Self harm can feel scary, shameful and very private. For many people it is a way of coping with intense emotions, numbness, memories or situations that feel completely overwhelming. If you are using self harm in any form, you deserve to be met with compassion, not judgement or criticism.

​

I really understand what is behind this behaviour as I previously worked on the emotion regulation pathway and have a post graduate diploma in dialectical behaviour therapy, which specifically targets self-injuroious behaviours.  I work with people who self harm using evidence based approaches such as Dialectical Behaviour Therapy (DBT), Eye Movement Desensitisation and Reprocessing (EMDR), Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT). Together we focus on understanding what self harm is doing for you, reducing risk where possible, and building a toolkit of safer and more sustainable ways of coping.

​

You will not be told off for self harming. My aim is to understand your experience, help you feel less alone with it, and support you to move towards a life that feels more manageable and meaningful.

​

Understanding Self Harm

Self harm can look very different from person to person. It might involve hurting your body, restricting food, misusing substances, repeatedly putting yourself into unsafe situations, or other behaviours that you know are harming you in some way. Often, these behaviours develop because at some point they were the only thing that seemed to bring relief.

​

Self harm can be linked with:

• Difficult early experiences or trauma

• Feeling emotionally overwhelmed, numb or disconnected

• Intense shame or self criticism

• Feeling out of control or disconnected from your body

• Difficulties in relationships, attachment and trust

• Anxiety, depression, or other mental health difficulties

• Neurodivergence such as ADHD or autism, where emotions and sensory experiences may feel particularly intense

 

In our work together, we explore what self harm means in the context of your life. Rather than just focusing only on “stopping the behaviour”, we look at the underlying pain, patterns and needs that are driving it.

​

Safety And Managing Risk Together

Because self harm can sometimes involve significant physical risk, it is important that we think about safety together.

​

I do not work as an emergency or crisis service and I cannot manage high levels of risk alone. If we decide to work together, we will agree how to involve other professionals or services when necessary. This might include:

​

• Your GP or psychiatrist

• Community mental health teams

• Crisis teams or out of hours services in your area

• Other support services you already have in place

 

In practice, this means that:

• We will talk openly about any current self harm, suicidal thoughts or plans, and any changes in risk.

• If I have concerns about your immediate safety, I will discuss options with you, such as contacting your GP, crisis services, or emergency services, and I may need to share information with them to help keep you safe.

• We will develop a personalised safety plan that includes early warning signs, coping strategies, distraction techniques, and a list of people or services you can contact when you are struggling.

 

My approach is collaborative and transparent. Wherever possible, I will involve you in decisions about sharing information and we will talk through what feels safe and manageable for you. The goal is not to take control away from you, but to make sure that you are not holding risk on your own.

​

If you are in immediate danger or feel unable to keep yourself safe, therapy is not the right place to get urgent help. In those situations, it is important to contact emergency services or crisis support in your local area.

​

How I Work With Self Harm

Every person and every situation is different, so there is no one size fits all approach. However, therapy for self harm with me typically includes several core elements.

​

Creating safety and understanding - In the early sessions, our focus is on getting to know you and helping you feel safe enough to talk. We might:

​

• Explore when self harm started and how it has changed over time

• Look at what tends to trigger urges and what tends to help

• Discuss any past experiences, including trauma, that may be linked

• Think about what you want from therapy and what “better” might look like for you

 

You are always in control of how much you share and at what pace. You will never be pushed to talk about anything you are not ready for.

​

Using DBT to build practical coping skills - DBT was originally developed for people who self harm and struggle with intense emotions. In this approach, we can work on:

​

• Emotion regulation skills, so that feelings become more understandable and manageable

• Distress tolerance skills, practical tools for getting through crises without making things worse

• Interpersonal effectiveness skills, to improve communication and boundaries in relationships

• Mindfulness skills, to help you notice urges and feelings without immediately acting on them

 

We may use DBT style exercises such as behaviour chain analyses, where we map out what happens before and after an episode of self harm, then identify points where something different could happen next time.

​

Using EMDR to work on underlying trauma - If self harm is linked to past trauma, EMDR can be a powerful way of processing distressing memories and the beliefs that go with them, such as “I am worthless”, “I deserve pain”, or “I am too much”. EMDR does not require you to go into every detail of what happened. Instead, we target specific memories, body sensations and emotions to help your brain process them in a different way.

​

As trauma processing progresses, people often notice that the emotional intensity behind their self harm urges starts to shift.

​

Using CBT to understand thoughts, feelings and behaviour - CBT helps us look at the links between your thoughts, emotions, physical sensations and actions. Around self harm, CBT work might include:

​

• Identifying unhelpful thinking patterns, such as black and white thinking or harsh self criticism

• Experimenting with alternative perspectives and more balanced thoughts

• Looking at routines, sleep, activity levels and how these affect mood and urges

• Building up small, manageable changes that increase a sense of control and hope

 

Using ACT to move towards what matters to you - ACT focuses on living in line with your values, even when difficult thoughts and feelings show up. In this approach, we might:

​

• Clarify what truly matters to you in areas such as relationships, work, health and personal growth

• Learn skills to make space for painful feelings and urges without acting on them

• Develop compassionate ways of relating to yourself, especially around shame and guilt

• Identify small, values based steps that move your life in a direction that feels more meaningful

 

Building Alternatives To Self Harm - Stopping or reducing self harm is not simply a matter of willpower. If self harm has been your main coping strategy, it is vital that we build a range of alternatives, rather than just taking it away.

Together we might work on:

​

• Short term crisis strategies, for moments when urges feel intense and immediate

• Sensory, grounding and self soothing techniques that suit your nervous system

• Ways of expressing emotions, such as writing, art, movement or talking

• Skills for asking for support and letting others in safely

• Reducing shame and self criticism so that you can be kinder to yourself when you are struggling

• Longer term changes that reduce the build up of stress and emotional pain

 

We will review regularly what is helping and what is not, adjusting the plan so that it fits you as a whole person, not just a list of symptoms.

​

Working Together

If you are considering therapy for self harm, it is completely normal to feel anxious, ambivalent or unsure. Part of our work may be simply creating a space where you can be honest about all sides of that, including any part of you that wants to keep self harming and any part of you that wants something different.

​

I offer a warm, non judgemental and trauma informed approach. I bring my experience as a Clinical Psychologist, my training in DBT, EMDR, CBT, ACT and other therapies, and a genuine belief that change is possible, even if you have been self harming for a long time.

​

If you would like to explore whether we might be a good fit, you are welcome to get in touch to arrange an initial consultation or to ask any questions. We can think together about your needs, the level of risk, and whether this type of therapy is the right next step for you.