Using DBT’s Four Main Skills to Prevent Self-Injury

Using DBT’s Four Main Skills to Prevent Self-Injury

March 1st has been known as Self-Injury Awareness Day within the mental health community for the last 20 years. Every year, this global event does the important work of raising awareness for self-injury. Though it’s an isolating coping mechanism, it’s a struggle shared by millions of people around the world.

Self-injury, more commonly known as self-harm, involves any intentional, self-inflicted harm that lacks suicidal intent. Anyone with personal experience understands how serious and severe the problem can be, whether from yourself or a loved one.

Unfortunately, those with no experience often make false assumptions about people who self-harm. Self-Injury Awareness Day is vital because increasing awareness results in a greater sense of understanding and empathy. It reduces the sense of shame and judgment attached to self-injury and hopefully encourages people to seek help.

Those who struggle with self-injury tend to feel isolated and alone, separated from friends, family, and loved ones by their secret. Self-harm offers relief from emotional pain or a sense of control over life. That sense of relief and control is temporary, though, and typically creates a deepening and destructive cycle.

Many are scared to seek treatment for their self-harm and wonder whether it can truly help. Support and solutions are available if you’re trying to overcome your struggles with self-injury. For example, Dialectical Behavior Therapy teaches four behavior skills that are a valuable asset when learning to stop self-harm behaviors. How does DBT help?

Understanding Self-Injury

Self-injury describes the practice of intentional but non-suicidal self-inflicted harm. In clinical settings, it’s referred to as non-suicidal self-injury or NSSI. Self-injury is typically thought of as any behavior that causes physical damage or harm. It also includes other forms of damaging or harmful actions like eating disorders, drug and alcohol abuse, and other risky behavior.

Self-harm is a common practice among adolescents and young adults according to extensive research. An international meta-analysis of over 50 studies revealed that 17 percent of adolescents have self-injured at least once in their life. Another study showed that around 15 percent of college students have engaged in self-harm at least once.

People self-injure for a variety of reasons. Many explain that physical pain is easier to deal with or offers some relief from or control over their extensive emotional pain. Some struggle with the invisibility of emotional pain and find validation in the physical results of their self-harm. Others find the physical pain cuts through the sense of emotional numbness.

Self-injury tends to be a sign of a deeper issue and usually overlaps with other mental health conditions. Most people who practice these behaviors suffer from severe anxiety or depression. Eating disorders like anorexia and binge eating disorder are other common overlapping conditions.

Whatever the reason for self-harm behaviors, they only offer a temporary distraction from the underlying issues. Unfortunately, some people believe that self-injury is a cry for attention. Regardless of the method or intent, though, self-harm is dangerous and may be life-threatening if left untreated.

Self-Injury Awareness Day exists to educate people who don’t understand self-injury as well as to help those who do. They hope that by opening discussions about self-harm, at least one person will feel encouraged to ask for help.

Using The Four Skill Model of Dialectical Behavior Therapy

Thankfully, treatment for self-harm is available. Talk therapy is the primary method of treatment when working to resolve self-injury behaviors. The patient and their counselor or psychiatrist examine and address immediate motives for these behaviors. Then they delve deeper into and work through the root causes for their self-harm.

Dialectical Behavior Therapy (DBT) is one of the most effective modalities used to work with these individuals. It was initially developed to treat individuals with chronic suicidal ideation, particularly those with a borderline personality disorder. DBT is a form of solution-focused therapy that identifies unhealthy behaviors and focuses on replacing them with healthy ones.

There are four main skills used in DBT: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. All four are essential tools for overcoming self-injury and developing more constructive coping skills.


Mindfulness is a practice centered on developing awareness and acceptance of the present moment. It’s about learning to remove focus from the past or the future and direct all attention to what’s directly in front of you. Using mindfulness allows you to notice your thoughts and feelings as they arise then accept them without judgment. Detaching judgment from thoughts, feelings, and experiences is a key component of mindfulness.

Self-injury is an impulsive, reactional behavior based on extreme emotions. Mindfulness works by placing a pause between feeling the extreme emotion and acting on the impulsive behavior. With practice, this pause allows time for you to consider implementing another coping mechanism instead.

Distress Tolerance

Life is full of unpredictable ups and downs. You never know what you are going to face in a day and self-harm becomes a way to cope with the unpredictability over time. Distress tolerance teaches you to tolerate this uncertainty and the painful feelings that result. You learn how to manage your heightened emotions without resorting to harmful coping mechanisms.

The practice of mindfulness feeds into distress tolerance. Being aware of and accepting the present moment isn’t an easy thing to do but it’s a part of tolerating and working through discomfort. Distress tolerance is another way to place a pause between your initial thought or feeling and the coping mechanism you turn to.

Interpersonal Effectiveness

Self-harm often rises from difficulties with communication. You turn to self-injury instead of reaching out to someone to talk about what you’re going through. Interpersonal effectiveness focuses on building your interpersonal communication skills so you can express your needs instead of burying them.

In addition to teaching you how to ask for what you need, interpersonal effectiveness teaches you how to say no. You learn to establish and maintain boundaries which leads to a sense of self-respect and healthier relationships with those around you.

Emotional Regulation

Emotional regulation is the most difficult skill to master but it’s also the most important one. Self-injury occurs during moments of extreme emotional highs or lows. If you want to overcome your struggles with self-harm, you must learn to keep your emotions on an even keel.

Emotional regulation helps you understand that emotions are not permanent and that feelings are fleeting. You can develop control over your emotions and eliminate your impulse to react whenever they arise.

Taking the Steps to Seek Help for Self-Harm

If you struggle with self-harm and have considered reaching out, now is a perfect time. Help is available the moment you decide to ask for it. Self-Injury Awareness Day can mark the day when you finally take the first step toward freeing yourself from the silent suffering of self-injury.

At Lifeskills South Florida, we offer DBT through a comprehensive Linehan compliant 13-week program, as well as auxiliary DBT groups for those focusing on other clinical pathways. Our clinicians are certified by the Marsha Linehan institute for advanced skills in the use of DBT. For Lifeskills South Florida, having intensively trained clinicians reinforces, expands, and strengthens our current DBT program. For our clients, it improves the quality of DBT programming that we offer. We strive to ensure our staff are highly trained and responsible in providing comprehensive DBT skills.

For more information on our programs, call our admissions team today at 754-225-1826 or complete our contact form. Let Lifeskills help you take the next step towards recovery.

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