You’re trying really hard not to self-harm. You’ve thrown away your blades, used the alternatives, and you’re getting help to deal with your underlying “issues”. You’re drawing on willpower you didn’t know you had and you’ve managed to go for longer than ever before without hurting yourself. Then something happens to trigger you, or maybe you just can’t keep up the effort any more, and you end up self-harming again. Does this mean you’re beyond help? Should you give up trying to get better?
Not at all! Experts on addiction (and self-harm can be very addictive) believe that relapsing is actually an important part of the recovery process. Every time we relapse, we learn more about what triggers us. By thinking about how the relapse could have been prevented, we learn new things to try on our path to recovery. Relapse can also help keep us on our toes: sometimes when we haven’t self-harmed in a long time, we assume we’re “better” and no longer need to go to therapy or take our meds or keep using self-help techniques. Sadly, this is not always the case, and relapse can serve as a useful reminder.
There are two important things to do if you relapse. The first is to keep the incident in context – don’t give up hope or lose sight of your achievements. The second is to learn as much from the experience as you can and use this information to help you recover. This page also gives some advice on how to prevent relapse in the first place.
Tips for Preventing Relapse
Build up a good support network. Many people (including doctors!) tend to assume that if you’re no longer self-harming, your problems are less severe and you no longer need as much help and support. In fact, your underlying problems (e.g. depression) may still be there and you may need extra support, not less, to help you cope without SI. Make sure everyone you would normally get support from knows about this. Try to find as many sources of support as you can (friends, family, health professionals, helplines, online message boards and chat rooms, self-help groups, etc). This avoids putting too much pressure on any one person and means you’re less likely to be “caught short” when someone’s unwilling or unavailable.
Try to improve your mental health overall. Don’t just focus on simply “stopping” – self-harm is a coping mechanism and if you want to live without it in the long term, you’ll probably need to find other ways of coping and tackle the issues that caused you to SI in the first place. Our Things to do instead and Tackling the causes pages can help with this. Otherwise, you might find you can go for a while without self-harming but then “explode” and hurt yourself worse than normal, or you might find you turn to other unhealthy ways of coping such as starving yourself or drinking too much.
Don’t worry if you can’t stop thinking about self-harm. This is fairly common, especially if self-harm has played a big role in your life up until now, but the thoughts should get less frequent with time. Secret Shame’s Dealing with intrusive thoughts after stopping page gives some suggestions on how to cope with this.
Keeping Relapse in Context
When you end up self-harming, it’s easy to feel that the weeks or months when you abstained don’t count any more. This isn’t true! If you went for six weeks without SI, that’s an achievement which nothing can take away. You’ve proved that you can cope for that long without hurting yourself, and if you learn something from your relapse, hopefully you can go for even longer next time. So don’t beat yourself up about it too much.
Remind yourself of your achievements so far. It can help if you write these down. How long did you go without self-harming? Were there any times you wanted to SI or came close to doing it but didn’t? If there were any extenuating circumstances that lead to your relapse (for example, something unusually distressing happened to you, or you didn’t have your usual support) remind yourself of these too. (They will also be useful when it comes to learning from the experience.)
If you keep track of exactly how long it is since you last self-harmed, try not to think of yourself as being back at square one. You have still achieved something, and you can learn from this experience. It might help to tell yourself something like, “I’ve only self-harmed once in the last six weeks,” rather than, “It’s only been a day since I last self-harmed.”
You might also find it helpful to read Realistic Acceptance.
Learning from Relapse
Write down exactly what happened that lead up to you self-harming. You might want to ask yourself the following questions:
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- What was going on in your life at the time of the relapse? Were there any particular events that triggered or upset you?
- What were you feeling before and during the relapse?
- What thoughts were running through your head?
- Could any recent changes to your treatment or recovery plan have contributed? (For example, changing your meds or no longer doing your CBT exercises.)
Now ask yourself if you could have done anything differently that wouldn’t have resulted in you self-harming. Alternatively, are there any changes you could make now to prevent something similar from happening in future? Focus on the things you can do and be realistic – for example, if the person you usually turn to for support wasn’t available, accept that this is going to happen sometimes and try to widen your support network.
Remember, the idea isn’t to beat yourself up about the things you did “wrong”. It’s OK to make mistakes, and not everything that contributed to you self-harming will have been your responsibility or under your control. The idea is just to learn what you can from the experience, look at what you could have done differently, find better ways of coping with the stuff you can’t control, and move along down the path of recovery.