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Urge Surfing, Alternatives, and Harm Reduction Image may not be published, presented, or duplicated without permission

To follow my post earlier this week on developing (new) coping skills rather than attempting to just desert our old ones, here are a few examples of ways to practice new skills (like asking for support, distraction, or alternative behaviors) when there is a desire for self-harm.

Instagram recently removed a different version of this post, which discussed/illustrated how the NHS (universal healthcare in the UK), based on research, is adopting a controversial model as best-practice, and how their model is working to reduce frequency and severity of episodes for people struggling with this issue (I’ve shared a bit of that content- mostly a list of research studies underlining the effectiveness of this approach- below).

It is easy to think, like the algorithms that edit us, that an issue is black or white, good or bad, pro- or anti-, but healing occurs when we can move into the grey areas and, with footing on the foundation of evidence from emerging research, engage people where they are with solutions that work.

If you are struggling with self-harm, know that you have so many options for getting good support- *and* you have the right to change providers if the support you are getting isn’t right for you. If you are having trouble reaching out for support, text the @crisistextline or ask a trusted friend to help you get connected with mental health services.

When it comes to other addictive behaviors, harm reduction is an increasingly standard practice, but with self-harm there’s often an all-or-nothing response. If self harm is someone’s only effective coping mechanism, it’s worth considering if we should focus less on an all-or-nothing approach, and more on developing new coping skills (like using social supports or participating in activities that self-soothe), providing tools and resources to learn to tolerate painful emotions (like information and support in learning to “urge surf” and mindfully noticing and “ride” the wave of the urge to harm) and information on harm reduction: like how to minimize the harm of self-harm episodes, when and if they do occur, through hygiene, good wound care, and making sure that shame doesn’t result in neglect of open wounds.

If you or someone you care about is in danger, call 911 or, in non-emergency situations, text the Crisis Text Line at 741741.

To learn more about urge surfing, and how ride out urges without acting on them, check out this article:

For academic research supporting harm reduction for self harm, see or or this research, which discusses this approach as the current recommended standard by the national institute of health in the UK:

Reading or engaging with the content on this education website is not therapy and does not constitute a therapeutic relationship. For more information see “Terms of Use” linked below.
Recovery Isn't "Getting Rid" Of Negative Coping Skills, It's Learning New Skills
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