Self-harm, suicidality and ACT

What is self-harm and suicidality?

While self-harm and suicidality can be related, they are distinct concepts:

• Self-harm refers to deliberate and intentional actions that individuals engage in to cause harm to themselves. It is often seen as a coping mechanism or a way to deal with overwhelming emotions or distress. Self-harm can take various forms, such as cutting or scratching the skin, burning, hitting oneself, pulling out hair, or intentionally ingesting harmful substances. Self-harm is often used as a way to release emotional pain or regain a sense of control, and individuals who engage in self-harm may experience temporary relief or a sense of emotional release following the act. Self-harm can be a sign of underlying mental health issues, such as depression, anxiety, borderline personality disorder, or other emotional difficulties. It’s important to note that self-harm is not typically a suicide attempt, although there may be an overlap between self-harm and suicidal thoughts or behaviours. It is crucial for individuals who self-harm to seek professional help from mental health practitioners who can provide appropriate support and interventions.

• Suicidality refers to thoughts, feelings, or behaviours related to contemplating or attempting suicide. It encompasses a range of experiences, from fleeting thoughts of wishing to be dead to more concrete plans or even actual attempts at taking one’s own life. It often arises from deep emotional pain, hopelessness, or a belief that there is no way to alleviate the suffering being experienced. Suicidal ideation is often a sign of significant distress and underlying mental health issues that require professional intervention. Mental health professionals, helplines, and emergency services are available to provide support to individuals experiencing suicidality and help find appropriate treatment and resources.

Understanding how ACT can be applied to instances of self-harm or suicidality

Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that can be helpful for individuals experiencing self-harm or suicidal thoughts. ACT is based on the idea that suffering is a normal part of the human experience, so focuses on developing psychological flexibility and promoting values-based action.

Here are some ways ACT therapy can support individuals who self-harm or have suicidal thoughts:

• Building psychological flexibility: ACT aims to enhance psychological flexibility, which involves being open to and accepting of challenging thoughts and emotions while still taking action in line with chosen values. This flexibility helps individuals respond more effectively to distressing situations and reduces the urge to engage in self-harm as a coping mechanism.
• Mindful awareness: ACT helps individuals develop skills to “defuse” from distressing thoughts and beliefs. This involves recognising that thoughts may not always be accurate or useful to us. By learning to observe thoughts without getting entangled in them, individuals can reduce the impact and influence of distressing thoughts related to self-harm or suicide. Mindfulness can help individuals observe their thoughts and emotions without becoming overwhelmed by them, allowing for greater self-awareness and the ability to make conscious choices.
• Self -compassion: By acknowledging and accepting difficult thoughts and emotions, rather than trying to suppress or avoid them, individuals can develop a more empathetic and non-judgemental relationship with themselves, which can lessen the urge to engage in self-harm. Developing self-compassion can help individuals counteract self-judgement and harsh self-criticism, which are often associated with self-harm or suicidal thoughts.
• Commitment to values: The process of identifying core values can provide a sense of purpose and meaning, serving as a motivation to engage in healthier coping strategies and seek support when experiencing distress. ACT supports individuals in taking committed action towards their values, even in the presence of difficult thoughts and emotions. This can involve seeking professional help, building a support network, engaging in self-care activities, or implementing healthier coping strategies as alternatives to self-harm. Engaging in activities that are consistent with their values can increase overall well-being and serve as a buffer against self-harming behaviours or suicidal thoughts.
• Relapse Prevention: ACT focuses on equipping individuals with relapse prevention strategies. This includes identifying warning signs, developing coping skills, and creating a plan for managing future challenges. By developing these skills, individuals can reduce the risk of relapse into self-harm or suicidal behaviours.

It’s important to note that ACT is just one therapeutic approach, and the specific techniques and strategies used may vary depending on the therapist and the individual’s needs. The therapy is typically conducted in collaboration between the therapist and the individual, with the goal of fostering increased psychological flexibility, resilience, an well-being.

For individuals:

If you or someone you know is experiencing self-harm or suicidal thoughts, it’s crucial to seek professional help from a qualified mental health practitioner who can provide personalised support and guidance. Our ACT therapy team is available to help too.

For professionals:

We offer a range of live training and on-demand courses covering how ACT therapy can be used to support individuals with suicidal or destructive thoughts. Also take a look at our free resources and blog for additional reading and insight.