When I met Renee she told me she was nervous all of the time. And, she was cutting herself.
Some people resort to self-harm when they're overwhelmed by emotions. When we feel utterly alone and out of control, we’re capable of doing illogical things to stop bad feelings. Self-harm can become a reliable way to cope. It can also be unlearned and replaced with healthier ways to soothe ourselves.
Fear and feeling "bad."
When we met, Renee told me that part of her mind was constantly yelling at her, just as her father had yelled at her throughout her childhood.
“You’re a stupid little shit,” the male voice in her head would say.
As an adult, this made her feel she was a “bad person.” Both the real and imagined anger of other people terrified her – they were huge triggers for Renee, connecting her back to early memories of her father’s rages.
The feelings would come up quickly and were absolutely excruciating. The only way she had discovered to stop them was to inflict pain on her own body.
Her cutting seemed to satisfy two purposes:
Self-punishment for her perceived badness; and
It somehow stopping the emotions from intensifying any further.
Start with compassion.
Symptoms like cutting are often described as “just crazy.” In fact they are, in some ways, wise. They can be thought of as a person’s best attempt to become calm in the face of utter aloneness. Despite the fact that they are ultimately hurtful, both the intention and the short-term effect of self-harming behaviors are, in a way, helpful to the sufferer.
Time and again, my patients are relieved when I share this positive understanding of their self-harming behaviors. I invite them to approach their behavior with a stance of curiosity and compassion for themselves.
Then learn healthy ways to self-soothe.
Symptoms like cutting won’t go away until the sufferer has other ways to calm their emotional overwhelm. To ask someone to stop cutting without offering alternative ways to achieve comfort is akin to asking a trapeze artist to give up their safety net.
Renee and I experimented with many ways to help calm her emotions such as:
Grounding her feet on the floor,
Talking about light-hearted things like her favorite television shows
Wrapping a blanket around her,
Calling a trusted friend,
Trying to parse out the overwhelm into bite-sized pieces.
Renee and I worked together on calming her anxiety by learning what emotions were being triggered and accessing and processing the anger at her father. She slowly learned how to tolerate and channel any feelings of anger at others in a healthy way by asserting herself. She eventually built up her access to and tolerance of the full spectrum of emotions and their accompanying physical sensations.
After about six months of treatment, Renee grew much more compassionate to herself. She came to understand how her traumas affected her and her self-harming behaviors were no longer needed. She appreciated them for how they helped at one time. She still had painful and powerful feelings like we all do, but now Renee was relieved and proud that she had new, better ways to cope.
(Patient details have been changed to protect confidentiality)
Hilary Jacobs Hendel, LCSW is a psychotherapist, author, blogger, and speaker specializing in emotions and how to work with them to feel better. Her New York Times article, “It’s Not Always Depression, Sometimes It’s Shame” was the #1 emailed article on March 10, 2015 and lead to the book Hilary is currently writing entitled “It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, & Connect to Your Authentic Self "(Random House USA & Viking Penguin UK, 2018). She also enjoyed being the Mental Health Consultant to the television show Mad Men.
You can sign up for Hilary’s blog to learn more about emotions, tips for everyday living, and updates on the book at hilaryjacobshendel.com.
(Originally published on Hilary's blog on September 15, 2016)