How to Make Self-Injury Comfort Cards

Individuals struggling with self-injury may be suffering from a variety of mental illnesses, including depression, Borderline Personality Disorder and anxiety disorders. Therapists may engage patients struggling with these disorders in dialectical behavioral therapy, which focuses on acceptance and validation, as well as motivating patients to learn healthier coping skills to deal with destructive behaviors. A key component to this therapy style is the diary card, which is a self-monitoring tool used by the patient and the therapist to keep track of urges, emotions, skills and actions experienced or practiced every day.

Things You'll Need

• Large index cards or sheets of paper

Show More

Instructions

Front of Cards

• 1

  Draw a table with rows and columns on the front of each card . At the top of the card, above the table, put your name and the date you started the card. Make columns for urges, emotions, drugs (if applicable) and actions. Each row should correspond to a day of the week.

  Add a second, separate section at the bottom of the card for urges and the ability to self-regulate and maintain control. This final section will be filled out with your therapist during your appointment.

• 2

  Write the urges you struggle with most (such as self-injury, suicidal urges or the urge to use drugs) under the "Urge" column, thus splitting that larger category into smaller ones. Rate, on a scale of zero to five, how strong each urge was on a given day. Suicidal urges or the urge to use drugs may not apply to you, however, if they do, tracking them can help you identify how they influence your urge to self-harm. If they do not apply, write only the urges that do apply to you.

• 3

  Write emotions and feelings that you struggle with most (such as misery), or are striving to experience (such as joy), under the broader "Emotions" category --- making sub-columns for each feeling or emotion --- and rate from zero to five how intense any emotion was on a particular day.

• 4

  Write down "Alcohol," "Illicit Drugs," "Prescribed Medications" and "Over the Counter" under the "Drug" column category, if applicable. List the number or amount of each drug used and its specific name on the line corresponding to a given day. If you never use any alcohol, illicit, prescribed or over the counter drugs, then feel free to leave this section out. This section's purpose is to help track what role, if any, these substances may play in your urge to self-harm.

• 5

  Write "Self-harm" and "Skills" under the larger "Actions" column category and write "Y" for yes and "N" for no to indicate whether you self-harmed on a given day. Under "Skills," write the number of skills you practiced (the list of skills will be something that you and your therapist compile together) on the line corresponding to the appropriate day. Examples of skills include mindfulness, confidence building, healthy eating , focusing on positive thoughts and focusing on the facts. Practicing positive skills can help you alter behavioral patterns that lead to self-harming incidents.

Back of Cards

• 6

  Create a table with rows listing the days of the week in order from left to right in each row. Leave a blank column with rows after the last day of the week.

• 7

  List the skills that you and your therapist have determined you need to work on in the table in the blank column and rows after the days of the week.

• 8

  Write each skill next to a row of days, so that a week's worth of days corresponds to every skill. Check the skill when you practice it and circle the days of the week on which it was practiced.