be true.

Everyone thinks in the ways described above sometimes. The problem comes when it's such a habit that as soon as people start thinking like that, the brain recognises what's going on and sends the old familiar pattern of distress signals straightaway, because it assumes you're in an upsetting situation, because those thoughts made you upset before.

The reason thoughts like that can be so upsetting is that people tend to make the mistake of thinking their thoughts must be true, especially if they come with emotions. People tend to assume their emotions are always telling them about something they need to believe is true and take seriously. So, for instance, someone might feel anxious before they go into a crowded room, so they assume there really is something to be scared of in there. But the real reason they're feeling anxious might be because they've been worrying and worrying that things will go wrong that evening. Or they might think they're a failure because they've got depressed after making a mistake, when really, the only reason they've got so depressed is because they automatically get feelings of failure after making little mistakes, because someone in the past always criticised them over trivial little things and made them feel bad about them, when that wasn't fair at all. Or they might feel sure they're a bad person just because they feel as if they are, when if they looked at the evidence, they might realise they're not really. And so on. Emotions don't always tell you things you need to believe.

One thing that can help change thinking patterns is if people realise that thoughts aren't necessarily true; so if they notice themselves having thoughts like, "I'm a bad person", or "I'm a failure" and so on, they can think to themselves something like, "Hang on, it's only my opinion at this moment in time that I'm ..." whatever it is. If you try to analyse your thoughts rather than just accepting them, for instance asking yourself what triggered them off, how true they really are, and so on, it can help to make them less powerful, if you catch them before they get so bad they convince you they're right so you don't question them. If you can catch them early enough, you'll find you can be the one in control of them, rather than them controlling you.

Talking Back to Negative Thoughts

Some people find it helps to talk back to thoughts. For instance, if they keep having self-critical thoughts like, "I'm worthless" or whatever, they can talk back with the truth of the matter.

You could even give your self-critical thoughts a silly name, to signify that whichever part of your brain is giving you them isn't saying anything of any importance. You might even find it helpful to ask it what it thinks it's achieving by giving you discouraging thoughts while the rest of you's trying hard to build a better life for yourself.

How One Style of Negative Thinking Can Lead to Another

One kind of negative thought can start a spiral where people think more and more negative things, until lots of other kinds of negative thoughts can crowd into the mind, making a person more and more distressed, if the thoughts aren't recognised and stopped as soon as possible after they start.

For instance, someone who hasn't got much confidence that his relationships will last might have an all or nothing thinking style when he's a bit upset, so if he has a minor argument with his wife, he might start to worry that his relationship is over.
Then, because he worries his relationship's over, and he's upset so he isn't thinking too rationally, he might start depressing himself and making himself think things are hopeless by telling himself things that aren't true but that feel true at the time, like "Relationships always go wrong for me." That would be over-generalising.
Then he might begin to think there isn't anything good about him at all, perhaps thinking, "I'm completely hopeless and unlovable." That would be Disregarding the positive.
Then he might think that if things are that bad, they're bound to always be that bad. He might think, "I'll never be able to have a decent relationship, and I'll live my whole life lonely and unloved". That would be catastrophising.

So basically, just from thinking about a minor argument, he's made himself feel utterly hopeless about himself and his future, and probably deeply depressed, because one kind of negative thinking has led to another in his mind, and he's upset himself more and more. If his thoughts had been different, he might not have thought the argument had much significance at all, and it might have just been forgotten about, and his relationship might have gone along as happily as it had before.

Examining Your Own Thinking Inaccuracies

Every one of us could do with being aware of when our thoughts become inaccurate and make us feel worse than we need to.

You could have a think about which kinds of mistaken negative thinking you've done, and think about how it made you feel, and what it made you think about yourself, and how it made you behave after that. Think about what problems you had because of that style of thinking. That'll show you, if you're not convinced already, that it's important to recognise mistaken thinking when it begins, and try to correct it as soon as you can.

It's best to try to get out of the habit of negatively biased thinking altogether, although it might take quite a bit of practice stopping it in its tracks, since habits you're used to can be hard to break, and remembering to stop your thoughts and correct them when they've already made you upset can be difficult. But it's definitely worth having a go, and the more practised you get, the easier it'll become.

It's definitely worth doing, because thoughts like that don't just depress a person for a few hours or so, but that kind of thinking can be such a habit that it can blight a person's whole life.

For instance, a woman who was abused might have developed a negative thinking style because of the nasty things her parents said and did to her; and whenever anything goes wrong, she might blame herself and think she's worthless and stupid. She might not think much of herself even years later. She might have forgotten that they did praise her sometimes, and thought quite highly of some of the things she did, and also that their criticisms of her were exaggerated and sometimes not even true at all. So she might have learned never to value herself. So when she hears someone praising her, she just dismisses it, because it doesn't fit in with her view of herself. And she carries on feeling worthless, with low self-esteem.

But if she realises that it can't be true that nothing about her is good, and that she does really have some talents and other good qualities, she'll realise that she was being made miserable by a mistake in her thinking that was making her feel worthless and depressed when she didn't need to. She might have made the mistake of thinking it must really be true that she's a worthless failure, because she feels like one; she feels depressed and despairing about ever achieving anything in life. But once she realises that her feelings don't mean something's true, no matter how strong they are, but they just come on because of what she's thinking, and that what she's thinking isn't true, she can change her feelings by changing her thoughts to more accurate ones, and reminding herself of them as often as she notices the old thought patterns and the old feelings coming into her mind.

Why Some People Think Biased Thoughts are a Good Thing

Some people think negatively biased thoughts are a good thing because they can be protective. For instance, some people might think that if they assume they can't trust anyone and never will be able to trust anyone again, after they have a bad experience with one person, it's good, because it means they won't get hurt like that again, because they'll never get involved in a relationship again. The trouble is that they might end up being very lonely.

Or a person might have the kind of all or nothing thinking that makes them think that they'll either succeed or fail at something, and that if they fall short of total success, it means they've failed. They might think that's a good attitude, because they might think people who think like that are spurred on to greater effort by their fear of failure, so they'll achieve more. But if they end up not succeeding perfectly, and instead of thinking they've at least done quite well, they think they've completely failed, they'll be depressed and discouraged for nothing.

Or if they think that if a friend or partner is going to be either completely faultless, or a nasty person who can't be trusted at all, then all their relationships are likely to fail, because no one's perfect.

Changing Your Thinking Style

So you could think about whether you think in extreme ways. If, for instance, you find yourself thinking that if you haven't succeeded perfectly, it means you've totally failed, ask yourself whether it wouldn't be better to think of there being degrees of success, such as:

Success
Almost complete success
Partial success
Perhaps not great
Partial failure
Failure.

And likewise with other things. Think about whether you're thinking in extremes, and whether there aren't in reality several grey areas in between the two. Whenever you realise you're thinking something that could be a bit extreme, you could think something like, "Hang on, is this all or nothing thinking?"

It might take a while to get out of that style of thinking if it's quite a habit, and especially because when people are upset, they tend not to think so rationally anyway - that's just the way the brain works. But if you practise examining your thinking style, and trying to remember to stop and think about whether your thoughts could be inaccurate whenever you realise you're thinking in extremes, it will probably come more naturally and easily over time.

Try and think of the things about yourself, other people, and situations, that you think of in extreme ways now, and ask yourself whether your thinking is truly accurate, or whether the truth is really somewhere between the two extremes.

For instance, you might think that a person you know is totally disgusting and nasty. But are they really, or:

Is it just one thing about their behaviour you don't like?

Do they have some very unpleasant qualities, but on the other hand, there are some good things about them?

Are you just angry with them because of a few things they said to you that you didn't like?

Could they just do with improving their social skills a bit?

Are they all in all the kind of person you don't want to be around, but nevertheless they have done some good things in the past?

And that kind of thing.

Distinguishing Between Someone's Character and Their Behaviour

One thing that helps is to differentiate between a person's character and a person's behaviour. For instance, if someone does something stupid, they might be called a stupid person, when in reality, they're quite intelligent, but just do stupid things occasionally. So thinking, "That was a stupid thing to do" is far more accurate than thinking, "You're stupid"

A lot of parents accidentally demoralise their children because they say things to them like, "You're stupid", when really, they're just angry about one thing the child's done wrong, which might not even have been that stupid at all.

More Questions You Can Ask Yourself to Find Out How Accurate Your Thoughts Are

When you have a think about the depressing or upsetting thoughts you typically have, there are more questions you can ask yourself to help you decide whether they're inaccurate, or whether they're truthful, or whether they're really just partly truthful, mainly truthful, or they have a mere grain of truth in them.

If you're finding it difficult to decide how accurate a thought you keep having is, there are questions you can ask yourself to help you decide, like:

1. How much actual evidence do I have that this thought is true?
2. What evidence is there that this thought isn't accurate?
• I mean, have I looked at all the facts?
• Am I missing something important?
• What might someone else think of this situation?
• Have I had experiences that don't fit in with the upsetting way I'm looking at things now?
• If someone else had this thought, what would I say to them?
• If I told a good friend about this thought, what would they say?
• If I was feeling cheerful, how would I view this situation then?
• What might be some alternative ways of viewing this situation?
3. If my depressing thought is true, what's the worst thing that could happen?
• Would that really be likely to happen?
4. What could I do to cope if the worst did happen?
• What would be a few steps I could take first of all to make things a little better?
• What could I do next?

If you feel up to coping with thinking about such things, you could have a good session of thinking about how you'd solve such a problem, perhaps asking friends and other people you know for their ideas.

When you've thought all that through, you could decide what the most accurate way of viewing things seems to be.

Here are a couple of examples of people working through this process:

Example 1: A Woman Who Thinks She's a Bad Mother

A woman called Donna gets depressed because her children are fighting. She thinks, "I'm no good as a mother".

Her thought makes her feel worse, but actually, it's inaccurate. She's blaming herself when it isn't all her fault, and exaggerating things, because she is a good mother in some ways. And she's having unrealistic expectations, because it's natural for children to fight.

She thinks of the evidence that her thought is true, and she comes up with something that at first sounds convincing:

"My children are fighting, and I can't stop them."

But then she thinks of the evidence against her thought that she's a bad mother, and comes up with a few things:

"All children fight sometimes. It's not as if mine fight all that much. And just this one fight doesn't make me a bad mother. I know I'm a good mother sometimes. When I'm in a better mood, I know I'll be able to think of quite a few reasons why I can tell that."

Then she thinks of the worst thing she can think of happening:

"What if they won't stop fighting, and I can't split them up?"

Then she thinks about what she could do if that happened:

"I could phone my husband, and he'd be willing to come home in his lunch break to help me with them."

So she thinks about what a more accurate way of thinking of the whole thing would be, and comes up with:

"My children are fighting, just like most kids do. It doesn't mean I'm a bad mother. It just depresses me a bit, so I think things are worse than they are. If I can't deal with things on my own, I'll still be allright, because I can get someone to help. I could get other opinions on whether I'm a bad mother by phoning a few friends and seeing what they think, if I'm still unsure later."

Example 2: A Man Who Thinks He's Lost a Friend

His distressing thought might go:

"David didn't seem to want to talk to me today at work. He was a bit abrupt. That must mean he doesn't like me any more. So that's another friend I've lost! I won't have any friends soon."

"Hang on, this is biased thinking. I might be blowing things out of proportion. Let's see if I am:

The evidence in favour of what I'm thinking is that he didn't seem to want to talk to me the whole day.

The evidence against it is that he's usually quite friendly and we haven't had a major disagreement recently, so I can't think of a reason why he'd just stop being my friend. And even if he doesn't like me any more, other people are still quite friendly to me, so I haven't got any evidence that no one will like me soon. It's impossible to please everyone all the time anyway.

The worst thing that could happen is that I'm right and that I lose all my friends.

How would I cope?

I could assume they might be my friends again if I talk things through with them and sort out what's bothering them.

What alternative explanations might there be for David's behaviour?

Well, he seemed a bit abrupt and unfriendly with me today; but since he's been quite friendly in the past, it might not mean he isn't my friend any more. It might just mean he was in a rush, or that he had something upsetting on his mind, or that I'd done something to annoy him that could easily be sorted out and we could be friends again.

What action could I take?

I'll talk it through with him."

Taking Risks

Whenever you decide on an action to take, there will be the risk that things won't go as you'd like them to and you'll end up feeling bad. For instance, a woman who thought she was a bad mother might phone her friends, and they might say she must be to blame for her children fighting. The man who'd lost a friend might decide to talk the matter through with him, and get an earful of unconstructive criticism.

