What We Treat
Compassionate, individualized treatment for self-harm and the pain underneath it from licensed clinicians, in person in San Pedro or online.
Self-harm is often not a suicide attempt, but if there is any danger to your life, you have seriously injured yourself, or you are having thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911. Both are free, confidential, and available 24 hours a day. Coastwise provides ongoing outpatient therapy, not emergency crisis care, so please reach a crisis line or emergency services first if you are not safe right now.
Non-suicidal self-injury is hurting your own body on purpose as a way to cope with emotion that has become overwhelming. It can look like cutting, burning, scratching, hitting, or other ways of causing physical pain. For many people it is not about wanting to die. It is about finding some relief, feeling something when you have gone numb, or letting out a pain that has no other way to come out.
Self-harm is usually private, hidden, and carried with a lot of shame. It is not attention-seeking, and it is not a character flaw. It is a sign that the pain has gotten bigger than the ways you have to handle it, and that deserves compassion and real care.
Hurting yourself to release tension, ease emotional pain, or feel a sense of control.
A build-up of feeling that the self-harm briefly quiets.
Feeling disconnected, and using pain to feel present again.
Hiding injuries and carrying shame about it.
Urges that come back even when you want them to stop.
Self-harm rarely stands alone. It usually grows out of pain that has another name, and treating what is underneath is part of the same work. Each area below has a page that explains how we approach it.
Low mood, numbness, and hopelessness that self-harm can briefly quiet.
Painful experiences that often sit beneath the urge to self-injure.
A nervous system stuck on high alert after trauma, treated alongside the self-harm.
Trauma from prolonged or repeated harm, which frequently overlaps with self-injury.
Overwhelming worry and tension that can build until it needs an outlet.
Related but distinct, and if thoughts of suicide are present, we treat that with care too.
We begin where you are, without judgment. Early sessions focus on understanding what the self-harm does for you and building other ways to get through the moments that trigger it. From there, we treat what is driving the urges rather than the behavior alone.
Well suited to self-harm, building concrete skills for emotion regulation and distress tolerance so intense feeling has somewhere to go besides your own body.
Works on the thoughts and patterns that feed the urge, so it loses some of its hold.
Because self-harm so often grows out of trauma or depression, we treat those underlying conditions as part of the same work.
| Approach | Best suited for | How it works |
|---|---|---|
| DBT | Strong urges and overwhelming emotion | Builds emotion-regulation and distress-tolerance skills so intense feeling has somewhere to go besides your body. |
| CBT | The thoughts and patterns that feed the urge | Reworks the thinking that keeps self-harm feeling like the only option. |
| Trauma-focused care | Self-harm rooted in past trauma or depression | Treats the underlying condition so the urge has less to draw on over time. |
Starting therapy should feel clear, not overwhelming. Here is how it works at Coastwise.
We start with a short, private conversation to understand what you are carrying and what you want from therapy, at whatever pace feels safe.
We pair you with a licensed clinician experienced with self-harm and the trauma or depression underneath it, not whoever happens to be free.
Your clinician builds a plan with you and works gently, so you build other ways to cope and progress feels steady.
Outpatient therapy is a strong fit for ongoing self-harm urges, for the trauma or depression underneath them, and for building skills and a steadier life over time. It is not a substitute for emergency care. If you have seriously injured yourself, are in acute crisis, or are having thoughts of suicide, a crisis line (988) or emergency services (911) is the right first step, and we are glad to be the ongoing support once you are safe. If a higher level of care is ever needed, we will help you find it.
See us in person at our San Pedro office or work with a clinician securely online anywhere in California. We will help match you to a therapist experienced with this, and we treat what you bring with care and without judgment.
If you are in immediate danger, have seriously injured yourself, or are having thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911. These services are free, confidential, and available 24 hours a day. Coastwise provides ongoing outpatient therapy rather than emergency crisis care, so please reach a crisis line or emergency services first if you are not safe right now.
Often it is not. Non-suicidal self-injury is usually a way of coping with overwhelming emotion rather than an attempt to end one's life. That said, self-harm and suicidal thoughts can overlap, and the risk is real. If there is any danger to your life or you are having thoughts of suicide, call or text 988 or call 911 first.
No. Self-harm is usually private and hidden, and it is a way of managing pain that has become too much to hold. People turn to it for relief, to feel something, or to express what they cannot put into words. It deserves compassion and real treatment, not judgment.
Dialectical Behavior Therapy (DBT) is well suited to self-harm, building concrete skills for emotion regulation and distress tolerance so you have other ways to get through the hardest moments. CBT addresses the thoughts and patterns that feed the urge. We also treat the underlying trauma, depression, or anxiety, because lasting relief usually comes from addressing the whole picture.
We work with insurance, and many clients use their benefits toward therapy with us. Call (424) 536-3002 to learn how your insurance can help cover the cost of therapy. Cost should never be the reason you don't reach out.
If you are safe right now and ready to talk, call us for a free, confidential consultation and we will match you to a clinician who treats this. If you are in danger or having thoughts of suicide, call or text 988 first.
Call (424) 536-3002 Get Started