There’s a lot of value in demystifying mental health issues that leave us feeling isolated from our peers like we’re somehow too strange to be understood. We might not even grasp everything that’s happening to us and start to believe the looks we receive from those more interested in judging than helping. I really struggled with that until I finally encountered a therapist who specialized in treating self-injury. She was able to explain to me why my body responds to pain in a way that makes it an addictive problem. All of a sudden, things about me that used to seem weird were normalized and I was able to be more accepting of myself as an imperfect human being striving toward health.
I know people cut for a variety of reasons and hope to achieve different things from it. I can’t speak to every situation, but I can talk about mine so that others can draw from it what they find helpful and leave the rest. I dug up some of my old notes from sessions I attended a year or so ago. This information revolutionized my ability to tackle my problems. I hope this will be a beneficial read for you. She talked about 2 different theories that could be used to make sense of my cutting—addiction and OCD tendencies. If either of them resonate with your self-injury experience, it might be worth bringing up with your counselor.
Self-injury as Addiction
I personally get a “high” every time I cut that leaves me feeling very euphoric for a while. This happens as a result of the opioid receptors in my brain getting overstimulated along with the body’s natural release of endorphins when an injury is sustained. But after the rush subsides, I feel like all my emotions crash and my body feels terrible and sluggish. When I’d been cutting over an extended period of time, I even woke up with nausea and dry heaves for days afterward. Apparently for some people, there is such a thing as withdrawal from self-injury. I was hesitant to call it this at first because withdrawal only seems like an appropriate phrase to me within the context of drugs/alcohol where a foreign substance is introduced into the body. However, I became more comfortable with it as she discussed how my relationship with cutting met the 2 major hallmarks of addiction.
A behavior becomes seriously addictive when you have to increase what you’re doing to get the same high that is later accompanied by withdrawal symptoms when you don’t do it. I also found that I had to cut progressively more and more to capture that same rush. Additionally, the fact that I experienced cravings for the sensation I got from hurting myself even when my day was wonderful and I had no other reason to hurt myself was also somewhat characteristic of an addict’s brain getting reprogrammed into trying to “score” every chance they get.
How this changed my approach:
When I started thinking of myself as an addict, I invested a lot more effort in researching ways to think differently that I could practice to recondition my brain to make cutting less of an instinctual urge. I also stopped putting myself in foolish situations where I was likely to grab something I could use later to hurt myself instead of trying to tell myself that cutting wasn’t really that bad of a problem for me. I guess you could say I started treating the problem more like a serious enemy than just another bad habit. I asked a close few I trusted to hold me accountable and gave them permission to ask me at any time whether or not I was cutting and made an agreement that I had to answer instead of get upset that they were wondering. I basically tried to replicate every helpful rule I could imagine helping an alcoholic stay safe from alcohol consumption between me and cutting. I tend to treat cutting like it will always be a problem for me just so I will never think I’ve outgrown it, let my guard down and mess up. Made that mistake once already.
Self-injury that has OCD Tendencies (apparently this isn’t the same as having OCD)
Cutting has always been something I’ve done in a very premeditated, thought out manner. I’m very particular about what I use to hurt myself and I have a very predictable way I go about doing it. I usually feel the urge to cut when I’m not in control of a situation that’s really important to me. I take comfort in my orderly ritual of cutting because it’s something I have complete control over. I can damage by body when and how I choose. That’s not something anyone can make me do differently. I feel calmer when I get to do it the way I want to. It also quiets the badgering urge to go do it even when I don’t want to. Apparently, those of us who need to see blood to feel that we’ve cut “correctly” share that checking aspect in common with the obsessive-compulsive drives that would make someone need to check a door multiple times to make sure they locked it.
How this changed my approach:
My therapist suggested that breaking down the behavioral part of the OCD tendencies was the way to unravel my cutting problem. I began spending more time with other people when I was upset instead of slinking away to some place where I could have the privacy or time needed to cut myself the way I’d grown attached to. If I didn’t allow the conditions that I preferred to cut in to be accessible, then I wouldn’t go through with cutting because I wouldn’t be able to do it in the way that would provide me the very damaging sort of relief I wanted.