Much of the work we do with clients in DBT is rooted in mindfulness. As DBT therapists, we find the power of mindfulness to be incredibly grounding and effective in curbing unhealthy behaviors. Here are a few mindfulness skills for when you or someone you love is experiencing the urge to self-harm.
In mindfulness practices, breathing and the breath itself are important components. When you feel the urge to self-harm come up, take a breath. More specifically, take a long exhale first. This should last for a count of eight. Then, after all the air has been pushed out, inhale for a count of four. Try to do this for at least ten minutes before engaging in self-harming behaviors.
When you feel the urge to self-harm, in whatever way that looks like for you, challenge yourself to put off the urge for a certain amount of time, then revisit it until the urge dissipates. For example, you feel the urge coming up, then set a 5-minute timer. Sit with the urge for five minutes. If it has not subsided by the end of your timer, set the timer for another five minutes. Keep sitting with the urge and resetting your timer until the urge has subsided.
When you feel the urge to self-harm arise, observe it. Sit with it and think about the emotions and body sensations that are happening internally. This can help you stay more present with the challenging emotions and sensations, instead of jumping to a solution that may be unhealthy. Sit with the feelings. Yes, it will be emotionally difficult. But challenge yourself to sit in the moment and let the feelings and sensations run their course.
Ride the Wave
This skill can be done during urge surfing and observing. While you are taking note of the emotions and sensations in your body, think about this: the urge to self-harm will peak and come down. Think of this as a wave. While you are observing what’s going on in your brain and body, the urge may intensify, then decrease, then go through multiple cycles. By sitting with the urge while it cycles, you are learning distress tolerance. This will help you become more resilient to the urge to self-harm both in the present moment and in future incidences.
Do Something Else
My last tip is to just do something with your hands. Preoccupy yourself with a task. Perhaps you choose to color, paint, draw, cook, knit, brush your hair, or paint your nails. The idea is to do anything to keep your hands busy while you are riding the wave and waiting for the urge to pass.
You can refer to this: