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These suggestions for dealing with panic are not a replacement for the Distress Tolerance skills. They are about being effective in the moment - which means doing what it takes to be safe. Believe it or not, even the ones that sound stupid usually help a little, and the best skill of all is to wait 15 min, and then ask yourself if you can wait 15 more, and so on. If 15 min is a long time for you, try 5. The point is, self-injury urges usually hit and you want to do it "right now". If you can wait, then maybe you don't have to do it at all. Emotions come to us in waves. The longer you wait, the more likely the urgent need will dissipate. As you go along in life without self-injuring, one day you will think about doing it and a little voice says, "Ouch! That would hurt! That's not going to make me feel better." Self-injury can be addictive but over time, with practice, you'll find other ways to tolerate distress and it will become more manageable.
Distress tolerance options for when you feel angry, frustrated, restless
* Try something physical and violent, something not directed at a living thing:
Slash an empty plastic soda bottle or a piece of heavy cardboard or an old shirt or sock.
Make a soft cloth doll to represent the things you are angry at. Cut and tear it instead of yourself.
Flatten aluminum cans for recycling, seeing how fast you can go.
Hit a punching bag.
Use a pillow to hit a wall, pillow-fight style.
Rip up an old newspaper or phone book.
On a sketch or photo of yourself, mark in red ink what you want to do. Cut and tear the picture.
Make Play-Doh or Sculpey or other clay models and cut or smash them.
Throw ice into the bathtub or against a brick wall hard enough to shatter it.
Break sticks.
Sometimes these things work even better if you rant at the thing you are cutting/tearing/hitting. You could start out slowly, explaining why you are hurt and angry, but you might end up swearing and crying and yelling. It helps a lot to vent like that.
Crank up the music and dance.
Clean your room (or your whole house).
Go for a walk/jog/run.
Stomp around in heavy shoes.
Play handball or tennis.
Distress tolerance options for when you feel sad, melancholy, depressed, unhappy
Do something slow and soothing, like taking a hot bath with bath oil or bubbles
Curl up under a comforter with hot cocoa and a good book
Baby yourself somehow. Do whatever makes you feel taken care of and comforted.
Light sweet-smelling incense.
Listen to soothing music.
Smooth nice body lotion onto the parts of yourself you want to hurt.
Call a friend and just talk about things that you like.
Make a tray of special treats and tuck yourself into bed with it and watch TV or read.
Visit a friend.
Distress tolerance options for when you feel craving sensation, feeling depersonalized, dissociating, feeling unreal
Do something that creates a sharp physical sensation:
Squeeze ice hard (this really hurts). (Note: putting ice on a spot you want to burn gives you a strong painful sensation and leaves a red mark afterward, kind of like burning would.)
Put a finger into a frozen food (like ice cream) for a minute.
Bite into a hot pepper or chew a piece of ginger root.
Rub liniment under your nose.
Slap a tabletop hard.
Snap your wrist with a rubber band.
Take a cold bath.
Stomp your feet on the ground.
Focus on how it feels to breathe. Notice the way your chest and stomach move with each breath.
Distress tolerance options for when you feel wanting focus
Do a task (a computer game like tetris or minesweeper, writing a computer program, needlework, etc.) that is exacting and requires focus and concentration.
NOTE: Some people report that being online while dissociating increases their sense of unreality; be cautious about logging on to the internet in a state like this until you know how it affects you.
Eat a raisin mindfully. Pick it up, noticing how it feels in your hand. Look at it carefully; see the asymmetries and think about the changes the grape went through. Roll the raisin in your fingers and notice the texture; try to describe it. Bring the raisin up to your mouth, paying attention to how it feels to move your hand that way. Smell the raisin; what does it remind you of? How does a raisin smell? Notice that you're beginning to salivate, and see how that feels. Open your mouth and put the raisin in, taking time to think about how the raisin feels to your tongue. Chew slowly, noticing how the texture and even the taste of the raisin change as you chew it. Are there little seeds or stems? How is the inside different from the outside? Finally, swallow.
Choose an object in the room. Examine it carefully and then write as detailed a description of it as you can. Include everything: size, weight, texture, shape, color, possible uses, feel, etc.
Choose a random object, like a paper clip, and try to list 30 different uses for it.
Pick a subject and research it on the web.
Distress tolerance options for when you feel wanting to see blood
Draw on yourself with a red felt-tip pen.
Take a small bottle of liquid red food coloring and warm it slightly by dropping it into a cup of hot water for a few minutes. Uncap the bottle and press its tip against the place you want to cut. Draw the bottle in a cutting motion while squeezing it slightly to let the food color trickle out.
Draw on the areas you want to cut using ice that you've made by dropping six or seven drops of red food color into each of the ice-cube tray wells.
Paint yourself with red tempera paint.
Paint a doll red.
Use black and red paint, crayons, pens or pencils to scribble hard on paper.
Distress tolerance options for when you feel wanting to see scars or pick scabs
Rub Elmer's glue on the part of your body that you want to hurt. Let it dry. If you want it to dry faster, use a fan or hair dryer. When dry, pick it off a little at a time.
If you still have the urges for self-injury, try answering these questions in a journal.
Why do I feel I need to hurt myself? What has brought me to this point?
Have I been here before? What did I do to deal with it? How did I feel then?
What I have done to ease this discomfort so far? What else can I do that won't hurt me?
How do I feel right now?
How will I feel tomorrow morning if I hurt myself?
Can I avoid this stressor, or deal with it better in the future?
Do I need to hurt myself?
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