Change is a process

The idea that there are stages of change that people go through when they want to change something in their lives is intuitive. Human beings tend to resist change, particularly when it feels risky, so virtually all of us have some amount of resistance to moving farther along than we are. Knowing that change is a process, takes time, and that it can feel scary even when the benefits are also clear may help foster patience.

Healing and growth in the presence of hardship generally occurs in stages, although there can be some movement back and forth. Starting at the bottom of the model below the stages of change tend to look like this:

Why stop?

Everyone has their own unique relationship with self-injury – one that can be challenging to break until a person is truly ready. Some individuals describe self-injury as a close friend, one they feel they can rely on to help them feel better, at least temporarily. However, this friend comes with significant drawbacks – it can leave scars that may require explanation years later, it can cause more harm than initially intended, and it can be confusing and concerning to loved ones.

When it comes to stopping self-injury, there’s no universal answer. Some people can identify specific reasons for quitting, while others simply feel they’ve “grown out of it.” A common motivator is recognizing the impact on loved ones. Others find that as they develop more positive coping strategies, the urge to self-injure gradually diminishes. For some, increasing feelings of shame, embarrassment, or sadness prompt them to seek help or stop on their own. And in some cases, people want to quit because self-injury no longer provides the relief it once did.

The reasons for wanting to stop can be as diverse as the reasons for starting. Whatever the motivation, it’s beneficial for someone to be clear about their reasons when the urge to self-injure arises. It’s also important to anticipate triggers and have a plan in place.

The first step in overcoming self-injury (or any negative habit) is being honest with oneself and often with others. Sometimes, people don’t stop even when they’re in therapy or have strong support, simply because they’re not yet ready to quit. It takes courage to acknowledge that recovery isn’t happening because one isn’t fully committed, rather than because something else is going wrong.

Self-injury can become a familiar routine with perceived benefits (like temporary relief), so it can be challenging to walk away from unless there are alternative ways to cope with life’s difficulties. This is all part of the change process, and everyone is at a different stage in that journey.

What to expect

Change can be scary and hard. Most often these feelings arise from the simple discomfort most of us feel with not knowing what to expect. We can become rather discombobulated and uncomfortable when our expectations do not match what happens; indeed, this discomfort is one of the main reasons for slips. Here are a few of the general things you can expect:

• Non-linear progress (slips are normal!)
• Mood swings
• Resistance in yourself and possibly others
• More time than you thought it might
• Strong emotions that may occur at seemingly random times (e.g. fear, anger, frustration, grief, relief, hope)

Recovery is about more that just stopping the behavior – it requires a changes in thought, emotion, and behaviors.  Since many of these thought and feeling patterns become neurologically habitual (meaning that the brain has essentially been trained to link specific thoughts, emotions, and behavioral reactions), learning other, healthier patterns takes time and effort.

It is important for supportive others to know that there is no set formula for healing and that the absence of the behavior is only one part of the healing picture.

Healing Strategies

The healing process from self-injury is a journey that requires time, patience, and readiness. Changing self-injury patterns can be challenging initially, but the skills it takes are worth the effort it takes to develop them since the journey will leave you stronger, healthier, and better equipped to manage life’s ups and downs in every way. It’s normal to struggle or doubt your ability to cope without self-injury, especially when it has been a quick fix for negative emotions (or lack of emotions). However, it’s precisely because you’ve faced intense emotional experiences that you’re uniquely positioned to grow as a result of your experience, live a rich, authentic life and potentially help others in similar situations.

Remember, your capacity for growth and change is only limited by your own thoughts and beliefs. While this isn’t a small thing – beliefs are powerful, especially when reinforced by others – it’s important to recognize that feelings of unworthiness or inability to help ourselves are often just thoughts, not absolute truths. When we open ourselves to other possibilities, we can begin to see different futures for ourselves.

It’s a common human experience to doubt our strengths and resort to negative thoughts about ourselves or others. Often, this is an attempt to cover up intense feelings like grief, fear, shame, or rage that we’re struggling to face. This can happen automatically and quickly, making it feel impossible to stop. A crucial first step is simply observing our patterns of thoughts and emotions. The better we understand our automatic processes and assumptions, the more choices we have.

