Self-Harm Intervention:
A Program to Tame Extreme Feels
These honest and comprehensive resources help individuals, therapists, and program managers in treatment centers and detention facilities support skill-building in self-soothing, transforming distress into insight, and communicating needs effectively.
Looking for strategies to cope with distress and navigate intense emotions? Download the free workbook
Need adaptable tools for relaxation, self-reflection, and ease? Try our free audio files
Workbook
It Already Hurts Enough
A Brain-Changing Read
If you struggle with self-harming behavior and are ready to break the cycle, change is possible. You just need the right tools.
It Already Hurts Enough is a comprehensive, compassion-based approach to changing your self-harming habits by changing your mind. This thoughtful and frank guide creatively weaves insights from psychology (MBCT, DBT, ACT), neuroscience, yoga, mindfulness, meditation, and bodywork—offering pragmatic and powerful strategies to help you:
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Calm chaotic thinking and emotional overwhelm without self-harming tactics
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Understand the deeper meanings behind painful thoughts
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Respond gently to yourself and others
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Change habits that fuel self-sabotage and self-injury
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Communicate truthfully without increasing conflict
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Cope skillfully with effects of trauma or abuse
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Create a life that feels good to live.
No matter the ways you harm yourself, this book—equal parts resource guide, pep talk, and trusted friend—will support you as you learn to quiet the chaos in your mind and interact with your thoughts and emotions so skillfully that you don’t need self-harm.
Program Supports
Relaxation
Taking 20 minutes a day to purposely relax and restore yourself can do wonders for your brain and emotional state. Whether you're listening to the audio files available below or taking time out of your day to relax in other ways, make sure you take the act of getting comfortable seriously. Listen to your body’s requests for different types of support and alter your positioning as needed to increase your comfort. Try a few relaxation positions and notice what feels best to you.
You may have gotten used to enduring discomfort but, if you're trying to feel better, there’s no value in forcing yourself to be uncomfortable. When you're taking time to relax, give yourself permission to change your position any time you need to, but don't let your brain use fidgeting as a way to avoid fully relaxing.
Guided Imagery
Guided imagery (aka Guided Visualization) is a great brain-changer. Instead of diving into chaotic thoughts or painful emotions, you can dive into the safety of a sensory "Comfort Zone." When you don't know what you think or feel, you can take some time to hear what your "Inner Child" has to say. When you're at your limit of emotional tolerance, coming of your head and into your body with a Body Scan can shut down painful rumination.
Use these audio files to tap into the power of your imagination and bring sensations of ease and strength to the forefront of your experience.
How to use the files
Next time you're feeling tangled up in pain or mental chaos, set up a relaxation area, grab some headphones and listen to one or more of the audio files below. They'll offer a different experience every time you use them, supporting you in your deepest moments of pain or making the most of your clear times to expand your sense of self. Each file is intended to help you support yourself, and learn to tolerate, understand, or redirect painful thoughts or feelings so you can create ease without using self-harm.
Choose a relaxation position and get your support set up before pressing play. Tracks are formatted for specific positions but you can always mix it up based on how you're feeling. Use the first 10 seconds of silence at the start of each track to settle in after pressing play. Once you've heard a track, work with the ideas and visualizations in your daily life. Then, come back and listen again. You'll notice that your experience of yourself, and your pain, changes with time and practice.
Note: You may want to take a few minutes to prepare yourself to reenter your day after using an audio file. Some visualizations can leave you feeling a little otherworldly--like you've had a mental massage. Give yourself a few minutes to mindfully transition back into the world without rushing. Try to carry the stillness you've created into your day.
Audio Files
From the Workbook...
The tracks below are audio versions of descriptive content in the workbook denoted with a icon.
Each file description lists the workbook page(s) where related content can be found. Every audio file has some space at the beginning so you can settle into a relaxation position before the narrative starts.
Let the imagery in each audio file guide you toward self-compassion, and create a practice of using focused attention to actively soothe yourself and work constructively with your lived experience. Notice how something as simple as listening can be a form of self-care.
Summer Day
Workbook Page: 66
Relaxation Position: Seated
Good For: Experiencing a simple guided visualization
A playful example of how guided visualization brings your brain and body into an imagined scene. Your brain believes what you tell it. Or, what it's allowed to tell itself.
Kids on the Bus
Workbook Page: 80
Relaxation Position: Seated
Good For: Giving voice to feelings and unmet needs
A visualization that personifies chaotic thinking and deconstructs cognitive dissonance. Quiet the chattering voices in your head so you can get where you want to go.
Comfort Zone
Workbook Pages: 158 & 248
Relaxation Position: Any
Good For: Finding comfort and ease
Build the most nourishing inner landscape you can imagine. Drop into this space when your body and mind are overwhelmed. Watch the landscape change over time.
Basic Body Scan (*30sec intro)
Workbook Pages: 244
Relaxation Position: Supine (On your back)
Good For: Calming thoughts by focusing on the body
A body awareness exercise (with ambient audio) to remind you that you are more than your thoughts. Relax, restore, and get out of your head by focusing on your physical body.