It's as well to minimise the risk to yourself by trying to work out what the least risky approach will be and doing that; and also, give yourself credit for anything that did go right, or even for having the courage to have taken the risk, even if things mostly go wrong. And put it down to experience, asking what, if anything, you can learn from the setback.

Negative Emotions Making You Feel Like Doing Things That Turn Out to Make Them Worse

Another reason negative thoughts are so powerful is that when upsetting emotions get strong, it's difficult to think of other perspectives on things; and they make people want to stay in on their own, so they don't have anyone to help them get things in perspective, so the thoughts can just get worse and worse, and they can feel more and more lonely.

This can be worse if they think they're such inadequate people that they don't think anyone would want to be their friend, and they would find it difficult to discuss their strong emotions with others and put them into words, so they isolate themselves even more when they've got them.

But they can feel lonely as well when they're in company, if everyone else seems to be enjoying themselves and they're the only one sitting there feeling miserable.

One thing that might help is if when you get an urge to self-harm, you don't think of it as just an urge to self-injure, but as a signal your brain's sending you that it'll be worth thinking back to find out what triggered off the flood of emotions, and dealing with it. It's a signal something's wrong in your life that needs to change.

Planning Your Recovery

You might decide you want to be a changed person with much more stable emotions and a much better job, a much better social life and vastly improved relationships. But don't try to achieve all that at once, or you'll just get discouraged when things change more slowly than you're hoping for. Also, so you don't get lost wondering exactly how to go about things, plan small steps of progress at any one time. For instance, instead of thinking, "I want to be happy", try to think of things that could be achievable in the near future that could help lift your mood. You can work on doing more and more new things as time goes on, going at a pace you can handle.

If at any time you become dissatisfied with the progress you're making, look back to how you were before you started working on recovery. You might realise that compared to how you used to be, you've made quite a bit of progress.

It might be worth you thinking about how you can measure your progress. For instance, someone who wanted to improve their relationship with their husband or wife might measure it by whether they're having fewer arguments, whether they're spending more time together doing things with each other, and so on.

When you've thought about how you could measure your own progress, you'll have more ideas for specific things you can work towards.

Then you can investigate ways of working towards them. For instance, there might be articles on conflict resolution on the Internet that give good advice on improving communication skills so arguments don't happen so often. And so on.

Goals that at first don't sound very specific can be clarified by you into more specific things if you ask yourself questions like, "What will I notice that's different when that starts to happen?"

For instance, if someone's goal is, "I want to feel better about myself" they might not have any idea about how to go about that at first; but they might well get some ideas if they ask themselves questions like,

"What will I notice I'm doing differently when I'm feeling better about myself?"

"What will other people notice about my behaviour that will show them I must be feeling better about myself?"

If the answers are things like, "I'll have the confidence to go to an evening class, believing I just might achieve something after all", or, "I'll be able to get into a relationship without worrying about being abandoned", or something specific like that, then it might be possible to work out what kinds of things to work on achieving, like building up confidence, or learning ways to stop worrying so much. Or whatever the needs are.

Again, it's best not to try to achieve too much at any one time, in case you don't achieve as much as you wanted and think you're a failure. But if you try to break progress down into small steps forward, then you might achieve everything you want, bit by bit, at a steady pace.

It might help guide you in the right direction if you ask yourself questions like,

"If I realised that I'd fully recovered from the effect my past had on me, and I could take full control of my life, feeling confident and cheerful, what specific things would have changed about my life and my emotions that would tell me I'd recovered? What would I be doing differently that would show me I'd recovered?"

The things you think of might not be able to be achieved in one go. But you could think about how to break them down into little steps.

For instance, a man who'd think it was evidence that he'd regained his confidence if he could get to an evening class he'd love to go to could build up to going in little steps, so he got more and more confident. For example, first, he could visit and look around the building where the classes take place. Next, he could sign up for an introductory session, or a very short course, before he takes on a whole term's worth of classes.

A woman who wanted to stand up for herself more at work with the boss and others could practice standing up for herself with people whose reactions she was less worried about, until she got more used to it. Then she'd be better at standing up for herself because she'd have practised things she could say and become more confident, so she could gradually stand up for herself more and more at work as her confidence and skill at it grew, perhaps privately rehearsing what she'd like to say first for a while.

An Example of What Someone With Social Anxiety Might Do

A woman who gets fearful in social situations might decide that a goal of hers is to be able to go out more with friends. She might decide on a specific thing to work up to, to give her something solid to aim for, like, "I want to go to the office Christmas party". She knows that just trying that without building up to it gradually to get more and more confident would just make her so anxious she'd hate it. So she plans to work up to it in little stages, doing things that won't make her so anxious first so she gets used to being out.

She might start by doing something that will hardly make her anxious at all, doing it a few times till she's used to it; and when she's confident about doing that, she might do something that would have made her a bit more anxious before, knowing it won't be so bad now she's got a bit used to going out. When she's confident about doing that thing, she can move on to something that would have made her a bit more anxious before. And so on, gradually working up to going to the office party, which is something that would have made her very anxious before, but hopefully won't, now she's got used to doing smaller things that used to make her anxious but don't any more.

So, for instance, the goals she sets for herself to work up to it might go something like:

• Go out to watch a film with my best friend Sarah a few times, or maybe we could go swimming. I won't be under pressure to make much conversation there.
• Meet her for a cup of coffee several times, and get used to chatting.
• Go to watch a film with someone from work who I'm not so familiar with.
• Go for a cup of coffee with them and get used to chatting to them.
• Go out for a cup of coffee on a few occasions with both my friend and the friend from work at the same time.
• Invite my best friend and two friends from work over for supper.
• Arrange a little party at my house for Sarah and a few trusted friends from work.
• Go to the Christmas office party with friends.

If she feels uncomfortable moving on to the next stage at any time, for instance if she's quite comfortable going out for a cup of coffee with her best friend, but thinks it would make her too anxious to go out for one with someone from work, she could always do something a bit more difficult for her than just going out with her best friend, but something that won't make her as anxious as going out with someone from work would. For instance, she could maybe go out with her best friend to a place where she knew some people from her work liked to go, where it was possible one or more of them might come over and chat to them.

It would be important to plan steps she was confident about being able to handle, rather than taking on too much in one go, and risking getting really anxious and being put off trying anything like that again for a long time.

So when you work out what you'd like to change about your life, try to make a distinction between things you can achieve in one go, and things that you'll need to build up to in stages.

Before you start thinking about your past, think of things you can do to soothe yourself if your emotions get too strong while you're doing it, things that won't make a problem worse for you in the long-term like self-harm might. They could perhaps be things like:

• Listening to soothing music;
• Talking things over with a trusted friend;
• Going for a walk;
• Having a relaxing bath.

Or whatever you find helps you most personally.

Make a note of anything you find is helping, so you remember to use it again.

Relaxation

As well as doing something you find relaxing when you're especially stressed, it can help to deliberately do something relaxing every day, because even if you don't feel stressed that day, it can help to stop stress levels beginning to rise.

Some people might think deliberately taking time out to relax sounds like laziness. But it isn't really. The body wasn't designed to work solidly all day. People were designed to spend time relaxing.

You might think you don't deserve to spend time indulging yourself relaxing. But that's unlikely to be true; and whether it is or not, relaxing will help you de-stress, so it's definitely worth doing.

You could use some of the relaxing things you put on your list of things to do when you want to self-harm to do every day, just to relax you. You might be able to think of more things.

If you schedule in at least half an hour's definite relaxation time a day, you'll hopefully find your stress levels come down.

There are lots of different ways you might be able to relax. Some will probably suit you better than others.

Managing your time so you're not trying to fit too much in in one go can be relaxing as well. Some people find that writing themselves a schedule of things they want to do in the day ahead helps them do things in a more relaxed way, because following it means they're doing them one at a time, rather than trying to do several things at once. If you do that, you can schedule in a specific time to relax, that you set aside to use for relaxation unless something much more serious comes up.

Imagining a Comfortable Place of Safety you can Go To in your Mind

Here's one way to relax:

Imagine you have a special place you can go to, where you feel comfortable and secure, where no one can hurt you, and where you feel completely in control. Imagine it's a place where you're surrounded by things you love and that you find uplifting. It could be a place you remember going to once that you really enjoyed being in, or a place you make up. It could be a place like someone's home where you felt really made welcome, or somewhere like a nice woodland with flowers and trees and birdsong and things. Whatever you like. The idea is that whenever you feel a bit fearful or stressed, or are tempted to self-harm, you can relax by closing your eyes, and imagining you're in this nice place. Try to imagine each detail as vividly as you can, including things like colours, fragrances, any furnishings, what the entrance is like, and so on.

You might have to build the image up bit by bit if you're not used to thinking of such things. And it might take practice before you can imagine going there and relaxing and really enjoying it. But some people find it really helpful when they're used to thinking of it.

Working Out What Things Give you the Urge to Self-Harm

Often, things that increase your stress levels might give you an urge to self-injure, even when you've made quite a bit of progress in your recovery. That's normal. You could think of the urge as your brain telling you that there's still something about your life you need to change so you can be better off and won't get the urges any more.

If you can regularly work out what specific things are giving you an urge to self-harm, then you can develop ideas about what needs to change in your life and how to go about changing it, so you don't get the urges so much any more.

For instance, if you tend to get an urge to self-harm after you've argued with someone, perhaps you might consider whether it's someone you could do with seeing less of, and if so, think about how to go about seeing less of them, if that's possible; or maybe it could mean you'd like to improve your assertiveness skills so you can argue with them in future, knowing you'll be able to put your point across so well you won't end up feeling defeated. Or it might mean it might be worth investigating ways of communicating differently so arguments with that person don't even start.

For instance, a husband and wife might always find themselves arguing with each other before dinner when they come in irritable from work and haven't had time to relax. They might make a rule that the two of them don't discuss anything controversial before dinner, and it might turn out to cut down the number of arguments they have a lot. Even little things like that can work with some people.

Or there might be other things you can think of that might help in your situation.

Or one of the main times you feel like self-harming might be when you feel you've made mistakes. If so, you might decide that in future, you'll try to take the attitude that mistakes are at least good for teaching people things, like how not to do something, and instead of feeling bad, you'll try to just think about the things you can learn from what you did wrong and move on with your life as a wiser person, or focus your attention on how to put right what went wrong.

After all, I heard that when Thomas Edison invented his light bulb, it was after lots of trial and error. But at one point, he said to the press, "I haven't failed; I've just discovered 164 ways how not to do it." Or something like that.

If you self-harm when you're feeling very angry, you might want to investigate possible harmless ways of releasing anger, as well as thinking about what's making you angry and trying to change the things you can, so there are less things in your life that make you angry.

If you get the urge to self-harm when you're feeling depressed, you might do something similar - thinking about investigating harmless ways of overcoming depression, as well as thinking about what's in your power to change about your life so you don't get so depressed.

If you self-harm because you feel as if you deserve to punish yourself, perhaps you could reflect, when you're in a calm state of mind, on whether you really do deserve to be punished, or whether, perhaps, you only feel as if you do because of horrible things people said and did to you which were actually unjustified and cruel, but which made you feel as if you were a worse person than you actually are, and that in fact, rather than punishing yourself, you actually ought to be congratulating yourself for having survived through it all.

Or if you really did do something wrong, you could think about whether you're to blame as much as you think, or whether, under the circumstances, things were happening that mean you weren't as much to blame as you usually think.

If you want to self-harm when a memory of abuse comes into your mind that you don't feel as if you can deal with, it might be worth doing a bit of research to find out more about the ways other people have discovered of dealing with memories like that, so you can try out what they've done.

And so on.

A Way of Thinking Through What You Can Do About Self-Harm

To help you plan things like that, whenever you think of something that triggers off the urge to self-harm in you, you could write it down at the top of a page of a notebook, so you end up with a list of things that trigger your self-harm urges, all on separate pages, so you have as many of them as you can think of all together, so you can plan what to do about them more easily.

It might help if you look at each trigger event you've written down, and think about what actual feelings you felt then, and then write those down under whichever trigger event caused them, so when you realise you're getting those feelings again, you can have worked out ways of dealing with them other than self-harm. I mean, they might be things like:

• Furious;
• Threatened;
• Very very sad;
• Unlovable;
• Unworthy of anything good;
• Self-hating;
• Self-despising;
• Depressed;
• Overwhelmed;
• Resentful;
• Scared;
• Panicky;
• Emotionally numb;
• Frustrated;
• Not good enough;
• Disturbed;
• Very stressed

And so on.

If it will help to write a sentence or two elaborating on some of the emotions, do that. For instance, Someone might write, "Frustrated, as if I'm not being listened to and I don't know how to make them listen".

