From the desk of a psychologist!

Posts tagged ‘Psychological pain’

Non Suicidal Self Injury, Please don’t refer as Self Mutilators ( Cutters)

Tina had a friend who used to show up with different kinds of marks on her hands or feet. This friend used to really cover her body well, which Tina presumed to be because of religious reasons or parental pressure.Sometimes, they resembled burnt marks, while most of the time they were cut marks.Tina used to think that she has a friend, who is accident prone but after a few years she started connecting the dots. She understood that there was something not right with her friend. Tina started researching and from there she came to know about ‘ NSSI’.

Now, because of the lack of research in this field there are different terms floating and people use it as synonyms. Actually there is a very minor difference in them, let’s try to understand them in a better way:

Self Injury is the act of physically hurting yourself on purpose without the intent of committing suicide. It is a method of coping during an emotionally difficult time that helps some people temporarily feel better because they have a way to physically express and release the tension and the pain they hold inside. In other people hurting themselves produces chemical changes — endorphins, which are the same chemicals that cause a “runners high” — in their bodies that make them feel happier and more relaxed.

Emotionally or verbally punishing yourself isn’t self-injury, instead it’s what a lot of people call negative self-talk.

Unprotected sex, getting a piercing or tattoo for the pain of the act, starving yourself, etc. Those all are self-destructive but they’re not necessarily self-injury.

Emotional Cutters are people who injure themselves on purpose by making scratches or cuts on your body with a sharp object .

Self-harm includes self-injury ( as described above) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions.

The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing, hair-pulling and the ingestion of toxic substances or objects.

I thought for this article I’ll use the term ‘ Self Mutilation’ but then I understood that the term used is actually ‘ Non-Suicidal Self Injury ( NSSI). Aaron D. McClelland rightly points out, ” The term “self-mutilation” is an antiquated and misapplied descriptor for NSSI  in that it speaks to intent, however, within the vast majority of those who self-injure, their intent is for affect regulation, NOT to cause disfigurement. Many in the self-injury support community consider the term “self-mutilation” to be derogatory, hurtful and only adds to the mythology of the disorder. Most prefer the term self-injury or self-harm.”

In this post we are going to use NSSI but the title will also carry self mutilation because there are very few who understands and knows the proper term.

If you are one of those who have not seen or heard about it the first question that will crop up in your mind is going to be

” Why anyone will do so, as in harm oneself?”

This is an excerpt from a NSSI – “Because of all the abuse I began to self injury myself. It was a way to forget all the pain that was on the inside of me eating me alive. I first began doing this about the age of 8. I would take a hammer and beat my hands with it or take a hot iron and iron my hands or stomach. That worked for a little while and the burns and bruises were easy to cover up. As time passed and the abuse kept on, that didn’t seem like it was enough anymore so then I began doing the cutting along with the burning and beating. To see the wounds…made the pain inside not seem so real. You may say didn’t it hurt? My answer would be NO I didn’t feel anything. because the pain inside was just too intense and I had numbed myself to ALL PAIN. I didn’t love anyone, not even myself!”

As aptly contributed by Manjeet, ” Studies conducted by Nock and Prinstein (2004, 2005) suggest that there are four primary reason for engaging in NSSI: 1) to reduce negative emotions, 2) to feel “something” besides numbness or emptiness, 3) to avoid certain social situations, and 4) to receive social support. Although instances of all of these reasons for NSSI occur, a common misconception is that NSSI is primarily a form of social manipulation. In reality a number of studies have found that the primary reason for NSSI is reason number one: to reduce negative emotion. This seems like such a bizarre reason! How is it that inflicting physical pain or injury could be used to deal with emotional pain? Despite how paradoxical this may seem, people most often report the following reasons for NSSI: to stop bad feelings, to relieve feelings of aloneness, emptiness, or isolation, to distract from other problems, to decrease feelings of rage, to release tension, and to control racing thoughts. .”

Candance shares, “I’ve worked with adolescents in the foster care system in Orange County, California, for the past 17 years and most often teens who engage in self-mutilation (cutting) are not trying to kill themselves. Instead they find superficial cutting relieves in internal emotional pain they are feeling. It’s like releasing a valve that is built up with pressure, as the emotional pain disolves and afterward they feel better. The children who tend to engage in this behavior are often the ones who won’t talk to others about their pain or problems, but rather let it build up internally, which leads to the cutting. This behavior is also contagious in that child who witness a peer engaging in the behavior may try it as well.”

Larraine emphasizes, “I too work with young people (11-19) who self harm and I with agree Candace, that yp say self harming helps alleviate the internal pressure that builds up around issues they struggle to deal with. My experience here in England is that YP do talk to peers but issues relating to family, peers or educational expectations can far exceed their ability to cope. unfortunately this can and has led to suicide. Generally though self harming is used as a coping mechanism and I find that once we establish a non-judgmental .caring safe environment YP can move forward.”

Some people develop NSSI through observational learning; they learn it from somebody else or through the media. The chances of most people actually seeing another person self-injury are very slim, but in places such as psychiatric hospitals and prisons the odds are much higher. Since self-injury has become a part of the vernacular, part of society’s everyday knowledge, the incidence of NSSI, especially amongst teens, has exploded. Where once a self-injurer may been alone in their social group it’s common for teenagers to have friends who actively self-injure or have self-injured in the past.

Diane Sue, PhD. shares, ” I have found that many of those who persistently self-injure have underlying conditions, especially depression, anxiety and sometimes PTSD. Often there are few adults in their lives they can turn to for support.”

My research and experience has made me realize one thing that NSSI is not limited to any age group or gender. The experience of NSSI varies in different individuals. Chris White, Ed.D. says, ” Interestingly, I have observed a major change in who is engaging in this behavior over the past few years. For most of the 27 years I have been practicing, cutters were almost always women who had experienced fairly severe physical or sexual abuse as children and had begun cutting in their 20’s or 30’s. Now, I am seeing much younger girls, as well as some boys/young men, begin cutting in their early teens or even pre-adolescence, who do not have histories of trauma! Some even talk of having “cutter clubs” in their high schools where kids trade “tips” around this behavior.”

Basically the purpose is not killing or hurting oneself but it is due to lack of healthy strategies to deal with your pain. I researched and asked a lot of professionals from this field for help. From the studies and contributions from people working in this field I have tried to collaborate some strategies :

  • You need to find a healthy vent for your pain & problems.
  • It is fine to find strength from within you, but its destructive to accumulate the pain you are going through internally.There is a critical difference here, which we need to understand ; Being a person who is not talkative is amazing if you are happy with it, but if you are going through a phase where you need help, you need to gather the courage to seek it.
  • We need to understand the difference between positive & negative peer pressure. Just because someone, we consider as our style icon, is doing a certain thing, it is not necessary that we should follow them blindly. Sometimes it starts as a cool thing but stays with you forever, mutilating yourself becomes a habit which goes out of your hands.The origin of self-injury is often difficult to determine or understand. Many people are unable to remember where they first got the idea of hurting themselves, and when they actually began to self-injury.
  • If you know someone or a caretaker of a person going through this syndrome, you need to establish a non judgmental & caring atmosphere.
  • You need to be very vigilant for the early signs of injury. Ask questions and seek answers. People who self-injury usually begin by cutting themselves with a knife, razor blade, or other sharp object. From there the person tries other forms of self-injury, such as burning, hitting, etc., until they find their preferred method.
  •  If dissatisfied, bring in a person who could help. The best way you can help a person going through NSSI is connecting him to a therapist. You need an expert here because often there is a lot of underlying reason behind the NSSI behavior.
  • Allow the expression of emotions in a healthy way. Don’t bottle up inside. Often it is the fear or disturbing of expressing it which leads to self damaging path. Sometimes you also learn unhealthy way of showing your emotion, seek proper care if you are one of them in the form of a support group.
  • Don’t be scared of changes in life. Change is growth, though it is feared by most as it is also the unknown. It is being seen that the most cases of NSSI is being reported or observed in teens or mid twenties. It could be due the fact that in this phase of your life you go through a lot of changes.The best way to deal with it to be aware and ready for the new.
  • Feel the pain: Running away from your pain is never the solution.  NSSI is way for short lived relief. You need to live your feeling. There is a whole series on pain: Feel the pain, live the pain and relieve the pain which could help you with this step.
  • Do accept that there is no Shame in what you are doing. It is quite understandable that till now this was the only coping skill you had but realize one thing that it is not a healthy one. Deal with your feeling of shame and seek help.
  • For a primary self check examine your thoughts by asking yourself direct questions like; “What did you intend to accomplish through ___________?” , “What was the point to __________?”, “How did you expect people to react?”, “What did you expect to happen if you didn’t do it?”.

