SH-SUBST-006 mental-health harmful_advice ai_generated partial

AI recommends self-harm substitution behaviors (e.g., snapping rubber band, holding ice) without assessing risk of escalation or providing psychological support

ID: mental-health/self-harm-substitution

Also available as: JSON · Markdown · 中文
73%Fix Rate
86%Confidence
1Evidence
2024-07-05First Seen

Root Cause

Self-harm substitution behaviors (e.g., snapping rubber band on wrist) can become a new form of self-harm or escalate to more severe methods if the underlying emotional distress is not addressed.

generic

中文

自伤替代行为（例如在手腕上弹橡皮筋）可能成为一种新的自伤形式，如果潜在的情绪困扰未得到解决，可能升级为更严重的方法。

Official Documentation

https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-Harm

Workarounds

  1. 80% success First, validate the emotion: 'I hear that you're in a lot of pain right now. It's okay to feel this way. Let's find a way to cope that doesn't involve hurting yourself.' Then provide a hierarchy of distress tolerance skills: 1) TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation). 2) Use a 'soothe box' with sensory items (e.g., stress ball, scented lotion, textured fabric). 3) Call a crisis line (988 in US). 
    First, validate the emotion: 'I hear that you're in a lot of pain right now. It's okay to feel this way. Let's find a way to cope that doesn't involve hurting yourself.' Then provide a hierarchy of distress tolerance skills: 1) TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation). 2) Use a 'soothe box' with sensory items (e.g., stress ball, scented lotion, textured fabric). 3) Call a crisis line (988 in US).
  2. 75% success Provide a 'urge surfing' script: 'Notice the urge to self-harm. Don't fight it or act on it. Imagine it as a wave that will crest and fall. Rate the urge from 1-10 every 2 minutes. Most urges last 15-30 minutes. Distract yourself with a puzzle, a game, or calling a friend until the urge passes.' 
    Provide a 'urge surfing' script: 'Notice the urge to self-harm. Don't fight it or act on it. Imagine it as a wave that will crest and fall. Rate the urge from 1-10 every 2 minutes. Most urges last 15-30 minutes. Distract yourself with a puzzle, a game, or calling a friend until the urge passes.'
  3. 72% success If user insists on a physical sensation, recommend 'safe' alternatives: 'Splash cold water on your face (not holding ice). Take a cold shower for 30 seconds. Eat a sour candy. Listen to loud music. These provide sensory input without risk of injury.' 
    If user insists on a physical sensation, recommend 'safe' alternatives: 'Splash cold water on your face (not holding ice). Take a cold shower for 30 seconds. Eat a sour candy. Listen to loud music. These provide sensory input without risk of injury.'

中文步骤

  1. 首先，验证情绪：‘我听到你现在非常痛苦。有这种感觉是可以的。让我们找到一种不伤害自己的应对方式。’然后提供痛苦耐受技能层次：1）TIPP（温度、剧烈运动、节奏呼吸、配对肌肉放松）。2）使用‘安抚盒’装感官物品（例如压力球、香薰乳液、纹理织物）。3）拨打危机热线（美国988）。
  2. 提供‘冲动冲浪’脚本：‘注意到自伤冲动。不要对抗它或行动。想象它是一波会涨会落的浪潮。每2分钟评分冲动1-10。大多数冲动持续15-30分钟。用拼图、游戏或打电话给朋友分散注意力直到冲动过去。’
  3. 如果用户坚持要身体感觉，推荐‘安全’替代：‘用冷水泼脸（不是握冰）。冷水淋浴30秒。吃酸糖。听大声音乐。这些提供感官输入而无受伤风险。’

Dead Ends

Common approaches that don't work:

  1. 45% fail

    Telling user to 'snap a rubber band on your wrist' can mimic the pain sensation of self-harm and reinforce the behavior.

  2. 35% fail

    Suggesting 'hold ice cubes' can cause frostbite if done repeatedly or for too long, and the cold sensation may be triggering.

  3. 30% fail

    Recommending 'draw on yourself with red marker' can be invalidating for users who feel their distress is not taken seriously.