If you think about it and it turns out that the feeling is actually out of proportion to things, such as if you start feeling really angry or worthless after someone just calls you a silly name, it might be worth trying to think back, to try to remember a time when you first got angry or felt worthless, to see if the reason it's happening is because you got reminded of something else that made you feel angry or worthless. For instance, your brain might have quickly associated the silly name with a time in your past when someone belittled you by calling you horrible names in a much more serious way, and it triggers off the same emotions you felt then. When you think about it, you might realise the situations are totally different; that people aren't as nasty to you nowadays, and that in any case, you're much better at defending yourself than you were when you were little. So you don't need to have all those emotions. Your brain's triggering them off by mistake. Realising that might mean that when the same kind of thing happens in the future, you'll remember your brain gives you stronger emotions than you need to have in situations like that, so you might not get carried away by them the way you might have done before.

Also, if you can think about what feelings you get, you can decide what to do next time one of the things that triggers it happens. For instance, if it's anger, you can think about whether it would help to:

• Soothe yourself by doing something relaxing;
• Do something energetic to work it off;
• Think about what caused the anger and what you can do about it. For instance, if you realise it's because someone laughed about you in front of other people and you didn't like what they said because it seemed to be belittling you, and you're angry because you didn't say anything at the time but just brooded on it, you might decide to ask them if they could please not speak about you like that in future.

And so on.

Another thing that might help is if you think about what you're trying to gain when you self-harm. What are your needs at the time, that you'd like to be met? Then you can start planning other ways to meet those needs, as far as you can.

For instance, if you self-injure to soothe your feelings when you get really lonely, maybe you could think of things to do when you begin to feel lonely that'll stop the feeling getting that bad, like phoning a friend, chatting on an Internet forum, watching an amusing video, or whatever you think would work. You could think of other ways of soothing your feelings.

Write down all the needs you can think of that make you want to self-harm. Then go through each one, trying to think of other ways you could meet those needs.

While you're doing that, you might want to consider ways of:

• Getting emotion out of the system;
• Distracting yourself from your urges to self-harm;
• Soothing and calming yourself;
• Talking to someone;
• Doing something fun;
• Telling yourself positive uplifting things that'll make you feel encouraged or more cheerful.

You might be full of self-hatred and self-criticism you don't really need, and have low self-esteem, so you feel depressed because you don't think much of yourself. But sometimes, people can exaggerate the negative things about themselves in their minds, without realising they're doing it, and they can forget the good things. Things like that can happen especially if people have often said horrible things to you in the past, like that you're no good, or will never achieve anything, or whatever. If a person gets told something often enough, they might well come to believe it. That's especially if they're a child when they get told it, and adults are saying it, and the child takes it for granted that adults know best, so they think that if the adults are saying those things to them, they must be true.

Writing Encouraging Notes to Yourself

You might help yourself stop believing such bad things about yourself and start believing ones that'll give you encouragement and hope for the future, and make you think of yourself as a more worthwhile person, if you write down every positive thing you can think of about yourself on a piece of paper, and put it somewhere where you'll see it often, or keep it with you in your bag or somewhere, and where it'll be handy for you to add to the list whenever else you think of anything positive about yourself.

It might help you think of positive things if you think about what any good friends you have, or any family members you were close to, would say about you. And you could think through the things you often do, to help you think of more things you're good at.

Also, you could think of the horrible things people have said to you that you might have started to believe, but which you know deep down aren't true, and you can contradict them by writing truer messages about yourself.

For instance, if someone always used to tell you you'd never achieve anything in life, you could write a message to yourself about what you have achieved, or what you feel fairly sure you can achieve in the future if you try.

If someone used to tell you you were stupid, you can think of and write messages about things you've said and done that prove you're not stupid.

Or they could be reassuring positive messages that you know might soothe you when you begin to feel bad about yourself, perhaps like,

• It's allright to feel angry. It's not the feeling of anger that's the problem, but what people do with the anger.
• It's OK to want to cry. Crying is just a natural healthy human emotion, meant to be a safety valve to let strong emotions out. Crying when you're sad isn't really a sign of weakness.
• It's OK to feel scared. Feeling scared is just a natural human emotion, and even if I'm feeling scared when there isn't any need to any more, it'll just be my brain triggering off the emotion because it's got into the habit. It's nothing to feel bad about.
• If I'm feeling worthless, it's just because people made me feel that way, and my brain's got into the habit of still giving me the feelings that make me feel that way. But it isn't true really.
• I might have made a mistake, but everyone makes mistakes. I don't have to keep going over it in my mind as if it was something worse than it was.
• It's OK to treat myself nicely and do something caring for myself, to soothe myself and indulge myself a bit. It isn't selfish. Everyone needs to be nice to themselves sometimes to stop themselves getting too stressed. So I don't need to feel as if I have to self-injure before I can do anything caring for myself. I deserve to care about myself anyway.

You could keep adding to the list of positive messages every time you think of another one, and read them often to remind yourself what they say.

Whenever someone pays you a compliment, you could write it down and put it in a little box, and then when you feel like self-injuring, get the box out and read the compliments to encourage yourself that you deserve better.

Another thing that might help is doing your best to remember any good things that have happened to you in life, and things that make you feel good, and think about them hard. It might soothe your bad feelings a bit.

Suggestions for Things to Do That Might Soothe Your Emotions

• Make yourself a warm drink;
• Stroke a pet;
• Listen to some soothing music;
• Reassure yourself that you're a good person and that it's OK to feel strong emotions;
• Sniff something with a nice fragrance;
• Phone a friend for a chat, or go into an Internet chat room on a website you know is a good one, or phone a crisis line. You could write down the numbers of several people you trust, or find out the numbers of a few different crisis lines and write those down, along with the times of day when any helpful crisis lines are open, and then copy the list out a few times, and put it in a few places where you'll see it easily, so you can remind yourself there are people you can call when you feel like self-harming, and that if the first one or two aren't there when you phone, others might be. If you're calling a friend, it doesn't necessarily have to be someone who knows you self-injure. It just has to be someone you feel sure it will be helpful to phone because talking to them might be enough of a distraction to make the urge to harm yourself fade.

If someone were to think through and write down what makes them self-harm and what they could try doing about it to make the urge fade away, in quite a bit of detail, a page of their notebook could perhaps look like this:

My emotional trigger to self-harm:

The people I'm with are all talking together and I feel left out.

Feelings I'm having:

Unwanted; lonely; abandoned; inferior; as if they don't really like me; unlovable; unloved; sad. As if I want to harm myself.

What happened in the past that made me react this badly in situations like this:

My mum was always telling me no one would love me, and my parents would often laugh and talk together but tell me to go away if I wanted to join in.

What I'm hoping self-injuring will do for me:

Give me a distraction from how badly I feel; doing something that would give me an excuse to care for myself for a while.

What could I do instead to get out the emotion?

Phone a friend I know I can chat and talk about my feelings to; write a poem; draw a picture that symbolically expresses how I feel; write about my feelings in a diary; go for a walk with a friend; cry if I want to.

And so on.

Relaxation Techniques

One type of stress management is learning relaxation techniques. There are quite a lot of different ones.

One is controlling the breathing.

Controlled Breathing

When people get anxious, their breathing typically gets faster, because it's the body taking in more oxygen to use as fuel, preparing to take on anything that's threatening it. It's just an instinctive reaction, that happens whether anything is threatening it, or whether they're anxious because of something else entirely. But it makes people feel more agitated. They can calm themselves down again if they breathe for a while as slowly as they can, getting into a nice rhythm.

So whenever you're feeling a bit stressed, try breathing slowly and steadily for a few minutes.

Don't take in too much air at once, or you'll begin to feel light-headed. It might help limit the amount of air you take in if you breathe through your nose with your mouth shut.

Some people find it helpful to count slowly as they breathe, for instance counting very slowly to four as they breathe in, and then counting very slowly to four as they breathe out again. Breathing deeply isn't important, but breathing slowly and gently is.

Try to do the slow breathing several times a day, not just when you're in most need of it. The calmer you are throughout the day, the less you'll be stressed by everyday things.

You might need a reminder to do the breathing exercise, so perhaps put an eye-catching mark or something where you'll see it often and remember what it's for. For instance, you could perhaps put a dab of bright nail polish on your watch strap or something. Then each time you see the mark, you could check how fast you're breathing and practice breathing slowly for a few minutes.

Your body might breathe more slowly naturally a lot of the time after a while. Or you might get into the habit of remembering to start breathing slowly every time you feel stressed.

Another Relaxation Technique

One relaxation exercise you could try is to sit still, close your eyes, and bring to mind a favourite image of yours, such as a nature scene, a favourite animal, a favourite ornament, the inside of a friend's house where you felt comfortable, or whatever you like. Or it could be a sound you could think of, like the sound of waves crashing against the seashore, or birdsong, or whatever you think sounds good. Or it could be a word repeated over and over again, like the word "calm".

The important thing is that you find the image or word or sound calming.

It might take a bit of experimentation before you find something calming enough to make a difference.

It could be a day-dream about something you're actively doing, like walking through an art gallery, walking along a beach, picking flowers to sniff, or even doing the hoovering if that's what you like.

Sit in a comfortable chair to do the day-dream, so you won't be distracted by being uncomfortable. Then, you could imagine your body becoming heavier and more relaxed if it helps.

Breathe slowly and gently, and then begin to bring the image or sound or word or day-dream to mind.

Don't worry or be annoyed with yourself if irrelevant thoughts come into your mind. Just gently push them away and carry on with your relaxation. Don't worry if you're not much good at keeping your mind on it at first. Just try to keep gently pushing distracting thoughts out of your mind.

Do this for several minutes. By the end, you should feel calmer.

Don't get up too quickly afterwards or you might feel a bit dizzy. Open your eyes and get used to your surroundings again for a minute or so before getting up.

If you can find the time to practice that two or three times a day, it might calm you down quite a bit when you get used to it.

If you programme it into your daily schedule by writing set times to do the relaxation in your diary, it'll mean you're more likely to set aside the time to do it. If you don't set aside specific times, you might not get around to doing the relaxation. You might think of it as a chore at first, but look forward to it in the end.

Also, any time you're particularly stressed, you could do that exercise as well, if you've got time. And if you wake up in the middle of the night and can't get back to sleep, you could use that relaxation technique to lull you back to sleep. You could also use it as soon as you go to bed at night, to help you drift off.

See how you like that relaxation exercise anyway.

Stopping Yourself Spacing Out So Much

If you learned to deal with physical or emotional pain caused by abuse by spacing out when you were little, basically distancing yourself from it so it didn't feel so bad, you might now have a problem with your brain doing that automatically whenever you get any kind of reminder of it, such as if someone raises certain disturbing topics of conversation or when you see something related to abuse in the media, or when you're stressed, and it might stop you from concentrating or taking things in. You might feel unreal, or emotionally numb. You might be annoyed that you missed things. You might find that condition uncomfortable. You might even self-injure to get yourself out of it.

Another thing you could try to stop it happening is to try to catch it when you notice it starting, and try to focus on the painful issue just for a short time, and then space out a bit if it starts to get too much. Then gently try to bring yourself back to the painful issue and focus on it for just a bit longer, and then space out if you feel you have to. Then try focusing on it for a little bit longer still before spacing out. And so on. Over time, you might find you can tolerate thinking about the painful issues for longer and longer.

If it's really bad, it might be best to seek professional help.

Another way of dealing with spacing out that might work is doing something to remind yourself you're in the present and safe now. Here's some advice on ways of doing that, as well as on coping with distressing memories that don't make you space out:

Coping With Problem Memories

It's possible that as you think more about your past to help you sort through your problems and recover, distressing memories, or even flashbacks, where you feel as if you're reliving past abuse, might get stronger. But there are ways of coping with them to stop the memories triggering off so much emotion, and to help to get rid of distressing flashbacks.

Some of the techniques can also be helpful when people dissociate and want to stop.

Friends Can Sometimes Help

If you sometimes have flashbacks when you've got a friend with you, your friend can help to get you out of them. One way they can try is by reminding you you're in the here-and-now, and prompting you to remind yourself you are. For instance, they can ask you questions and say things like,

"What year is it?"

"What's my name?"

"Tell me where we are."

And so on.

You could perhaps discuss that with friends, and arrange some kind of routine with them.

Concentrating All Your Attention on Your Surroundings

One way you can stop flashbacks and intrusive memories in their tracks is to try to catch them as soon as possible after they begin, while they're not so strong it gets more difficult, and then try to concentrate all your attention on something else. It's impossible to concentrate hard on two things at once. So if you focus all your attention hard on one thing, whatever else was taking up your attention will stop.