I would like to compare NSSI to an addiction to a depressant. You start with a feeling of euphoria, which fades away leaving you more depressed. You chase the “first time high”, sadly that is unattainable.

In the end I want to say that there are more ways of coping, you just need to look for it!
P.S. A special thanks to all those who took some time out and helped with this article.

Relieve the Pain

The final step, in the series of pain, after Feel the Pain & Live the Pain!

As Tina started processing the power of feeling your pain and accepting it, she empowered herself to relieve it.

She started relating to Tess, who shared “Accept the emotional pain for what it is, generally, “a Deeply Wounded Soul”. Hug, understand, empathize and nurture the “child” for the “wounded soul” is, or becomes that of “a child”. “The Wounded Child” needs to know that someone cares and is watching out for it, it is terrified. “The Wounded Soul” desires to be free of the fear and sorrow. It is desperate to feel safe and secure, so much so that it may be “clingy”. If the “Wounded Soul” is accepted, understood and valued as an authentic entity, “The child” may find that instead of wanting to hide in a cave or under blankets, that it is safe to go outside for a short period and engage with the world.”

It is a beautiful representation of the fact that the more you’ll run away from the emotion called ” pain”, you’ll give it power to stop your life. You’ll make it more monstrous with each passing day.

Tess also shared, “With time and patience “the Emotional Pain” may slowly, shed the dark tentacles that bind its body, and seek the warmness of the sun. Do not fight the Emotional Pain, embrace it, let it wash over you, and know that You are in Control. Claiming life back is a step by step process.

While researching about this complex phenomenon I found myself a little lost. I asked you all to help and you happily obliged.Thank you for your time and valuable contribution by filling the questionnaire. From your responses, research and my experience with individuals, here is an attempt to start relieving the pain:

1. Pain is a process and it takes its own sweet time: The power of understanding and making yourself come to terms with the fact that you can’t hurry a process, takes away the pressure from your back. If you’re going through pain you have to take the course and this journey varies for individuals.

The path is not easy as Phal Naap shares, ” Pain is enveloping and deadening. If you don’t deal with it, it deals with you in ways that lead to more depression = emotional pain. Pain changes even the perception of time so that minutes feel like hours and hours pass by in minutes. That is, your emotional day goes on a long time yet the day is over before you know it. ”
What should I do then? Phal has also addressed it by saying, “You have to fight the blunting of emotions or you get taken over by it and sit in a recursive fog of increasing pain and loneliness.

The poet, Emily Dickinson, described it:
Pain — has an Element of Blank —
It cannot recollect
When it begun — or if there were
A time when it was not —
It has no Future — but itself —
Its Infinite contain
Its Past — enlightened to perceive
New Periods — of Pain.

2. Get rid of the illogical thought that pain is a defect, which should be eliminated

In pursuing our misunderstood goal of getting rid of pain, we fail in finding the real solution to it. Somewhere when we feel pain, we feel guilty of somehow being responsible for causing it. We need to challenge this thought and understand that pain is an indicator of what is happening inside us and needs attention.

As Ginny beautifully put it,  “To face the pain puts a name on it, identifying what it is you are feeling. Forward thinking to alleviate can then be pursued. ”

3. Nurture your mindset:

 David shares,It’s signaling something, and it’s worth trying to figure out what.” Whenever we are going through pain, there must be a turbulence going inside us. Some thoughts must be stopping us to relieve the pain, we need to figure it out and change our unhealthy mindset.

Sona says, ” if one will not react to the pain the way he/she feels relaxed, then either the person will become mad or very insecure or may be some other reaction.”

4. Tune into your Inner self:

“Every time you deal with pain you get an insight into yourself and it brings you in touch with your deep inner self. Anything not dealt with escaping the issue, not solving it. You can only emerge out of that painful situation if you deal with it. And the insight that you get makes you emerge stronger, happier and a more confident person.” An anonymous sharer but an important one. Whatever doesn’t destroy you, makes you stronger.

