Coping with Self-Harm Urges: Ways to Delay Urges and Reach Out for Support

About this tool

Coping with self-harm urges means taking steps to stay safe while you get support: put distance between yourself and anything you might use to hurt yourself, try a noninjuring activity, and contact someone who can help. This worksheet organizes those choices into a plan you can prepare when you feel calmer. Emotional pain, numbness, and self-punishing thoughts deserve compassionate attention. You can ask for support even if you have never acted on an urge or cannot explain why it happens.

This plan brings together delaying action, choosing noninjuring activities, and reaching out for support. Urges can change in intensity, but there is no reliable countdown for when yours will pass. Use a delay as time to move toward safety and contact someone, rather than a promise that you may hurt yourself when the time ends. Try familiar music at a comfortable volume, holding soft fabric, or drawing on paper. Avoid activities that cause pain, numbness, skin damage, or increased distress. If your urge keeps growing, seek urgent help instead of repeatedly testing coping activities alone.

Building this plan when you are calmer means you do not have to think clearly in your hardest moment. You will already have written down what helps you, who to contact, and how to make your space safer. Be specific and honest, and be kind to yourself as you do it.

If you have thoughts of ending your life, or you are not sure you can stay safe, reach out for support now. In the US, call or text 988 to contact the Suicide and Crisis Lifeline. If there is immediate danger or a serious injury, call your local emergency number or go to an emergency department. The Suicide Safety Plan can help organize support during a calmer moment; completing a worksheet should never delay urgent care.

Researchers who study self-harm, including Klonsky in his review of the evidence, describe several possible functions, including regulating overwhelming emotion, interrupting numbness, and self-punishment. The same person may experience different reasons at different times. When you feel safe enough to reflect, describe what happened before the urge and what you hoped would change. Use that information to discuss your needs with a clinician. Feeling numb does not make painful sensation a safe coping strategy, and you do not need to identify a reason before asking for help.

Getting through an urge does not resolve every difficulty underneath it. Once you feel safer, the Behavior Chain Analysis Worksheet can help you describe events, feelings, and actions that preceded the urge without blaming yourself. A therapist can assess what support fits your circumstances and discuss approaches such as dialectical behavior therapy. You can search the Psychology.com therapist directory to find professional support. The DBT Skills Library provides educational practice materials to discuss with a clinician; it is not a substitute for an individual assessment or ongoing care.

Make each contact entry practical: include how to reach the person, what you can say, and who else you will contact if they are unavailable. A possible message is: I am having urges to hurt myself and need help staying safe. Can you stay with me while we contact support? Choose people who respond with care, and ask a trusted person to help make potentially harmful items less accessible. Agree on a backup plan while you feel calmer, so an unanswered message does not leave you deciding what to do during escalating distress. If someone cannot respond, contact another trusted person or crisis support; their availability does not determine whether you deserve help.

Review the plan after a difficult moment when you feel ready. Keep the actions that felt manageable, replace anything that increased distress, and discuss gaps with a professional. A completed plan is a support document, not proof that you are safe or a measure of willpower. The Emotional Dysregulation Test is optional self-assessment for reflection and cannot assess immediate danger or replace care for self-harm.

If you have already harmed yourself, seek medical advice about injuries even if they look minor. For a serious injury, possible poisoning, or uncertainty about immediate safety, seek emergency medical help. Support is appropriate for thoughts of self-harm as well as actions; you do not need to wait for injuries or worsening urges to speak with a healthcare professional.

You can bring this completed worksheet to a primary care appointment or a therapy session. To prepare, note what was happening around the urges, what you tried, whether anything made the distress worse, and what help you want now. You can hand the page to the clinician if starting the conversation feels difficult. The NHS advises seeking help for thoughts of self-harm as well as injuries; you do not need to explain your experience perfectly before care can begin.

Reviewed by Michael Callans, MSW
Reviewed for compassionate, non-judgmental framing, safety, and inclusion of crisis resources.

References

1. Klonsky ED. The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev. 2007;27(2):226-239.
2. Stanley B, Brown GK. Safety planning intervention: a brief intervention to mitigate suicide risk. Cogn Behav Pract. 2012;19(2):256-264.
3. 988 Suicide and Crisis Lifeline. Substance Abuse and Mental Health Services Administration (SAMHSA).
4. NHS. Where to get help for self-harm. https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/self-harm/getting-help/
5. 988 Suicide and Crisis Lifeline. Get emotional support. https://988lifeline.org/

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