So when a flashback starts, or you start getting absorbed in unwanted memories, try to concentrate really hard on something else. It doesn't have to be anything deep and meaningful. It could be a series of little things, focused on one after the other, such as the feel of the arms of a chair, the colour and texture of curtains, the titles of books on a bookshelf, a passage from a book you've got with you, the amount of dust on a windowsill, and so on. Or you could count things, like the number of electrical items or things made of wood you can see, and so on. Experiment and find out what works best for you. Concentrate on them as hard as you can. The idea is to completely distract yourself from the memory or flashback so it fades away.

To distract yourself from powerful memories, you'll have to concentrate hard. For instance, if you focus your attention on a chair, don't just stop with, "The chair's blue" or something, but really examine it, thinking about what texture it has, whether it's fabric or plastic, exactly what shade it is, how you'd describe its shape, how clean it is, and so on. Examine it in detail like you might if you were a scientist examining the results of an experiment under a microscope.

You could remind yourself you're in the present even more by shuffling your feet on the floor to get the feel of them touching something, or touch the things around you and repeat back to yourself what they are.

You can increase your chances of being good at distracting yourself if you practice while you're not having a flashback. Like now, perhaps. And then some more in the coming days. You could see how hard you can focus on things around you, and how much detail you can pick up. Experiment with focusing on different things. When you've got into the habit, it should be easier to do it when you actually need to.

Using an Object to Ground Yourself in the Here-And-Now

One technique that can work is if you carry a little object around with you, something that means a lot to you, because it brings back good memories, or makes you think of something nice, or gives you hope for the future, or reminds you of people you enjoy being with, or something like that. For instance, people have used cute little soft toys, pretty scarves, seashells, and so on.

What they do is squeeze them or touch them when they're beginning to have a flashback or a bad memory, and they can be reminded of good things, and that can distract them.

Do you have anything small that reminds you of a time when you believed in yourself or felt confident, and could make you feel more confident again if you held it or looked at it? Some people have used a bracelet they were given in happier times, or a little doll, or something. Do you have anything you got when you felt loved and safe, or that was given to you by someone who you know cares for you, that would remind you of them, or of safety and caring?

Holding it might also remind you that you're in the present, not in the past having a bad experience, especially if it's something that's only been given to you recently, since the abuse happened.

It might be particularly good if the object's scented, since it'll provide even more of a distraction if you can sniff it. For instance, a lavender bag could be good, or a little wooden object that smells of spices, or something perfumed, and so on.

You could even make something nice for yourself.

Have a good think about what you could use. Several things might come to mind, and you could write down a list. Then you could choose a different one every day or week if you wanted.

Bringing a nice Image to Mind to Ground Yourself in the Present

When you're feeling quite relaxed, you could start to imagine you're somewhere you really enjoy being. Either somewhere you really have been in the past, or somewhere made up, full of details you imagine. Make it somewhere nice and soothing. Think about what you personally find relaxing, whether it be a woodland, a beach in the summer, a beautiful house full of nice antique furniture and pictures and ornaments, a noisy park full of children playing, a ski slope or sports centre where you're enjoying doing some kind of exercise or sport, somewhere where you're doing another favourite hobby of yours, or whatever. Think of something you'd really enjoy doing, or somewhere you'd really like to be.

Then gradually make the image as detailed as you can in your mind. Add more and more little bits whenever you think of them.

You don't have to feel under pressure to think of the whole thing at once. You might get more and more inspiration over the next several days. But do your best to think up new details for it.

So, for instance, if you imagine being in a park with children, you could imagine more and more things in the playground. If you imagine a nice big house full of old furniture and ornaments and pictures, you could gradually imagine what more and more of them could look like. And so on. Think about whether you want an image that's noisy and full of life, or something calming.

When you've built up an image of something in your mind, it can become your safe place, where you can go in your mind whenever you begin to be troubled by unpleasant memories or flashbacks, or when you wake up after having had a nightmare.

While you're building up the image, imagine doing more and more things there. For instance, if you're imagining a beautiful old house, imagine going from room to room, looking at different pictures and ornaments in each room. If you're imagining being in a woodland, imagine what different trees you might come across as you walk along, the colour of the leaves, what birds you might see, and how thick the leaves are under your feet, or what else is there, such as tree roots and flowers, and so on. Fit things to your chosen image.

It might help you build up a nice image if you take inspiration from things around you. For instance, if you see a picture in a magazine of some nice plants and flowers, or you see some while you're outside, and your safe place image is a beautiful garden full of flowers, you could fill in part of your image by imagining the flowers you see in it.

Don't just think about what you'll be able to see, but what you'll be able to hear and feel as well. For instance, if you're imagining walking through a wood, imagine listening to the birds singing and the leaves crunching under your feet. If you're imagining a nice garden, imagine sniffing the flowers and what they might smell like, and the feel of the sun on your face or back, and perhaps the sound of a fountain in a little pond. Or if you imagine you're on a crowded beach, imagine listening to the sounds of children playing. Or if you're imagining swimming in a pool, imagine you can hear people talking and the sound of the water. And so on. Make it like a really detailed day-dream. Imagine the lay-out of the place where you are in detail, so you get familiar with walking around it.

Or if you're imagining doing a hobby, imagine it's one you can really get into. For instance, if you like painting, imagine you're painting something really detailed and you're enjoying yourself. If you're imagining playing the piano, imagine every detail of what you're playing and how you're playing it.

Or you could imagine having a beauty treatment or massage, if that's what you'd like, imagining the scents of the oils or whatever's being used, and how it would feel, and so on.

Basically, imagine the details of something you really like the idea of.

Imagine being there regularly, building up more and more detail of the image in your mind. It's important to rehearse being in your safe place, so you can get used to it and imagine going there more easily when an upsetting memory or flashback begins.

If you've chosen something really enjoyable, it shouldn't be a chore to bring it to mind several times a day to rehearse being there. The more you rehearse it, the more quickly you'll be able to tune into it when you want to distract yourself from nasty memories or flashbacks.

Something that might make it even easier is if you have a much, much less complex image as well, one you can imagine works like a bridge, to take you from upsetting memories to your safe place image. For instance, you could perhaps imagine floating away from the traumatic scene to your safe place, or a trusted friend taking you out of the traumatic scene to the safe place, or a wall crumbling to let you out of the traumatic scene to your safe place, or whatever you find helps.

Start to work on the safe place image as soon as you can if you like the idea of it, so you can build up as much detail in it as you can before you have another traumatic memory and could use it.

You could try to make your image more vivid by drawing what it would look like. Or you could cut out bits from magazines and make a collage of things to do with it.

The more vivid your image is, the more distracting from nasty memories it will be. Also, the more you think about it, the easier it'll be to tune into it when they come on.

You don't have to only go to the special place in your mind when you get a nasty memory. You can go there for a while any time you feel stressed.

Developing a Phrase to Help You Stay Aware of Where You Are

One technique when you catch a flashback beginning is to repeat a phrase or part of a tune over and over again, which says something that encourages you and reminds you that things have changed since you were abused, and that you're strong enough to have survived and will carry on. The phrase could be something like,

"I've survived. I'm strong. I believe in me and I'll go on surviving".

Or it could just be a short and simple phrase like, "I'm OK."

Or anything in between that you find helps.

Get yourself familiar with it so it comes into your mind without effort when you want to use it to replace the beginnings of flashbacks or nasty memories in your mind. You could write it down several times and stick notes with it on in various places around the house, like perhaps on the computer screen, the fridge, and any place you like the idea of putting it where you'll see it often.

If standing in a particular position makes you feel more positive so you feel stronger when you say it, for instance standing up straight with shoulders back, try that. Or if you'd rather have some kind of soothing position, like sitting somewhere relaxing, try that. Think about what you'd like and what might work for you.

Trying Till You Find Something That Suits You

You might have to try a few things before you find something that really works for you. If one thing doesn't work, see if something else does.

But also, the success of the techniques depends on how easy it is to switch to doing them when a nasty intrusive memory or flashback takes you unawares; and you'll only get familiar with the techniques so they come naturally if you keep practising them.

Those techniques might also work on strong emotions, stopping you getting absorbed in them, and bringing you back to the present. The techniques will come more naturally if you practise them first in less challenging situations.

Facing Traumatic Memories

Sometimes, distraction techniques only work in the short term. Some people find that to permanently get rid of flashbacks and stop memories upsetting them so much, they have to face them and think them through. Once the memories have been fully processed by the brain, they're not so troublesome.

Don't feel you have to do this. But if you think facing bad memories will help, go at your own pace, and only when you feel ready.

Memories can be processed by the brain and moved and stored somewhere where they don't trigger off so much emotion, when people have thought them through, thinking about what the experiences meant to them, and examining their thoughts and feelings about the memories; so it's like getting things out of the system so the memories don't keep coming back to haunt the person.

Some therapists recommend people first write down what actually happened during a traumatic event that keeps coming back to haunt you, in some detail. Then, you write about what you felt and thought during the traumatic experience. Then, you write about what it led you to believe about yourself, about other people, and about the future.

If you try that, and at any time, you become more upset than you want to tolerate, drop the task, and do something soothing. Only come back to it when you feel strong enough.

If you find it too painful to write about a traumatic experience that's giving you flashbacks, you could start by imagining you're not yourself but a more distant person, perhaps like a police psychologist, who's been brought in to help with an investigation, but who doesn't know you or anyone else involved, and is just taking down the main facts in a detached way at first.

When you feel more used to the idea of writing memories down and more able to cope with the memories, you can write about them in more detail, including sounds, smells, sights and sensations. So it ends up being a vivid account not only of what happened, but also of what was going through your mind and how you felt.

It might be best to use relaxation techniques for several minutes before you try, to get you feeling as relaxed as possible, so you don't start to feel stressed so quickly.

But to give some idea of how it might be done:

A woman who was bullied at school by a group of children she'd thought were her friends and keeps getting upsetting memories about it could write a bit about how it made her feel humiliated and betrayed. She could write about how it led her to believe that she's socially unacceptable, and how she can't trust anyone, and how she assumes she'll always be a loner, never really being accepted by anyone.

The memories she gets about the episode might still make her feel the shame and hurt of the humiliation, and make her feel afresh that she isn't acceptable, and she might accept those beliefs as absolute fact, rather than thinking of them as things she assumed at the time that might not be true at all. So she might have low self-esteem.

Similarly, a man who used to get beaten by his stepfather might have upsetting memories about it, and write a bit about a typical incident of it, about how when he was practising the piano, he would get beaten if he played just one note wrong. He would get more and more panicky as he was playing, and then feel terrified when he did hit a wrong note, and then he'd have to suffer the pain of being beaten. It made him believe he was weak and incapable, and that other people were dangerous and judgmental, and that the future was terrifying. Those beliefs had stayed with him for years, and were now making him a very anxious adult.

The woman who'd been bullied might think about the beliefs she'd ended up with after she'd been bullied, and realise they aren't really true. She might realise that now she's more experienced, she can tell that a more accurate way of looking at things is that it was actually only a group of five children out of the whole school who'd bullied her; and while she hadn't had any good friends, she knows she can make friends, because there are people around her nowadays who she gets on with much better.

The man who'd been beaten by his stepfather as a child might realise that a more accurate way of looking at himself and the world is that as a grown-up, he'd proved he's just as capable as anyone else, and that although there might be some people around who might not wish him well, most people wouldn't want to hurt him, so he doesn't need to be anxious like he is.

It might not be easy to work out what beliefs your traumatic memories have left you with about yourself, about others and about the future, and to review them and alter them so they're more accurate. But it's worth trying.

When you're writing down the details of one of your traumatic experiences, if there are details you can't remember, don't try to force a memory to come up. Just don't worry about it.

It's best to practise the grounding skills until you get good at them, before you ever start to write down the details of traumatic memories, so If you get too distressed when you're writing them down, it'll be easier for you to distract yourself from the memories by doing things that remind you you're in the present and take your mind off them.

If you have a trusted friend who cares for you, you could write the memories down while they're there, so they can be supportive.

When you've written down your final account of what happened, read it to yourself, with just as much caring and compassion as you'd read a best friend's account of a traumatic memory they had. Imagine how you'd react if a best friend asked you for a bit of care and support, and treat yourself just as well. Try not to make any judgments about yourself with the benefit of hindsight. Read it feeling as protective as you would of a child who went through that.

Reading it will be helping your brain to process the memory so it stops intruding into your consciousness when you don't want it to.