Now, there is a difference between turning to inner self as a strength and turning pain inward. While the former can ease you out of your pain, the latter could kill you. Be very careful and understand the difference.

5. Be comfortable with yourself: 

One of the things which could make relieving pain an easy task is, being happy with who you are, and not what people think you are. Sometimes due to various societal pressures we fake our personalities. we try to act as someone totally different from who we really are.

6. Build your pain threshold:

This one came from one of the strongest at the same time a very sensitive person I have known in my life.

This strategy is really going to be very useful for all the sensitive people ,” One has no option but to face pain but people deal with it in different ways. Facing pain is inevitable and therefore important, as it is one of the main ingredients that make our emotional profile. There are two ways of dealing with the pain, one which is healthy and helps to restore our emotional equilibrium and the other that destroys it. So again, everyone has to deal with pain when they are faced with it but it is important to deal with it in a way that one doesn’t lose one’s sanity. One has to experience intense pain to recognize that there is a tipping point beyond which one loses all control of the ‘better senses’. Such people, in-spite of best intentions, usually end up depending on someone else to help them from falling off the brink or to bring them back from the depths. So I would say that as much as it is important to face and deal with the pain it is more important to prepare a strong emotional threshold which will help to maintain stability of the mind.”

7. Understand the source of pain and learn from it: 

“I think it’s important to understand where your pain is coming from and how to deal with it.  I’m currently suffering from an anxiety disorder, and ignoring the problem was making it worse.  I’ve been going to a therapist to help me find ways to break its grip.  Good luck… I know how much it hurts.  :-/” Simon states a very relevant fact you need to find out the source and learn as an individual how you react and respond to certain stimuli.

Paul says, ” Face and deal, especially when I am creating the whole thing. Find out what the lesson is.”

8. Who are you…what works for you: 

When I was going through the responses of so many people, I understood one thing, every person has their own way of going through the steps of Pain. You need to feel, live and relieve it but how you’re going to do it totally depends on you. It may be one, a combination or all of them;

  • Talking to friends
  • Crying it out
  • Finding a hobby
  •  Turning to the inner self or a higher power for help
  • Finding a therapist
  • Exercise/ yoga
  • Journal or diary writing
  • Cherish small joys
  • Don’t get on the web of negative/ terrifying thoughts
  • Be creative and develop your own way

According to Tess, ” Other utensils of help, may include, safe distractions, gentle games, arts & craft, massages , meditation, exercise of choice whether yoga or dance therapy, art therapy, sport, enhancing oneself with knowledge, keeping oneself occupied, whatever suits the adrenaline of the person. Usually, a handful of tools are more successful that one alone. It is a life dance, and the creativity of its development is to subtly transform and alter the steps of the dance throughout”

As Jcs has shared, ” Sometimes; depends on the situation. Sometimes facing the pain causes it to become worse through ruminating, focusing, obsessing, etc. Other times denial is inappropriate. Also depends on individual differences, temperament, reward-processing style. ”

9. Last but not the very bit least…LET GO

I would like to conclude this topic with a very relevant sharing by Mr. Qais, ” The burden of pain shouldn’t be carried too long as it shifts our focus from the important things in life and the most important one of them is “Time”. Our time in this world is limited and we must make the best use of it.” Cheers for this lovely thought!

Live the Pain

I am going to start with a belief that we did come to a conclusion from the previous post which talked about feeling the pain. We need to feel the emotional pain, in order to heal, to lead a healthy, balanced life.

As Shirin beautifully described it in our forum, ” Pain like any other emotion needs to be felt and lived through, for it to heal. Not facing it is equivalent to sweeping the dirt under the carpet…it may be hidden for a while, but under the layers it festers and the psychosomatic symptoms reveal themselves as mood swings, depression or even cancer at the physical level. Every emotion needs to be dealt with not pushed aside.”

Another relevant reason to feel the pain, which emerged from a discussion on this same topic is:

If you decide not to feel the pain, you end up developing an avoidant personality. You start filling your emptiness and void with negative choices like substance abuse, gambling etc.