To support your recovery process, consider:

• Journaling about thoughts, feelings, and experiences to understand your patterns
• Noticing and tracking positive experiences, feelings, and thoughts
• Practicing daily gratitude for both small and big changes and moments
• Engaging in activities that boost your mood, like dancing, listening to music, reading, playing an instrument, or spending time outdoors
• Maintaining communication with supportive friends and family members

Remember, recovery is possible, and you have the strength within you to overcome self-injury. It’s a process that takes time, but with patience and the right support, you can develop healthier coping mechanisms and build a life free from self-harm.
For more on tips for recovering from self-injury, see the Recovering from Self-injury, Coping, and Distraction Techniques factsheets.  

Supporting someone you love

Watching someone you care about navigate the path of self-injury recovery can be emotionally challenging. It’s crucial to understand that recovery is rarely a straight line and often includes setbacks. Relapse is a common part of the recovery process and doesn’t indicate failure or a loss of all progress. While you might feel a range of emotions – fear, frustration, disappointment, or anger – when your loved one struggles, it’s important to process these feelings without directing them at the person recovering. Expressing blame, anger, or pity towards your loved one may trigger feelings of shame, which can actually increase the risk of self-injury.

Instead, respond with understanding and support. Focus on acknowledging and celebrating small victories, as recovery is made up of many small steps forward. Encourage professional help while offering consistent, non-judgmental support. Remember to practice self-care and maintain healthy boundaries – you can’t control your loved one’s actions, and it’s not your responsibility to “fix” them. Stay educated about self-injury and recovery to better equip yourself to offer meaningful support. Your supportive presence can make a significant difference in your loved one’s journey, but remember that recovery is a process that requires patience, understanding, and often professional guidance.

If you are a parent or loved one of someone who injures you can purchase our book Healing Self-Injury from Oxford University Press, or anywhere books are sold. Also see our resources section here for helpful guides, such as Resources for Parents for specific information on how to support your loved one and yourself in their healing process.

Deciding to talk to someone

Deciding to open up about self-injury experiences, whether past or present, can be a daunting prospect. It’s natural to feel apprehensive, but it’s important to recognize that this step is also filled with potential for positive growth and healing. The decision to reach out is influenced by various factors, with perhaps the most crucial being the choice of whom to tell. It’s wise to select someone who is likely to be supportive and understanding, or who can help connect you with valuable resources, such as a qualified therapist. This thoughtful selection can significantly impact the outcome of your disclosure.

It’s also beneficial to prepare yourself for a range of possible reactions. People who care about you may respond with fear or even anger, not because they’re upset with you, but because learning that a loved one is suffering can be overwhelming and can make them feel helpless. Understanding this possibility in advance can help you navigate these reactions more effectively. Additionally, considering the setting for your disclosure can make a substantial difference. Try to choose a calm moment and, if possible, a private or safe-feeling space for the conversation. Taking time to think about what specific information you want to share and how you want to express it can also help you feel more in control of the situation. Remember, reaching out is a brave and important step towards healing, and with careful consideration, it can be a positive experience that opens doors to support and recovery.

For more on specific talking to someone about self-injury see the “Finding Your Voice” fact sheet.

Seeking Professional help

Seeking professional help can be a crucial step in recovering from self-injury. Therapy can play a vital role in recognizing the significance of self-injury in one’s life, uncovering behavioral patterns, identifying triggers, learning coping skills, managing stress, and recognizing personal strengths. However, finding the right therapist can sometimes be a challenging process. The most important factor is finding someone with whom you connect and who can provide both support and appropriate boundary-setting when necessary. While experience in treating self-injury is beneficial, it’s not always critical.

Before committing to a therapist, it’s advisable to do some research. This might include asking friends and family for recommendations, reviewing the therapist’s website or introduction page, having a phone consultation, or looking up online reviews. However, it’s important not to solely rely on others’ recommendations, as personal fit is crucial. It’s normal to feel anxious or awkward during the first few therapy sessions, as discussing sensitive topics with a new person can be challenging. Expect that the therapist may bring up subjects that others in your life might avoid. With time, these feelings of anxiety should decrease. Therapy is a relationship that often improves over time, but it’s important to remember that not all therapist-client pairings are ideal, which is why finding the right “fit” is essential. It can also be helpful to discuss the therapist’s approach to treating self-injury. Common treatment approaches include Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT) and other modalities with mindfulness-based components. A professional will work with you to set goals and to use strength-based approaches to helping you both accomplish what you want to accomplish and to feel positive and hopeful along the way. Remember, seeking help is a sign of strength, and finding the right therapeutic support can be a significant step towards recovery.

For more on therapy see Therapy: What to expect, and Therapy Myths.