Blaming Yourself Unfairly For Things

It's natural to want to find a reason why things happened when things go wrong. But there can be a problem when people don't have enough information to make an accurate decision as to who, if anyone, is to blame. Children who are being abused can often blame themselves, because they assume adults know best, and they know people get punished when they do bad things; so they can assume they must be being abused because they're bad. They'll especially believe that if they're told it's their fault. And they can be still blaming themselves long after they've grown up and left home. When someone's believed something for years, it isn't always easy to just stop believing it. It might take a while. But it won't necessarily take that long.

It can affect people badly not only because of the self-blame, but because the self-blame can cause shame and guilt, which can make people despise themselves. It can make people angry with themselves and treat themselves badly.

It isn't just blaming themselves for the actual abuse that's the problem, but condemning themselves for things related to it, like the fact that they didn't tell anyone it was going on, even if they were too scared to at the time; they might have forgotten that and just blame themselves.

The Advantages and Disadvantages of Letting Go of Self-Blame

There are obvious advantages with stopping blaming yourself for abuse. They'd include not feeling guilty any more, no longer being angry with yourself because of what happened, and not feeling as if you're a bad person any more.

But there are also things you might need to consider, that might make you feel stressed if you give up blaming yourself.

For instance, a man who realises that the abuse he suffered when he was a boy at the hands of his aunt while his mother looked on and did nothing wasn't his fault, might start to feel betrayed by his mother, who he might have thought loved him before. It might upset him to think that someone could have caused him suffering, while someone else didn't even protest, and there was no good reason for it at all. It was just cruelty. It might frighten him to think humans can be like that. And it might make him think the world's a less predictable and more frightening place than he thought, if things can happen without a good reason.

A woman who realises the abuse she suffered as a girl wasn't her fault, and so she isn't a bad and worthless person like she thought she must be, might realise she doesn't deserve the abuse she's suffering in her relationship with her husband either. She might realise she deserves better, and start to think she isn't happy at all working at a relationship that's abusive. She might eventually decide she needs to leave and plan a new future, which, while it will be a good thing in many ways, might be a bold, stressful and maybe frightening move in others, since, for instance, she might have children, and supporting them on just her income might be daunting.

A young woman who has always accepted that she was to blame for her abuse, and hated herself for it so much that she self-harmed, might be filled with rage when she realises she wasn't to blame and that her abuser had no right to do what he did, and that rage might make her want to hurt herself to get some relief from it.

A man who felt worthless because of the abuse he suffered as a child might have never tried to achieve much in life, thinking he didn't deserve to. So he misses out on doing some nice and interesting things he would have done if he'd felt as if he was worth more. When he realises he wasn't to blame for the abuse, he might be overwhelmed with grief at the things he's missed out on.

And so on.

So when you're examining whether you were in any way responsible for your abuse, or whether your trust was betrayed and you suffered totally undeserved cruelty at the hands of others, think about what stresses you might face if you stop holding yourself responsible, and think about what you might be able to do to stop them affecting you as badly as they might otherwise.

Think About Whether Children Can Really be Held to Blame for Abuse

If you blame yourself for abuse you suffered as a child, you might be forgetting just how vulnerable you were then, and just how much less knowledge children can have than adults.

You could think about whether that kind of thing applies in your own life.

Or if you were punished harshly for things, do you really think such harsh punishments were reasonable? If you wrote a letter to yourself as you were when you were a child being punished severely for even little things, would you tell the child she deserved it, or would you say she was being mistreated? Think of any words of comfort or encouragement you might have for her, such as telling her she was a decent person really, and that she would be able to live through what was happening and make a better life for herself when she grew up.

If it helps, you could look at the evidence for and against you being to blame. For instance, you could write down all the reasons you've assumed you were, and then question each one, examining them to decide whether they're really true.

If You've Abused Someone Else and Now Condemn Yourself For It

Some people who've been abused go on to abuse others, whether that's because they're full of anger because of their abuse, so it comes out in their treatment of other people even when they just do little things that annoy them, or whether it's because they were frightened and it made them respond to something with aggression, whether they're behaving the way they learned to behave as a child by following the example their parents taught them by abusing them, giving them the impression that that was the way it was natural to behave, or whatever.

If you've abused people in the past, and now feel guilty about it, it might help to realise why you did it. It won't excuse what you did, but it will at least make you blame yourself less. Guilt isn't good on its own. It can be bad, because it can keep you dwelling on the past, blaming yourself. A better thing to do is to think about the future, and work out what, if anything, you can do to make amends, according to what their needs are. It might mean writing a letter of apology. It might mean more. If you think you're at risk of abusing again, it might mean getting professional help, or researching techniques that can help you change your ways.

If you learn to understand why you abused whoever it was, even though you take the full responsibility for having done it, since you still had a choice in the matter, you can start to forgive yourself. That doesn't mean deciding what you did was allright, but deciding that although it wasn't, you want to try to repair the damage if you can and move on with life.

Having abused someone doesn't necessarily make you a bad person, or label you as an abuser. It was a bad thing to do, but there's a difference between doing some bad things, and actually being a bad person. People thought of as good can do things under some circumstances that they'd never do normally, things that violate the standards of decency they would normally want to stick to. It's human nature. So don't think that because you've done bad things, that automatically makes you a bad character. And if you're doing your best to change, that's naturally a strong point in your favour.

Dealing With Anger

Anger isn't bad in itself. Some children might have been punished for expressing anger, or learned never to express it because it was safer not to become angry when they were being abused because they'd have been hurt more, and because resigning themselves to the abuse was the least stressful option, because trying to fight against it would have inevitably ended in them being hurt more, as far as they knew. When they grow up, they can worry that if they ever release anger, they won't be able to stop because they've got so much inside. Or they end up taking it out on people who don't deserve it, because it's got to come out somehow.

But it's possible to learn healthy ways of releasing anger, and it's a good thing if people do express it in a healthy way, because for one thing, it gets it out of the system so it's not there causing stress, and for another, it can help people achieve good things. Anger can be like an energy boost, giving people the drive and motivation to do things that help humanity, or that make things better for them personally. For instance, if you speak out about something, spurred on to do that by the anger in you giving you energy, you might be able to change things. Or it can give people the strength to speak out against their abuser or go through the process of taking them to court in the hope that they'll be put in prison and not hurt anyone else's children.

Or anger could give you the drive to campaign for changes in the law that make it easier for children to speak out, or something like that.

You might be scared to allow your anger to come to the surface, because you might think there's so much of it that if it does, it might never go away again. But if you can let it out in healthy ways, then it won't be there lurking below the surface any more, blighting your life all the time.

Anger is a perfectly natural response to being abused. It's normal to be very angry about it.

A lot of anger might have built up because you weren't able to express your anger at the time you were being abused. Or perhaps you were punished for expressing anger when you were little, so you grew to think it was bad.

Or you might have come to think it was bad because people in your family always tended to get abusive when they were angry.

Or you might have turned anger inward on yourself, harming yourself, or condemning yourself as a bad person, putting yourself down all the time. You might have blamed yourself, or angrily hated parts of your body, for allowing you/themselves to get abused.

But really, the abuser was entirely to blame for the abuse, not you. It might have seemed safer to turn your anger against yourself. Or you might have tried to block it out with drugs or alcohol. Some people find themselves turning it against people who don't deserve it like partners and children. But there are ways you can express anger where no one gets hurt, and you end up feeling calmer. It's possible to express anger in a way you can entirely control, even if there's a lot of it.

Don't forget that when you take anger out on yourself by harming yourself, it doesn't hurt your abuser at all, (unless you tell them and they actually care). You're the one who's harmed, and you've surely suffered enough already; you're worth more than that.

Some people don't want to admit they were ever angry with their abusers, because they had some experiences of doing good things with their abusers where they weren't being abusive, and they think that if they allow their anger to come to the surface, it'll ruin all their memories of the good times they had. But when you've expressed your anger and it's calmed, you'll still have those good memories.

If you've become accustomed to not letting yourself feel anger, it might take a while before you can get back in touch with the feelings again. But that needn't worry you. Your healing's bound to take time. But you'll probably start noticing encouraging progress.

Enjoying Being Angry

Some people, on the other hand, enjoy their anger, because it gives them an adrenaline rush, so it's mingled with excitement; and feelings of powerfulness can come with it, because their aggression can intimidate people into not arguing with them. The mix of emotions can carry people away and they can say and do things that aren't fair to others at all. Only afterwards, when they look back on things, might they realise though. And it might not be enough to stop them reacting that way again, because they enjoy the feelings so much.

Anger That's Out of Proportion to the Offence

Sometimes, your anger might seem to be triggered off by a particular person or situation, but really, the anger is out of proportion to anything they've done. Trying to work out the real reasons you're angry can help you deal with it better.

Sometimes, anger can cover up other emotions, like fear, such as if a car passenger's scared because the driver's driving badly, and they start to feel aggressive and shout at them to drive better.

And sometimes, people can get much more angry about a situation than they need to, because it reminds them of something that made them angry in the past. For instance, someone might see a woman slapping her child, and it might remind them of things that happened to them as a child, and they might totally lose their temper. Or someone might be starting a relationship with a boyfriend, and he might just happen to mention an old girlfriend of his, and they might instantly be reminded of the way their previous boyfriend would talk about how his previous girlfriends did so many things better than them, and they might suddenly get angry and dump the current boyfriend, assuming for no good reason that he must be just the same.

So it's worth thinking about the things you often get angry or irritated about, to see if your anger is justified, and to ponder on whether you might be over-reacting, and if so, what are the reasons.

If you do notice patterns where you get angrier than necessary, you could make plans to try to stop that happening so much.

For instance, a woman might realise she gets especially angry after:
She's kept silent about something she isn't happy about;
When she's pre-menstrual;
When she feels as if someone's let her down,;
And when she feels a bit scared by something.

She might decide:
To practise speaking up about things she's unhappy with;
To find ways of building up her confidence to confront others;
To do relaxing things when she's pre-menstrual to calm her down;
To try being more assertive about expressing her dislike at being inconvenienced when she gets let down;
and she might decide to research ways of dealing with anxiety so she doesn't feel so nervous in some of the situations that used to scare her and lead to her feeling aggressive.

Releasing Anger

Some people find it helpful to do things to release anger in the short-term, such as writing letters to abusers and others, either to send, or just to get feelings out of the system and onto paper. The letters could express all your angry feelings, and then if you like, you could even just ceremonially rip them up afterwards.

Perhaps you could learn a martial art, like Judo or something, to work anger off, or something just as energetic.

Some people find it helpful to write stories about the abusive things that happened to them, as if it's happening to someone else. Then they can look at the things the character who was really them did, as if they're observing from the outside. It can help them realise that they're not to blame for what happened, because they coped in the best way they could and the best way they knew how to at the time. Maybe you could try it if you think it would help.

Being Angry With Someone Doesn't Have to Mean Ruining the Relationship

You might feel awkward about beginning to feel angry with someone who abused you, thinking that it'll totally ruin your image of them, and that that'll be a shame, because the relationship wasn't all bad. But you can be angry with them for the abuse, and still appreciate other things about them.

Or if you feel bad about getting angry with them because you can explain to yourself why they might have been like that, for instance if you tell yourself that they only did it because they were so stressed, or so drunk, you can still be angry about what they did, even if you can understand it to some extent. They still had the choice of whether to abuse or not.

For instance, someone might be able to say things like,

"I realise that Dad was very stressed, raising four kids on his own, and I admire him for trying; but I'm still angry that he chose to drink so much, and that he beat us for the slightest little thing."

If you're feeling really angry, doing something to get rid of the worst feelings, such as doing some vigorous exercise, can help get rid of the worst of the feelings. Then you'll be in a better position to be able to communicate with the people you're angry with without doing something you regret.

Writing to the One You're Angry With, Or Talking to Them

When you're feeling calmer, you could perhaps write them a letter. You don't have to send it, so you could put all kinds of angry things in it if you wanted to without worrying, as long as you can be sure they won't see it. You can perhaps look at it a few days afterwards, to see if you think all the angry things were justified, or whether in your anger, you said things that weren't fair.

Or you could perhaps imagine a conversation with them in your mind, where you said all the things you'd like to say to them.

If you think it would be safe for you to do so, and you want to write to them and send the letter, or talk face to face, you could perhaps rehearse conversations in your mind, or think of exactly what you'd like to say, and think through ways you could try stopping it just turning into an argument.