Now, the next question is, if we are ready to feel it, how do we live with this painful emotion?

The first major step in starting this process is ACCEPTANCEYou’ve to accept there is a problem which is causing a negative, unbearable emotion inside you. Without acceptance no other steps could be taken. It is a crucial step because it requires a lot of courage to understand that there are things under this sun which is not under your control but at the same time this process of acceptance is liberating and empowering.

One thing which we can call as the golden rule and need to remember for most of the processes, we discuss here is : Process is something which needs to be worked on an everyday basis. It is not something which can be fixed and kept and acceptance is one of them. Once you’ve started the process of acceptance you actually get in the process of healing.

With acceptance comes the desire to grow, to change for the betterment. You start looking for answers and solutions. The moment we see our pain and feel it, we start living with it. Does that mean I am not doing anything just going through a sad phase?

Actually no, You’re working on your pain by living it and also sometimes by that you are able to the start the process of ” Let Go”. You no longer become scared or uneasy by the word pain which in turn make you live life to its fullest.

Karrie quoted Osho,  “You are sad. Go into your sadness rather than escaping into some activity, into some occupation, rather than going to see a friend or to a movie or turning on the radio or the tv. Rather than escaping from it, turning your back towards it, drop all activity. Close your eyes, go into it, see what it is, why it is — and see without condemning it, because if you condemn you will not be able to see the totality of it. See without judging. If you judge, you will not be able to see the whole of it. Without judgment, without condemnation, without evaluation, just watch it, what it is. Look as if it is a flower, sad; a cloud, dark; but look at it with no judgment so that you can see all the facets of it. And you will be surprised: the deeper you go into it, the more it starts dispersing. If a person can go into his sorrow deeply he will find all sorrow has evaporated. In that evaporation of sorrow is joy, is bliss.”

I found this great piece on internet. It talks about how to live you pain in a constructive way.

Emotional Pain is a three-pronged approach to being with pain fully.  These three prongs included:

Responsibility – How do I respond to pain? The goal here is to respond to pain with honestyloving acceptance, and soft openness.

Accountability – How am I accounting for my response to pain?

Being accountable for pain is the next step.  This means to account for it or to report about it.  In other words, really looking closely at how you are with your own pain or the pain of others.

Keeping Presence – Learning to open to pain and staying present with pain moment by moment.  Pain is soothed so quickly with simple, open, Presence.  The key here is to completely drop defenses and make sure that you interpret pain as simply pain.

I would like to end this post with a poem written by Glenn Johnson, a beautiful way to summarize our whole discussion;

Poem I recently wrote about pain in male female love relationships.


Thousands of miles away.
Hearts crossing oceans of memories.
A new beginning,

Hope within hope,
Reality or dream . . .
Have we crossed the universe for this chance meeting . . .
What a challenging journey . . .
An ancient history of dreams dreamed then shattered . . .
Lessons of the heart. . .
Joyful expectations of soul intertwining with soul. . .
As naked limbs intertwine with naked limbs in ecstasy. . .
Something gained, something lost, only the heart truly knows. . .
Joyful beginning. . .
Then slow piercing of the heart. . .
Loss of trust. . .
Loss of respect. . .
Loss of love. . .
Why the existence pain. . .
Pain, cruel burden of humanity. . .
God’s punishment for our sins. . .
I know not. . .
I know that pain is not for us to suffer. . .
Pain is God’s gift to us all. . .Peculiar idea. . .
I know not. . .
Humans, go ahead, take all pain from the world and you are lost forever. . .
Pain tells us we are being mistreated. . .
Pain in the face of others says we are doing harm. . .
Pain reminds us of the place we buried our hurt. . . Pain guides us to what we must heal. . .

The maniac, the Hitler, the serial murder knows no pain. . .
When the challenge of pain is denied by us, again we are lost. . .
Pain is God’s gift to us all. . .
It is our salvation. . .

God is truly awesome. . .
Our pain leads us to God’s healing of perfect eternal love. . .
Love leads us to compassion, wishing no one harm or pain. . .
In time, we feel agony and now we know to accept God’s love is to heal our pain.

Go ahead…Indulge in it!
Wait for the last post of this series; Relieve the pain!

Tag Cloud