Water in the Well
Workbook Page: 67
Relaxation Position: Seated
Good For: Considering the impacts of your experiences
Look inside the well of your experience and learn how to change the quality of your thoughts. Drop into this space to balance and nourish youself from the inside out.
Inner Child
Workbook Page: 86
Relaxation Position: Seated
Good For: Making friends with yourself
Rescue your inner child. Create and nurture an inner landscape that supports your most vulnerable aspect. Give some love to the wounded part of you that needs care.
Energy in the Heart and Hands
Workbook Page: 243
Relaxation Position: Seated
Good For: Connecting with the energy in your body
An energy awareness exercise that connects you to your energy field. Use the concept as a way to release mental chaos and get back into your body.
Bonus: Front, Back & Inside
Workbook Page: Not included in workbook
Relaxation Position: Supine (On your back)
Good For: Expanding your sense of self
Expand your awareness of your physical boundaries by exploring different dimensions of the body. Use to reclaim your vastness when self-harm makes you feel small.
Relaxation Positions
Seated
What you need: A chair or floor
Optional supports: Couch cushion, bolster, small pillow, wall
If you choose the floor:
Place a couch cushion, bolster, or pillow on the floor and sit on it in a way that allows your outstretched legs to fall comfortably away from your body. Allow your knees to bend gently, and increase comfort by placing a pillow under your knees for support. Try to sit mindfully, using your pelvis to support the length of your spine, so the job doesn’t go solely to your back or abdominal muscles.
If that position doesn’t feel comfortable try sitting on your support with your legs crossed, knees falling away from your pelvis. If your hips won't let your knees fall away, place pillows or rolled up towels under your knees for support.
For additional back support, try sitting with your back resting against a wall so that your shoulder blades create an additional stabilizing point for your upper body.
Supine (On your back)
What you need: Blanket or yoga mat
Optional supports: Couch pillow or bolster, small pillow, block, wall, eye pillow, sandbag, blanket
Arrange a blanket or yoga mat on the floor. Lie down on your back, taking care to keep your spine long, your lower back comfortable, and your chin tilted slightly downward.
To increase comfort, place a pillow under your knees and adjust your pelvis so that your lower back is released completely. Let your legs roll outward from the hips, the sides of your heels taking the weight of your feet.
Modify this position in any way that increases your comfort: with your back raised to an incline, with your legs up the wall, or with support under your arms. Adding weight (sandbag, eye pillow, blankets) will deepen sensations of grounding as your body rests.
Prone (Face down)
What you need: Blanket or yoga mat
Optional supports: Couch pillow or bolster
Arrange a blanket or yoga mat on the floor. Lie face down, turning your head to whichever side feels most comfortable, resting the weight of your head on your temple.
Let your big toes meet as your heels fall outward, then widen your legs while keeping your foot position intact.
To increase comfort and ease strain on your lower back, place a pillow under your pelvis, or arrange a bolster on the floor to support the length of your entire torso as you lie on top of it like a starfish.
There are many ways to do this, just make sure not to create strain on your back or neck.
Knees at 90 Degrees
What you need: Blanket or yoga mat, two large couch cushions or bolsters
Optional supports: Small pillow, towel, eye pillow, sandbag, blanket
Arrange a blanket or yoga mat on the floor and place a chair or two stacked couch cushions or bolsters where your legs will rest. Sit down on the floor, oriented sideways to the support. Swing your legs up and onto the chair or cushions while turning on your butt and laying back. Extend the length of your spine along the floor, making your lower back as comfortable as possible. The intention is to get your knees bent at 90 degrees with each calf and foot supported. Your bottom should be as close as possible to the chair legs or pillows to release strain on your lower back.
For increased back support, tuck a small pillow or rolled towel under the arch of your lower back, or change the height of the pillows under your legs until you feel completely comfortable. Try adding an eye pillow, sandbag, or blanket to enhance sensations of grounding.
Reclining Butterfly
What you need: Two large couch cushions, or a bolster and two yoga blocks
Optional supports: Eye pillow, sandbag, small pillows, blocks, blanket
Place one large couch cushion on the floor. Place a second large couch cushion to rest on the edge of the first cushion so it forms an angle, a backrest that you will lie against. Adjust the support to create an incline that comfortably supports your back and head in a nice, straight line. If the top cushion is floppy, use additional pillows or yoga blocks to prop up the pillow, so you can lean against it without it collapsing. After you’ve arranged your inclined back support, sit back up to prepare the rest of your support.
While sitting on the floor with your bottom near the support you’ll be leaning back on, stretch your legs out in front of you. Bend your knees and bring the soles of your feet together to create a rough diamond shape with your legs. Place one or more throw pillows under each knee to support the weight of your knees and lower thighs. There should be no muscular tension in your groin—let the weight of the legs rest completely into the pillows.
Keeping your legs in this position, lie back onto the reclining cushion. Add a pillow under your head if your neck needs additional support, and adjust yourself as necessary so that you’re completely supported and feel no tightness or holding in your legs, back, or neck.
To increase comfort, place a small pillow under each arm. Add an eye pillow, blanket or sandbags on the knees or chest for a deeper sense of grounding.