One form of letter you could write if you wanted to, either to send or to use as a way of just venting your feelings before throwing it away or keeping it somewhere safe and private, is one where you balance talking about what makes you angry with telling them what you liked and admired about them. Or you could write one where you tell them exactly why you're angry with them, letting them know how their actions made you feel, and ending with telling them about something you plan to do to help yourself move on. For instance, someone's letter might say things like:

Dear Mother and Father,

I'm writing to you as a thirty-two-year-old man who has been through many years of unhappiness, failed relationships and a drink problem. It is only in the last year that I have realized that a lot of this has to do with you.

I'm angry with you because you did not protect me from the abuse my grandfather put me through; you did not speak up when I told you that teacher was sexually molesting me; you did not try to stop any of what was happening, even though you knew it was upsetting me. Even now, you try to play everything down, and tell me to try to forgive and forget. Nothing has changed, and I'm angry with you for that, too.

I don't know why you thought it wasn't worth trying to protect me, or that having good relations with the teacher and my grandfather were more important. There's probably an explanation, but I won't accept that as an excuse. I am moving on now, and if you won't come around to my way of thinking, I am going to have to leave you behind.

Trying to Express Anger to the Person Who's Made You Angry Directly

Only ever do that if it'll be safe to.

Before you try, think of things that could go wrong, and plan what you could do if they did.

Also, if they do go wrong, try to focus your attention afterwards on what you did achieve, even if the main achievement was plucking up the courage to confront them in the first place. Ask yourself what you can learn from the experience. And give yourself credit for being bold enough to take on a difficult task.

Then do something soothing, to help you calm down, such as listening to soothing music, or something else that helps you relax.

Don't assume you'll be able to think of ways of dealing with your anger when you're actually angry. When emotions are high, it's difficult to stand back from them and plan anything. If you plan what you could do beforehand, you'll have a better chance of being able to do it. You could make a list of things you could try, and keep it handy, so it'll be easy to find when you think you might be going into a situation that might make you angry, and you need a reminder of what it says.

Deciding Whether to Speak Out or Confront Someone About Any Abuse That Happened to You

It might be difficult to know whether telling people about abuse you suffered as a child would be a good thing. It's possible that you'd get sympathy and apologies, but on the other hand, you might be faced with denial, disbelief, ridicule, aggression and rejection. It's up to you whether to tell people and confront the abusers or not. But it's definitely worth weighing up the risks first if you decide to.

There is a theory that people have to confront their former abusers as part of their healing. But that isn't true. People can recover perfectly well without doing that. Whether you decide to confront them will depend on what you think your own personal needs are, and how risky or beneficial you think it might be. It should be entirely your own choice.

Examples of Reasons why some people would prefer not to speak out:

• If I tell the police, I'll have to go through the hassle of legal proceedings that might be very stressful;
• If I tell my family what happened, they'll think I'm trying to cause trouble in the family and hate me;
• If I tell my girlfriend, she might not believe me;
• If I tell my husband, he might be disgusted. And he might want to talk about the abuse a lot, and that'll be stressful for me, especially since it might stir up old upsetting memories;
• If I start talking about my abuse, it'll upset too many people;
• My family doctor would never believe me because she's always been friendly with my parents;
• If my dad knew, he'd kill the man who abused me;
• I feel too ashamed to talk about it;
• People could demand I take it to the police and I could end up having to testify against him in court.

On the other hand, there are good reasons for speaking out, that would have to be weighed against the reasons for keeping quiet. Reasons for speaking out might include:

• If I tell my family, it's possible they'll be supportive;
• If I tell my girlfriend, she might understand me better;
• If I tell my husband, he might be a good person to confide in and help me get through this;
• If I tell someone, I won't feel so isolated and alone;
• If I speak out now, I could protect other people from this person;
• I'm fed up of keeping the family's secret. I need a break;
• By not telling, I'm protecting my abuser from what might happen, and that makes me feel worse.

If you do decide to speak out, it's not as if you'll have to tell everything to everyone. It'll be your choice who to tell and how much to tell them.

Even if you decide not to tell anyone at the moment but think you might at some point, think about who would be the best person to tell. It would need to be someone you felt fairly sure you could confide in without them passing it on to other people without your permission.

Think about whether you'd prefer to tell a family member first, or a friend, or a professional, like perhaps a therapist or someone from the police.

You might find it helpful to think of a list of names of people, putting them in order of trustworthiness. That'll make you more confident that there are people you can confide in if you decide to, and help you decide who it would be best to talk to, since even friends aren't equally trustworthy. Deciding to tell one needs to be a careful decision, that shouldn't be rushed.

What You Can Do If You Decide to Tell Someone What Happened

It'll be worth giving some thought to whether it would be best to contact them by letter/email, by phone, or face-to-face. By letter or email, you can carefully consider everything you say before you say it, because you have the time to carefully compose it. Still, that doesn't mean you won't get sucked into a nasty argument if you get a reply that makes you angry. If you tell someone face-to-face, you'll of course need to consider whether you can be sure of being physically safe if you do.

You'd only have to tell one person at a time. Consider that you might get support and sympathy from some people, but disbelief, coldness or rejection from others. Some might be concerned, some might be shocked, some might get angry, and so on.

It can help to think out a plan, even writing it down, so you've thought through what could happen. It would mean considering questions like:

• Who will this involve?
• When would be the best time to tell them?
• Where's the best place to confide in them?
• What will I say?
• What might go wrong?
• What can I do if it does?

When you're thinking about what to say, bear in mind that if you're nervous, your mind might go blank and you might forget how you wanted to say things. Rehearsing what you'd like to say several times to yourself can help you keep it in your memory. Most people who want to make important speeches rehearse, even for things like wedding speeches. So when you have something much more important to say, that you want to make sure comes across the way you want it to, it's worth planning, and repeating it to yourself till you're familiar with the wording. That way, even if you're stressed, and still forget some of what you wanted to say, you'll still remember the main things. You might even want to write down what you'd like to say like a script, to help you remember when you're rehearsing it.

Don't Avoid Thinking About What Could Go Wrong, but try to have a back-up plan for something you can do if things don't go the way you want.

Confronting The Abuser or Those Who Didn't Stop Them

Confronting them will mean being assertive, and talking frankly and honestly about the abuse, your feelings, and the way it's affected your life. But it doesn't mean getting aggressive or disrespectful. Assertiveness means you stand up for your own rights or needs, or say what you think, so you should hopefully benefit, without having to demean others.

It should be totally up to you whether you confront them or not.

Some people's reasons to confront them might include:

• It might help protect my own children from abuse by him;
• I have the right to let him know how much he's damaged my life;
• I want her to know I remember what she did - I'm fed up of pretending it never happened.

On the other hand, reasons not to confront them might include:

• I think he's still violent and it would be dangerous to provoke him;
• I don't know what the consequences of confronting her will be, and that's frightening;
• It's possible my family will rally round to support him against the accusation and reject me.

You might hope people will care enough that when you confront the abuser, people will support you and take action against them. But that might not happen. So try to think about which hopes of yours are realistic before you decide whether confronting the abusers is worth it. Some hopes will be realistic, such as being able to tell your side of the story; but some will be about things that are really out of your control so there's no way of knowing how realistic they are, such as being supported by people who never cared about you much before; and some hopes will be unrealistic, such as the confrontation being the end of the matter. Try to work out how realistic each of your hopes and fears is, before you decide to confront them.

If you decide that too many of your hopes are unrealistic so it might not be worth confronting people, it doesn't have to be the end of the matter. You can come back to thinking about whether it's worth it again at any time.

Preparing to Confront Abusers

Bear in mind that if you do decide to, you might feel quite anxious, and you might end up disappointed if they react badly. No one can force another person to change their point of view, and sometimes, all the reasoning and appealing in the world won't do it.

Confrontation wouldn't have to be face-to-face; it could be by letter or a tape; someone else could be asked to pass on the message, and so on.

Here are more things the self-help books I've been reading advise:

Before you think of confronting anyone, consider that they might be dangerous. Also, ask yourself what you'd like to get out of it, and what you could say to give yourself the best chances of success, and what you think would have to happen for you to consider it a success.

Ask yourself just why you'd like to confront the person, and where the best place to confront them would be. Ask yourself whether it would be best to confront them alone, or whether you'd feel happier taking someone with you.

Ask yourself what's the worst thing that could happen. Then ask yourself what you could do to cope with it if it did.

When you've planned it all out, ask someone trustworthy for their opinions if you can, asking if they can see any problems that might come up that you hadn't thought of, and so on.

When you've thought through all that, rehearse what you'd like to say in your imagination till you're quite fluent and confident you know what you'd like to say.

If your confrontation doesn't go to plan, give yourself the credit for having had the courage to go through with it anyway, think about anything you did manage to achieve, and ask yourself what you can learn from the experience of trying that could help you in the future.

Deciding Whether to Forgive the Abuser

If you do decide to forgive them, make sure you're doing it for your own peace of mind and for the good of future relations as you see them, not because other people are putting pressure on you. No one has the right to try to force you to forgive.

And make sure that if you do decide to forgive, you're not accepting responsibility for the abuse again, and that you're not forgiving because you feel you ought to just try and move on rather than resolving issues you really believe need to be resolved first.

You don't have to forgive all in one go anyway. You can forgive the easiest things to forgive first if you find that easier.

It might be easier to forgive them if you can understand to some extent why they did what they did, although that won't mean excusing them as if what they did was allright after all. Also, it might be easier to forgive them if you can recognise that there are good things about them as well as the abusive side of their nature.

Remaining in Communication With an Abusive Family

Sometimes, it's best for people to cut abusive families out of their lives altogether and move on with life for their own well-being, at least for some time, making new friendships as a replacement. It might be worth deciding whether to cut off all communication with your family, or whether to keep in contact with them. If you keep in contact with them, there are things you can do to stop it being so stressful for you. For instance, one thing might be to just reduce the time you spend with them. Or you might find ways of avoiding the things that depress you most, such as arguments about certain topics.

Have a think about what triggers off the most aggravation or stress for you, whether it be arguments, criticism from them, not being listened to, or even just the disapproving way one of them looks at you, that reminds you of the criticism they used to say that made you feel bad. And so on. Looks and comments can have more impact than you might expect, because even just little things can instantly remind the brain of unpleasant things from the past, and it can set off the emotions you used to feel then.

If you can work out what triggers off the most unpleasant feelings for you, or work out what things start family behaviour that leads to stressful communication, then you can start to work on thinking up ways of changing things.

If it's difficult to work out exactly what triggers off the worst feelings, it can help if the next time you meet family members, as soon as you begin to feel bad, you ask yourself what was happening just before you did. One thing might be a comment that reminds you of lots of similar unpleasant comments from the past; it might be a critical look, even. Little things can sometimes trigger off big changes in emotions, just as smelling a whiff of chocolate can suddenly make someone really want a chocolate bar. Little things can have a powerful effect.

Or it might be certain topics of conversation where you reasoned and reasoned with them, but they just wouldn't change their stupid opinions. There's a saying, You can't reason a man out of a position he didn't reason himself into. Sometimes, people simply don't want to change toxic opinions they hold. So sometimes, going over the same old ground with families is pointless, so it might just be very depressing.

It may be that going to certain places triggers off old family disagreements that end up being depressing or stressful.

If you imagine yourself as a part-observer next time you're with them, and look out for anything that triggers off feelings of stress and depression in you, then you'll probably get a good idea of exactly what does it, and then be able to try thinking up things you can do to try to stop those things happening.

For instance, if being criticised in a certain way depresses you, but the criticism is really unjust, learning to speak up for yourself more, and thinking through all the reasons the criticisms aren't true, might help you not to feel so bad. Or if shouting matches often start with disagreements about what to watch on television, it might be possible to arrange to go on outings with them whenever you see them, where they won't be in front of the television, and where they'll be out in public where they'll be under more pressure to behave themselves.

And so on.

Making Rules About What you Are and Aren't Willing to Tolerate

It may be that you'll only feel safe and comfortable with your family if you make some rules about what you are and aren't prepared to tolerate, and when you will and won't see them, and ask them to agree to them. They might not agree to them; but

It might help you make your rules if you think about what your needs are first. You could perhaps write down a list of them. Then you could think through the list, and work out what will have to happen if those needs are going to be able to be met.

Examples of things that might appear on some people's lists might include:

• I need to feel safe.
• I need to be independent of my family.
• I need to feel comfortable in my own home.
• I need to feel confident my children are safe.
• I need to feel as if I'm at least not being totally disrespected.

Some of the rules you then come up with might end up being compromises between what you'd really like, and what you know your family would want, although some might fit in completely with your needs. For instance, some people's rules might be:

• I won't take care of my father when he's drunk. Then at least I know I'll be physically safe.
• I'm not going to visit the family for more than a couple of days at a time, and I'll cut down the number of times I visit them per year.
• I'll be willing to meet my brother in public places, but not in my house, so I don't feel uncomfortable.
• I'll let my aunt visit me, but I won't leave my children alone with her for more than a few minutes. Then they'll be safe from her.

