What can help reduce self-harm?
Different strategies help different people.
Share with someone you trust
Many people hide self-harm because they fear judgement.
You may find it helpful to:
- talk to a trusted friend or family member
- talk to a professional (teacher, support worker)
- contact a helpline
- speak to a GP
If talking feels difficult, you could ask someone you trust to help you or use online or text-based support services
Support regulation
Many autistic people self-harm when they become overwhelmed or dysregulated.
Helpful approaches might include:
- reducing sensory demands and use sensory supports
- taking breaks
- spending time in quiet spaces
- listening to music
- using movement and exercise
Examples:
- wearing ear defenders in noisy environments
- going for a walk
- spending time outdoors
Learn safer coping strategies
Possible alternatives include:
- using fidget items
- holding textured objects
- pushing against a wall
- squeezing a cushion
- taking a warm bath
- spending time with a pet
- listening to music
- watching a favourite programme
- drawing
- baking
- craft activities
- physical exercise
You can find some ideas on how to make a self-soothe box here
Some people find it helpful to:
- delay the urge for a few minutes
- use a timer
- move self-harm tools out of easy reach
- contact someone for support
Practise self-care
Self-care can be difficult when someone feels overwhelmed.
For more ideas see Everyday wellbeing for autistic people
Some people find it helpful to replace self-harm routines with self-care routines.
For example:
- applying hand cream
- taking a shower
- using a favourite scent
- wrapping up in a soft blanket
Use embodiment activities
Embodiment means connecting with your body in safe ways.
Examples include:
- stretching
- walking
- running
- dancing
- shaking out tension
- naming body parts while moving them
- deep pressure activities
Many people find these activities easier to use if they practise them before a crisis.
Create a safety plan
A safety plan can be helpful because it is harder to think clearly when distressed.
Include:
- early warning signs
- triggers
- helpful coping strategies
- sensory supports
- people to contact
- emergency contacts
- places that feel safe
Harm reduction
For some people, immediately stopping self-harm may not feel possible.
A harm reduction approach focuses on reducing risk while working towards safer alternatives.
This approach can:
- reduce shame
- increase trust
- help people stay engaged with support
- respect personal autonomy
Support should focus on understanding the person’s needs while helping them move towards safer coping strategies.
Advice for parents, carers and supporters
Supporting someone who self-harms can feel frightening.
What can help:
- Stay calm
- Listen without judgment
- Take the person’s distress seriously
- Focus on understanding rather than blame
- Use clear and direct communication and examples of feelings to help the person choose words
- Support the person’s preferred communication style
- Reduce known triggers where possible
- Support sensory needs
- Maintain predictable routines
- Encourage advocacy, with choices and control where possible
Try to avoid:
- punishment
- criticism
- threats
- labelling someone as attention seeking
- taking away all independence and autonomy
Many autistic people say that empathy, understanding and being listened to are among the most helpful responses
When to get help
Speak to a GP or mental health professional if you or someone you support is self-harming.
Seek urgent help if:
- there is a serious injury
- someone’s life is at immediate risk
- someone cannot keep themselves safe
If you cannot ask for help yourself, ask someone you trust to help you.
Key points
- Different strategies help different people.
- Understanding triggers and unmet needs is an important first step.
- Talking to someone trusted can help reduce isolation and increase support.
- Regulation, self-care and safer coping strategies can help manage distress.
- A safety plan can help during difficult moments.
- Support should be non-judgemental, personalised and focused on understanding.
- Seek professional help if self-harm is occurring, and urgent help if there is immediate risk to safety.
Further information
Understanding how autism affects your thinking - and can consequently cause challenges, can also help you to improve your emotional wellbeing. There are many great books and websites that can help you.
For these resources, click here
For information on getting help in a mental health emergency or crisis, click here
For resources and services to support with emotional health and wellbeing including self-harm, click here
Whilst most of these services don’t specialise for autistic people, they should all make any reasonable adjustments needed. Consider sharing with a therapist about any individual autistic needs so they can make the necessary adaptations.
Also consider sharing this booklet produced by the National Autistic Society with your therapist.
NAS-Good-Practice-Guide-MH talking therapies, link to PDF here
Also, further advice on adapting health care for autistic people, can be found here