I'm not going to pretend I've stood on the edge as you have, but I've got fairly close, so what follows is anecdotal, but represents my thoughts on such things; These are the kind thoughts you've got to cement into your mind. If you know that when you're thinking rationally you do care, then when you're in a position thinking "**** it, I don't care" it should be a good indication that you're not thinking rationally, and that the good bit of you is under attack from the bad bit of you - and when you're under attack you've gotta fight it, not embrace it. I know I've banged on about this before but I believe people have got to see things like this as an attack - to try and push it into the domain of the basic human instinct for survival. Part of the problem with alcohol/drugs, is that you're attracted to the good bits that it offers, but with no/little self control to go with it, it invariably ends up being the bad bits that come to pass instead.. but, at least it's clear why it's hard to fight that urge (to me anyway). The other self destructive urges we can sometimes get often don't bring such habitually addictive positive elements with them, so they shouldn't be as difficult to mentally fight, or run away from. Spoiler: I'm not suggesting any of this is rose coloured easy-ness. I know what this took to manifest itself with me in the past, the hot precise tug of a razor doing non-lethal damage, to bring my mind back together, and put the good bit of me back in control. I also now have 7 or 8 reminders that I'll be wearing until I die, of the fact that I must always fight to be in control of my direction. Obviously this is a deeply personal reaction and I doubt many people who have self harmed would point to this as being their motivation. But, the key thing is building that basal trigger that puts you back in control - having a wife and child is a far more positive one if you can get it engrained deep enough... ... but in any case, it's about finding something that acts as a barrier to actually stepping over that edge.