When you start thinking about the rules you'd like to have, you might start thinking you couldn't have rules, because you'd really be letting family members down, or being nasty, or that to demand they obey rules would feel really awkward. For instance, examples of reasons some people might have for feeling bad about making rules might be things like:

• But I couldn't leave my mum to deal with my dad on her own.
• I could never explain to my dad that I didn't want to spend my holidays with him.
• I don't know how I'll tell my mum that I won't have her son from her first marriage in my house.
• If I say I won't have much to do with my sister any more, I'll be depriving my children of playing with her children, and I know they get on well.

And so on.

It's natural that you'll see obstacles like that. Looking at both sides of things stops us from being too careless in what we do. But it's important that you carefully think through the objections you come up with to the rules you'd really like to make, to see if they really are things that need to stand in the way, or things that can't be got around somehow.

One reason you might not feel like making rules that protect you is that you think it's really important to please others, even if it means not getting your own needs met. The trouble with doing that is that, apart from the fact that it might put you at risk, you might end up feeling stressed and resentful. It's not selfish to demand that your needs get met.

Reasons people feel awkward about putting their own needs above the wants of others can include:

• People won't like me.
• They might reject me.
• I'll feel so guilty.
• I'll be made to feel inferior by being compared with my sister.
• I don't deserve to speak up about my needs.

Not all those fears will necessarily be realistic, and there are things people can do to stop themselves being affected so much by the others, and to lessen the likelihood of them happening. Imagine you were expressing your needs, and think about the reasons you might feel uncomfortable. Then try to think of ways you can express your needs without feeling so uncomfortable. One thing you can maybe do is practise being more assertive first.

Being Assertive

You don't have to worry that if you're assertive, you'll have to disregard the rights or needs of others. Assertiveness doesn't mean imposing your will on someone else no matter what. That's more like aggression. You don't have to be aggressive to be assertive. Assertiveness just means expressing your rights clearly and frankly, not giving in to the slightest protest, but at the same time keeping the needs of other people in mind and respecting them.

Assertiveness doesn't mean standing your ground no matter what. Since you still keep the needs of others in mind when you're assertive, it might mean compromising with others, just not giving in entirely to them if it's going to mean your needs get trampled on.

An Example of Someone Who Spoke Up For Her Needs Assertively

A woman decided she didn't want to visit her parents' house again. A relative had abused her there, and going back there upset her. But she knew that if she didn't go back there, she'd disappoint her parents, and miss out on seeing her younger brothers, who were there in the school holidays. So she decided to compromise, and only go there when her brothers were there, refusing other invitations.

When she came to that decision, she decided she didn't want to tell her parents face-to-face or on the phone, because she felt sure they wouldn't hear her out. But she still decided to be assertive, by writing what she wanted to say to them in a frank letter. It said:

Although you often invite me home and you might even think that I enjoy visiting you, I am writing to let you know that I find returning to the house where I was abused too upsetting. I have given this a lot of thought and I have decided that I shall be visiting less frequently in the future, and only when David and John are home. I hope that you will understand and respect my wishes, and that we can begin to work out ways of seeing each other that aren't too painful for me. If you trivialize how distressed I feel and are not prepared for me to visit when I choose, I can make arrangements to meet up with my brothers elsewhere.

Basically, she was compromising between having her own needs met fully and pleasing her parents, and suggesting a solution. Then, in the last sentence of the letter, she told her parents what she felt she'd have to do if they didn't respect her wishes - seeing her brothers elsewhere and not coming home. That wasn't a threat meant to manipulate her parents into doing what she wanted. She was just standing up for her needs, and saying how she was going to get them met if they weren't respected by her parents. It'll be reasonable if you, too, tell your family that if they're not willing to respect your needs, you'll do something to make sure they're met.

If you're thinking of speaking to them over the phone or face-to-face, you might feel more confident if you rehearse what you'd like to say first, either with a friend, or perhaps in front of a mirror.

Dealing With People's Reactions to What you Tell Them

However you phrase your assertive statements, you won't be able to control people's responses. They might respond in a way you'd want them to. But then again, they might not, so it's worth preparing for opposition, so you're more confident in dealing with it if it happens.

Some opposition might be direct, with people telling you frankly that they don't believe what you're saying or aren't prepared to take your wishes seriously, while other opposition could be more subtle, being more like emotional blackmail and blame. For instance, some people might get responses like:

"This would kill your father - you'd better not tell him!"

"How could you do this to our family? You've upset everyone."

"If you really cared about us, you wouldn't be asking us to do this."

"You brought your problems on yourself. You've got no right to make these new rules now."

Or you might even be intimidated by the disapproving look that you know means the person's thinking critically of you.

You need to practise being able to stand your ground till you're more confident you can before you risk that happening for real. Rehearse what you might say. Sometimes, reasoning with them will just give them a way of saying more things like that so you're more and more likely to be manipulated into doing what they want. So sometimes, it's best to simply say something like, "I disagree. I've carefully thought through these rules, thinking of you as well as me, and I'm sticking to them", and then maybe repeating them again.

You need to be able to stay calm, so focus on anything you can do that helps you relax, like breathing very slowly and steadily, and thinking about whether parts of your body are tense and slowly untensing them.

If you've rehearsed what you want to say to them till you can say it fluently, that should make you more confident and more relaxed.

If they're not prepared to listen to what you've said, it might be best to just walk away. Better that than getting into a heated argument where no one listens to what the other says. At least if you walk away from them if they refuse to listen, you'll know you've been reasonable and tried your best.

It might take a lot of courage to try to change your relationship with your family. Go at a pace you feel comfortable with, and if there's someone you can trust that you can talk things through with before you see them, that might help.

If you think it'll make you more confident, perhaps you could see if your local college runs an assertiveness training course, or find a book that teaches assertiveness skills.

Increasing Confidence and Social Skills

Being confident enough to stand up for yourself and to make good friends will make your life happier. Being willing to speak up for your needs, and say No when someone wants you to do something you don't want to do, will naturally give you a better quality of life.

If you don't really feel confident, you could try to imitate the mannerisms of people around you who seem confident and friendly. You could observe them to see what it is about them that makes them seem friendly and approachable. For instance, you could get an idea of the amount they smile and use eye contact, the amount they give compliments, and the amount they use the name of the person they're speaking to. Observe quite a few people who come across as friendly and confident, and copy the social skills like that that they have that make them seem attractive, - not robotically of course, but just get some idea of what makes them come across as friendly and try to do more of it.

Also, observe the way they deal with difficult situations, and try to do more of what makes them successful at it.

As well as real-life people, you could look for inspiration to the way fictional characters in books or on the television handle things, if you know of any who deal with difficulties well.

Make notes on useful things you find out, if you think you might forget them.

You could also ask other people how they would deal with certain things.

For instance, if a work colleague asks if you'll go to lunch with them, but you're not sure why they're asking or what to do, you could ask someone else for their opinion.

Rehearse social behaviours so you get to feel more confident doing them. For instance, you could rehearse your smile in front of the mirror if you think that would make you feel more confident using it. Try out friendly phrases on people you feel most comfortable around before trying them on people you don't know so well.

Do things that seem easiest before moving on to more difficult things.

Challenging Anxious Thoughts You Have Around People

If you're anxious around people, it might help if you think about the kinds of thoughts that go through your mind when you're with them, and try examining them to see how truthful they are. People can make themselves more and more anxious with thoughts that aren't realistic at all sometimes, because when people are feeling strong emotion, it's more difficult to work out whether thoughts are accurate.

But have a good think about the kinds of thoughts you usually have and how accurate they are. Then, when you catch yourself having them when you're out, you'll be more familiar with contradicting them, so it'll probably be easier to do it then and calm yourself down.

So ask yourself a series of questions, like:

1. Just what are my anxious thoughts, and any images that come to mind that make me more anxious?
2. Are there inaccuracies in those thoughts, such as exaggerations? I'll take one at a time:
3. I'll think about This one: Is there evidence that this thought or image is true? If so, how true? Fully true, partly true, or mainly false but with a grain of truth in it?
   What experience or knowledge do I have that could prove it's true if it is?
4. What evidence is there that my thought is wrong? What experience or knowledge do I have that can show me that my thought isn't quite true, or isn't true at all? How might someone else see the same situation?
• Looking at the evidence against my anxious thought being true, have I looked at all the facts I know of, or am I missing something important?
• Have I had experiences that contradict what my upsetting thought's trying to make me believe?
• If someone else had this thought, what would I say to them?
• If I told a good friend about this thought, what would they say?
• If I was feeling cheerful and confident, how would I view the same situation?
5. Really, what's the worst thing that could happen if my thought is true?
6. Would it really be all that terrible if it did? What are some ways I could cope if it did? Or what are some ways I could try to prevent it happening, while at the same time not denying myself the chance to be out with people?

You might realise it's the feeling of anxiety itself you dread more than anything else; so if you can do relaxing things to calm yourself down, just that'll help a bit.

Being Cautious

Naturally, there are some situations where anxiety is a good thing, because you're with someone who's genuinely dangerous, so the anxiety helps protect you by keeping you on the alert.

Also, it isn't always a good thing to be open and friendly with people. Get too friendly or trusting with some people, and they'll just exploit you. Confide too many personal things in some people, and if you displease them in some way, they'll turn nasty and use what you've told them to taunt you. It's best to take friendships slowly till you're more sure of what kind of person you're dealing with. That doesn't mean not being friendly and risking losing them as a friend, but just not confiding too many personal things in them or being too certain they're a good friend to have before you know a fair bit about their character.

Basically, there needs to be some kind of happy medium between being unnecessarily anxious, and being too trusting.

Stopping Relationships Being Ruined By Inaccurate Thoughts

It's natural not to trust people, or to be suspicious of them after a bad experience. But it's easy to jump to totally wrong conclusions about them because your thoughts can make things seem worse than they are. Sometimes, thinking of possible alternative explanations for their behaviour, or for the way you feel, can be helpful. For example:

• He hasn't come home yet. He said he'd be here by now. I'm really worried now. Maybe something bad's happened to him. Or maybe he's out with someone else having a good time. Yes! I bet he is! I'll give him a piece of my mind when I see him!

  ... But then, I could be overreacting. I know I've been worried and jealous before, and there turned out to be nothing to worry or be angry about. And really, all that's happened is that he's half an hour later coming home than he said he would be. Maybe he's simply held up in traffic.

  I know, I'll wait another hour or two before I start thinking there might seriously be something to worry about or be jealous over. When he comes home, I'll ask him what's happened, and then, if everything's allright, ask him nicely if he can let me know in future if he's going to be late, since it worries me waiting around not knowing where he is.

• She said she'd always be there for me, but when I needed help today, she told me to wait because she was busy. Well, if she's going to lie and let me down like that, I don't want to know her any more.

  ... But hang on. when she said she'd always be there for me, she probably didn't mean she'd always drop everything and come to help me as soon as I felt panicky. After all, she might have been doing something important so it just wasn't convenient. And she did say she'd come over when she could. Maybe I over-reacted.

  Maybe I should phone her up and apologise.

• I've done all that for her and she didn't say thank you. She can't have appreciated it. That's the last time I do anything to try to please her.

  ... But hang on. she did seem happy. I think I might be being too sensitive, because I feel insecure about not being appreciated, because so many of my efforts were just scorned by my parents when I was a child.

  I know, I'll ask her how she felt about it. Then I'll know.

If something seems to be going wrong in your relationships, see if taking that approach helps you work out what it is, and helps to smooth things over.

Dealing With Sexual Difficulties

It's not unusual at all for anyone who's been sexually abused to have difficulties of one kind or another with sex when they grow up.

If you felt any sexual pleasure while you were being abused, don't think it means you're a bad person or anything like that; your body will just have been responding the way it was programmed to do to certain types of stimulation. Just the design. Or if the abuse was only painful, don't think sex will always be like that.

If you dislike or hate your body, think about what you could do to get to like it more, for instance looking after it, perhaps by caring for it with scented oils, or feeding it healthily.

You might feel more comfortable having sex if certain needs of yours are met, such as if you're not in a position where you feel you can't control what's happening. Think through your needs, and then make some rules, which might be totally in accordance with your needs, or might be compromises. Some people's needs might be things like:

• I need to feel loved and appreciated for the person I am;
• I need to feel affection;
• I need to feel I'm never out of control of things;
• I need to feel that it'll be OK to stop having sex if I start feeling uncomfortable;
• I need to feel it's OK for me to say I don't want penetrative sex.

