When someone is struggling with thoughts of suicide or self-harm, the last thing they need is judgment or oversimplified solutions. At Greenpoint Psychotherapy, we know that healing isn’t linear, and sometimes the most helpful thing we can do is focus on keeping you safe while you navigate whatever you’re going through.
What is Harm Reduction?
Harm reduction is about being practical instead of idealistic. It acknowledges that sometimes you can’t just stop doing something that hurts you overnight, even when you want to. Instead of expecting you to go from crisis to complete recovery immediately, harm reduction focuses on making things a little safer right now, while you work on the bigger stuff.
Maybe you can’t imagine never having suicidal thoughts, but you could remove the pills from your nightstand or ask someone to hold onto them for a while. It’s about small steps that keep you alive and a little bit safer, even when everything else feels impossible.
Making Things Safer When You Can’t Stop
When you’re using self-harm to cope, or when suicidal thoughts feel overwhelming, we can work together on ways to reduce the damage while you’re figuring out what you need:
Finding Different Ways to Feel Something
Sometimes self-harm serves a purpose, maybe it helps you feel something when you’re numb, or helps you feel in control, or punishes you in a way that feels deserved. We’re not going to pretend those feelings aren’t valid. Instead, we can find other ways to get some of that same relief:
- Holding ice cubes until they melt can give you that sharp, intense sensation
- Drawing on your skin with a red marker can be visual without causing damage
- Hitting a pillow or screaming into it can release that energy
- Apps that let you “cut” or “pop” things on your phone screen can satisfy some urges
None of these are perfect replacements, and that’s okay. They’re just bridges to help you get through the hardest moments.
Taking Care of Wounds
If you are hurting yourself, you deserve medical care for those injuries, just like you would for any other wound. This isn’t about encouraging self-harm, it’s about acknowledging that infections and complications make everything worse. We can talk about what to keep on hand: clean bandages, antibiotic ointment, proper wound care supplies. We can figure out how to clean wounds properly and when you might need medical attention. Taking care of your body, even after you’ve hurt it, is still a form of self-care.
Making It Harder to Act on Impulses
When suicidal thoughts are intense, having easy access to methods can be dangerous. This doesn’t mean we’re going to lock you up or take away all your autonomy. It means creating some space between the thought and the action. Maybe it’s asking your roommate to hold onto your medication for a while. Maybe it’s driving to a friend’s house when you’re having a really bad night. Maybe it’s deleting the contact info for your dealer, or giving your gun to someone you trust. These aren’t permanent solutions, and you’re not weak for needing them. You’re being smart about working with your brain when it’s not working with you.
Working Together Without the BS
The relationship you have with your therapist matters more than any specific technique. We’re not going to pretend we know exactly what you’re going through, or act like therapy is some magical cure. What we will do is listen without freaking out when you tell us about suicidal thoughts. We’ll work with you to figure out what actually helps, not what we think should help. And we’ll be honest about what we can and can’t do, because trust goes both ways.
Sometimes the most helpful thing is just having someone who isn’t scared of your thoughts or trying to fix you immediately. Someone who can sit with the mess while you figure out what comes next.
What to Watch For
Sometimes it’s hard to know when thoughts about death cross the line into something more serious. Here are some signs that someone might be struggling with suicidal thoughts:
Things You Might Notice:
- Talking about wanting to die or not being here anymore
- Saying things like “I’m done” or “I can’t take this anymore”
- Giving away important stuff or saying goodbye in ways that feel final
- Suddenly seeming calmer after being really upset (sometimes this means they’ve made a decision)
- Withdrawing from friends and family
- Dramatic changes in mood, sleep, or appetite
- Increased drinking or drug use
- Taking risks they normally wouldn’t take
- Researching methods online or acquiring means
How Serious Is It?
Mental health professionals think about suicide risk in different categories, but these can change quickly:
Lower Risk: You might have thoughts about death sometimes, but they’re not constant. You have things and relationships you care about. You can imagine feeling different in the future, even if it’s hard to believe right now. You’re willing to try to stay safe.
Higher Risk: The thoughts are more frequent and you’re starting to think about how you might do it. Maybe you’ve looked into methods or you have access to things that could hurt you. Life feels unbearable most of the time, and it’s hard to see any way out.
Crisis Level: You have a specific plan and the means to carry it out. You might have a timeline in mind. You feel certain that death is the only way to stop the pain. You might be avoiding help or have stopped caring about consequences. If any of this sounds familiar, please reach out. Risk levels can change fast, and you don’t have to figure this out alone.
When Multiple Struggles Collide
Your identity and life circumstances don’t exist in separate boxes, they all affect each other and can make things harder in ways that aren’t always obvious.
Extra Challenges Some Face
LGBTQIA+ folks often deal with rejection from family, discrimination, and a lack of affirming healthcare. Finding a therapist who actually understands your experience shouldn’t be so hard, but it often is. Communities of color face racism in healthcare, generational trauma, and sometimes cultural stigma around mental health that makes it harder to get help. The mental health system wasn’t built with your experiences in mind. Financial stress makes everything worse. When you’re worried about rent or healthcare costs, or working multiple jobs just to survive, it’s harder to prioritize mental health care or find time for healing. Trans and gender nonconforming individuals deal with discrimination, violence, and barriers to basic healthcare. Society can be hostile in ways that are exhausting and dangerous.
Making Treatment Actually Work for You
Good therapy should account for all of who you are, not just your symptoms:
- Your cultural background and what family, community, and spirituality mean to you
- The real barriers you face and how discrimination affects your daily life
- Building on strengths that come from your communities and experiences
- Connecting you with support that actually gets your specific situation
- Sometimes helping you advocate for yourself in systems that aren’t set up for you
None of this erases the need for safety and harm reduction , it just means we need to be smarter about how we approach it.
The Point of All This
Harm reduction isn’t giving up on you getting better. It’s acknowledging that healing takes time, and keeping you alive and safe while that happens is the most important thing.
Some days, success might look like using a clean blade instead of a dirty one. Some days, it might be texting a friend instead of acting on a suicidal thought. Some days, it might be making it through one more hour. All of that counts. Your journey doesn’t have to look like anyone else’s. What matters is that you’re still here, and that we can work together to make things a little more manageable, one day at a time.
Getting Help
If you’re struggling with suicidal thoughts or self-harm, you don’t have to handle this alone. At Greenpoint Psychotherapy, we work with you wherever you’re at, no judgment, no pressure to be “ready” for recovery, just genuine support while you figure things out. Asking for help doesn’t mean you’re weak. It means you’re human, and humans aren’t meant to carry everything by themselves. If you’re in immediate danger, call 911 or go to your nearest emergency room. For crisis support, you can call or text 988 (Suicide & Crisis Lifeline) anytime.
At Greenpoint Psychotherapy, we provide therapy that takes your whole life and identity into account. Reach out if you want to learn more about how we might be able to help.