The rules someone makes based on those needs might be things like:

• I want my partner and I to start off giving each other compliments and saying we love each other.
• My partner and I must agree that either of us can stop sex if we start feeling anxious;
• It needs to be OK for me to say no if I'd rather not start having sex but just want to cuddle or go to sleep;
• We'll discuss how I can say I don't want to carry on during sex without hurting my partner's feelings;
• My partner will talk about, and try out, different positions where I feel more in control, and types of love-making that don't involve penetration.

It'll be important to be frank and honest with your partner about your wishes and feelings. Maybe rehearse what you'd like to say till you feel comfortable saying it again.

If the two of you don't feel all that sexually attracted to each other for a while, don't think it means the relationship's over. Chances are the attraction will come back again, and there are things you can do to spice up your love life.

Also, illness, depression and stress can make a person feel less like having sex, as can anger towards their partner. Also, sometimes, premenopausal women can feel like having sex more or less often at different times of the month. So it might be worth working out if any of those things apply to you, and thinking about what you could possibly do about it, or what you might want other people to do.

If you find sex physically painful and you think that might be because of damage caused by abuse, though it might be a stressful experience, it might be worth seeing a doctor about it. That might mean being physically examined, so it's worth spending time finding a doctor you trust.

Another thing that can make sex painful is muscular tension. Learning to relax can help with that, and there are books that can give guidelines on that.

If you start getting alarmed or having other distressing thoughts to do with sex itself, it might help to examine them to see if thinking about things differently would help, or whether there are other ways of interpreting things, as was suggested with other thoughts. For instance, some people might think:

• This is making me anxious. That hurt! And I'm beginning to feel dirty. I'm beginning to hate this now.

  ... But hang on. What he just did reminded me of my past abuse; but it wasn't his fault. And having sex with him isn't dirty; it only feels like that because it reminds me of what happened before.

  I'll have to tell him to stop what he's doing though, or I'll carry on feeling like this.

• I've done so much to please her and she still wants more. I must be really inadequate.

  ... But then, she might want more because she's enjoying what I'm doing so much. I know feeling inadequate's a habit of mine. But maybe in this case, it's the opposite.

  I'll ask her about it tomorrow.

• He hugged me. He must want sex.

  Or maybe he was just being affectionate. I probably shouldn't have shouted at him like that. I don't suppose he meant any harm.

  I'll go and apologise, and explain why I over-reacted. I think he'll understand.

It might help a lot to discuss your sexual difficulties with your partner. For instance, if you used to go into a daze and detach from reality when you were abused as a protective response to stop your feelings being so overwhelming, and you find yourself doing that by instinct now whenever you and your partner have sex, maybe you could experiment with doing different things, to see if it happens less with some things than with others.

One thing some couples find helpful when one of them starts getting flashbacks or intrusive bad memories when they're having sex, that might also work if you start spacing out, is that they discuss it beforehand, and if it starts happening, the one it's happening to asks the other one to stop, and the other one asks them questions to remind them where they are, who they're with, and that this is the present, not a time in the past when they were being abused. Their partner might help bring them back to the present by directly asking them to say where they are, what year it is, to say their partner's name, and things like that. Then they can say loving things to each other for a while, without doing anything, before starting where they left off.

If having sex at all seems threatening, it can help if couples gradually introduce sex into their relationship. First, they can spend a few weeks caressing and massaging each other's non-sexual parts, not doing anything sexual at all. You might both be pleasantly surprised at finding new ways to enjoy each other. Then, you move on to doing sexual things that don't involve penetration for a while. Then you can slowly move towards having full sex.

It's important for the happiness of both of you that you make your needs known, so both of you are comfortable with the relationship. It might feel uncomfortable talking about your needs, but it'll hopefully be well worth it because of the adjustments you can make in your sexual relationship that will help improve it.

If You Need to Give More Thought to Deciding Whether to Give Up Self-Harm

If you're still unsure about whether you want to give up self-injury, there are more things you can do to help you decide, and then to help strengthen your decision to if you want to.

Recovery has to be something you really want to do for yourself, or else when you're tempted to injure yourself, it'll be much harder not to give into temptation.

It might help you decide whether you really do want to recover for yourself if you get some paper, draw a line down the middle, put two headings at the top, for instance, "Pros" and "Cons", and on one side, write all the reasons you can think of why you want to stop; and on the other side, all the reasons why you like self-harm in your life, for instance if it makes you feel calmer. Don't worry about admitting to them all. It might be that when you've written them all down, you can think of other things you can do that'll achieve the same effects as self-harm. For instance, if it makes you feel calmer, maybe a warm bath, or getting rid of nervous energy by doing some exercise, might help just as much.

Don't pretend the disadvantages of self-harm don't matter much. For instance, think about whether you really want to wear long sleeves all summer to cover up the scars.

Don't worry if you end up with quite a long list of advantages of self-harming, such as giving yourself an excuse to take care of yourself afterwards, the strong feeling of relief from tension it might give you, the feeling of being more real if you've been in a bit of a daze, a way of getting anger out, and so on.

Disadvantages might be things like feeling guilt and shame about self-harming, and becoming so self-critical that you even start wanting to do it again; embarrassment about revealing scars, and not feeling free to wear what you like in the summer, and perhaps not feeling confident enough to do enjoyable things like going swimming. A big disadvantage is the risk of an injury becoming infected and causing real trouble, or a cut going too deep or being in a place where it could really damage you, which might even put your life at risk.

When you've written about the disadvantages you can think of for now, think about how you'll feel about self-harming five years from now, and think about whether there might be disadvantages then if you don't stop now that don't exist at the moment but will then. For instance, you might have a lot more scars, so you might be quite a bit more embarrassed to go swimming or to the seaside in summer. That kind of thing.

You don't have to write the list in one go. You can make it over days or weeks, adding new advantages and disadvantages of self-harm as you think of them.

If you can confide in anyone, you could talk it over with them.

When you think you've finished the lists, you could write a little paragraph summarising the advantages and disadvantages of self-harm for yourself on a piece of card, and carry it around with you to remind yourself why you're working on recovering from it when it gets tempting to do it, or stick it on a wall or on your fridge or something.

For instance, someone's paragraph might say something like:

Cutting calms my feelings for a while and makes me feel in control of something. But I know it's best to recover from it, in case I do myself serious damage; and there are less risky ways of achieving the things it does for me. And if I get too scarred, I might start feeling ashamed to go out in public in summer when people might see my scars.

The card could also include all the reasons you can think of why you don't have to resort to self-harm, such as perhaps:

• I know I'm a worthwhile person; I don't deserve to hurt myself.
• There are other things I can do instead to make me feel better.

And so on.

You could perhaps have other cards as well, with inspirational things you've written on them, perhaps things friends have said, or encouraging things you've thought yourself when you've been in a good mood, or little poems, or famous quotes you find helpful, or things like that. You could perhaps have a scrapbook where you build up a collection of things like that, and then look at it whenever you feel the need for something uplifting.

Try not to let people's comments about your recovery get to you, for instance, if a friend or family member says something like, "You should be over it by now", or, "You should be happy now you've stopped self-harming", or that kind of thing. What do they know! They probably won't know much about recovery from self-harm at all, and whatever else you're trying to recover from, and so their opinions don't have to make you feel bad. They won't really know how long it should take to recover properly. If years of misery have caused a person to self-harm, they won't get over it fully in a week or two. It's bound to take time, so don't let anyone try to rush you, and don't feel bad yourself if you're not recovering as quickly as you think you should. Some people might try to put pressure on you to just give up self-harming just like that, straightaway; but your recovery might really be more of a gradual process, with you self-harming less and less over time. That's normal, so don't think there's anything wrong with you if you can't stop completely straightaway.

At stressful times, your urge to self-harm might come back again after you thought you had it under control. But don't lose heart if you give into it. It won't mean all the time you spent trying to recover before was wasted and you're back to square one. It's just a signal that you need to work on trying to change the latest thing that's gone wrong in your life that's made you stressed.

When you start to work on recovering, you might find that things seem worse for a while, both because if other people are counting on you to recover, you might feel stressed by the pressure of trying, and if you do self-harm, you might feel more of a failure, and those feelings might make you feel like self-harming more; and the other reason is that when you start thinking of the reasons you self-harm, upsetting memories might come into your mind that make you feel worse, so you might want to do it more. It could help if you have someone you can confide in, to get things off your chest, someone who'll be caring and supportive, if that's possible. But also, be clear in your mind and explain to anyone expecting you to recover that recovery probably doesn't happen overnight for anyone. Most people will have relapses, or take a while to wean themselves off the habit.

Still, I hope you manage it.

Advantages and Disadvantages of Joining a Support Group

You might find some support groups more to your liking than others. For instance, some might focus more on stress management techniques and overcoming other problems, while others might focus far more on talking about the past. Some might have a fairly balanced mixture of both. So it's best to find one you feel comfortable in.

Apart from that, it's best to try to weigh up the advantages and disadvantages of joining a support group in general before joining one.

Possible Advantages of Being in a Support Group

You might feel relaxed and as if it's a safe place to talk where you'll be understood, since other people in the group have been through similar things to the things you have.

You might make some good friends and have a sense of belonging there, and so feel less isolated and lonely than you did before.

If you meet other people who've been through hard times but now they're getting on much better in life, it might encourage you and make you feel more optimistic about your own life.

Possible Disadvantages of Being in a Support Group

One is that if you hear people in the group talking about bad experiences, it might make you feel depressed or distressed, so it might make you want to self-harm more.

Being there might make for a few awkward conversations with friends and family, since what goes on in the group will be confidential, but friends and family might be really curious about it and nag you to tell them what's going on.

You might feel bad if other people in the group seem to be making faster progress than you are in your recovery, or you might feel stressed because you feel under pressure to do better than you are, even if the group leaders have reassured you that it's OK to go at your own pace and that it's normal for everyone to recover at different speeds.

Asking Yourself What you can Learn From Relapses Where You Start Self-Harming Again, to Make Them Less Likely to Happen Again

You might well be upset about giving in to self-injury again if you do. But don't think it means you're a failure. Just ask yourself what you learned from your relapse. It might mean you were extra stressed and resorted to your old ways of coping because they were so familiar. If so, ask yourself what different things you can do next time you face similar stresses. Try and make a plan.

You'll probably find it helpful if you make a note of anything you do that you find stops you wanting to self-harm so much, so you can remind yourself to try it again in the future. It'll also be a reminder to you that you can be pleased that you're finding things that are helping your progress.

Asking Yourself Questions to Help you Think About How you can Relapse Less Often

After you've relapsed and self-harmed, you could ask yourself questions that help you think through ways of making that less likely to happen in future, such as:

• I cut myself three days out of the last six, but how did I stop myself cutting myself on the other days?
• What have I been telling myself that's helped me not to self-harm up until now?
• Has anyone else done anything that's stopped me self-harming again since my relapse, or since I decided to recover from self-harm?
• Did I learn anything from what led to my relapse that I can use to make it less likely to happen again?
• What's different about this relapse that means I can learn to do something else to add to what I learned last time?
• When I feel like hurting myself in the future, what can I do that might help me not to?
• What do I need to do more of to stop myself wanting to injure myself?
• What helpful things would the people I know say I needed to do to try to keep from relapsing again?
• What things could I ask my friends or family to do when I'm feeling stressed, that won't put too much of a burden on them, but will help me not to self-harm?

Every day, try and think of anything that's happened that day that's making you feel more confident and less stressed, and less likely to harm yourself. They could be things you tell yourself, ways your family are behaving differently than they used to, different ways you've found of coping with certain things, and so on. You could keep a notebook handy and write down what you've decided helps, so you can remind yourself of it often and do more of it.

I hope what I've said helps.

Notes and Links

The Backstory

Janine is in her early twenties. She's thinking back to a time at school when she knew a boy who used to cut his arms when he got too stressed. Something she hears on the television reminds her of him, and she wishes she could have done more to help him; but she had no idea what might have worked at the time. She's lost touch with him now, so there's nothing she can do. She doesn't even know what he's doing now. But she decides to learn up about self-harm, in case she meets anyone like him.

She buys a couple of books on self-harm, and starts going to Internet forums for people who injure themselves, to try to find out more about why they do it and what they find helps them not to. She's interested by people's stories on the forum, and decides to try to help by giving people there some suggestions as to what might help them improve things in their lives so they hopefully won't want to self-harm any more, based on what she's read in the books.

When a few people thank her for the information she's given them, she becomes optimistic that it's helping people.