![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 12 to 36 of 36. Go back in thread:
Posted by bob on March 15, 2000, at 21:22:53
In reply to Re: noa - self injury, posted by Cynthia on March 15, 2000, at 10:54:12
My therapist has done a lot of work with adolescent teen girls and various forms of self-injury. She told me once that there are a number of reasons why someone would do this ... but the one reason I identified with was pain control. Creating pain that drowns out the pain that just happens to me without my understanding is just part of it -- knowing that *I* am hurting myself...knowing the cause, feeling (mistakenly) that I have some control over it, thinking that it's all some rational process that I understand perfectly well actually gives me some pleasure in the pain I can inflict upon myself. In that oh-so-twisted way, its more rewarding than it is painful.
eke!
bob
Posted by PattyG on March 15, 2000, at 22:02:30
In reply to Re: self injury, posted by bob on March 15, 2000, at 21:22:53
Are any of you folks diagnosed with Borderline Personality Disorder?
Posted by Vesper on March 15, 2000, at 23:09:08
In reply to Re: self injury, posted by PattyG on March 15, 2000, at 22:02:30
I read that last post about self-injury, and felt quite an adrenaline rush. It was like when I am feeling bored or depressed and suddenly remember what it is like to slide a needle into my vein, draw, watch the stream of blood enter the methamphetamine mixture, then press that plunger...instant happiness. Too bad it doesn't last and does a lot of harm. Same with cutting. I really want to cut myself lately, I long for that gush of blood pouring out...hot liquid salvation....
Can anyone relate?
Posted by Elizabeth on March 15, 2000, at 23:44:04
In reply to Re: noa - self injury, posted by Cynthia on March 15, 2000, at 10:54:12
> I thought I was alone in this. I have cut myself severaltimes, always on my left wrist , alwayst with something dull so I would have to push hard, and just enough to see the blood , over and over and over. So I have these faint scars and everyone, even the Psych think it has something to do with suicide but I am never suicidal when it happens just in a rage episode. I have never heard anyone talk about it before. I thought I was just really really weird. Thanks for the info.
There really are a lot of people who suffer from repetitive self-injury, especially (but not exclusively) young women. Actually I have a hard time believing there aren't any support groups out there for this. (Are there?)
On the other hand, as Vesper has discovered, you have to be careful. I was in group therapy for a while, and several times people were triggered to commit "parasuicidal" acts when others discussed their own self-harming. This could be a lot worse in a support group, where there's no therapist to talk to if you're feeling unsafe.
BTW I think it goes way beyond things like cutting, burning, and head-banging -- I've known people to do things like get into auto accidents, take drug overdoses, and get into unhealthy relationships.
Nobody was ever really able to explain to me why they did it (in a way that made sense to me, anyway), but it seems like there's often some sort of dissociation involved. Does that conform to people's experiences?
Posted by lizzie on March 16, 2000, at 15:40:34
In reply to Re: self injury/triggered!!, posted by Vesper on March 15, 2000, at 23:09:08
> I read that last post about self-injury, and felt quite an adrenaline rush. It was like when I am feeling bored or depressed and suddenly remember what it is like to slide a needle into my vein, draw, watch the stream of blood enter the methamphetamine mixture, then press that plunger...instant happiness. Too bad it doesn't last and does a lot of harm. Same with cutting. I really want to cut myself lately, I long for that gush of blood pouring out...hot liquid salvation....
> Can anyone relate?i can relate, big time-when i start cycling
downward i listen to nin a lot --the song
hurt, well, it says it all.
Posted by bob on March 16, 2000, at 18:31:01
In reply to Re: self-injury, posted by Elizabeth on March 15, 2000, at 23:44:04
> Nobody was ever really able to explain to me why they did it (in a way that made sense to me, anyway), but it seems like there's often some sort of dissociation involved. Does that conform to people's experiences?
Abso-f*ck*ng-lutely.
"Some sort of" is nowhere near strong enough from my perspective.
bob
[ps. that's about the only infix -- as opposed to a prefix or suffix -- in the English language ;^]
Posted by Mark H. on March 16, 2000, at 22:22:04
In reply to Re: noa - self injury, posted by kellyR. on March 13, 2000, at 19:06:08
>I don't feel myself cutting,it's like i'm not there.I geuss i'm not any help,sorry
KellyR.,
Your comments add insight and value to this discussion, so don't think you are not of any help. I've learned from you. Thank you for sharing.
Posted by Elizabeth on March 17, 2000, at 3:24:55
In reply to Re: self-injury, posted by bob on March 16, 2000, at 18:31:01
> > Nobody was ever really able to explain to me why they did it (in a way that made sense to me, anyway), but it seems like there's often some sort of dissociation involved. Does that conform to people's experiences?
>
> Abso-f*ck*ng-lutely.I take that as a "yes." :-) Can you tell me more about your dissociative experiences?
> "Some sort of" is nowhere near strong enough from my perspective.
Well, I mean, which sort(s) of dissociation can lead to self-destructiveness?
> bob
>
> [ps. that's about the only infix -- as opposed to a prefix or suffix -- in the English language ;^]And a damned useful one!
Posted by Cynthia on March 17, 2000, at 9:08:45
In reply to Re: self-injury - bob, posted by Elizabeth on March 17, 2000, at 3:24:55
Fascinating- always the same place , and always the same song- never thought of the song as a trigger. Never making the "real" connection until the next day and then what? embarassment, shame, feelings of stupidity? Vesper- I can relate to the feelings of euphoria, the release. Very hard to explain.
Posted by Kathleen on March 17, 2000, at 16:43:51
In reply to Re: self-injury - bob, posted by Cynthia on March 17, 2000, at 9:08:45
1-3 people have become triggered.
Anyone else think maybe self-injury should not be discussed because of this?
Posted by Mark H. on March 17, 2000, at 18:33:52
In reply to Re:This Thread is very Disturbing, posted by Kathleen on March 17, 2000, at 16:43:51
> 1-3 people have become triggered.
>
> Anyone else think maybe self-injury should not be discussed because of this?Dear Kathleen, I see your point, but I wonder if talking about it is triggering *because* the subject is taboo and under-discussed? In therapy I choose to ask for lots and lots of details from my fellow therapands, because it tends to normalize the experience and take the charge off of it. Some people don't like my inquisitiveness, but most perceive it as nurturing. I think, perhaps, that most people need to tell their story over and over and over again in order to put some air and light around it. Otherwise, the old wounds tend to fester in the dark of secrecy and shame, behind sterile labels.
I worked with a woman for several years who said she had been raped. When I finally asked for details, she said an old man on the street in a large city grabbed her arm and hit her on top of the head with his fist, because she didn't make eye contact with him as she walked by. Apparently, her militant sister decided that constituted "rape," and convinced my friend that that was the correct label to apply to the experience. There was no sexual contact attempted and the whole matter lasted a few seconds.
My wife was raped at 13, walking home alone from a pizza parlor at midnight in Fresno. Two men in their early 20s grabbed her and shoved her into the bushes next to the sidewalk, and one held the blade of a hunting knife in her mouth while the other had intercourse with her. It was her first sexual experience. She felt she couldn't tell her parents. She became pregnant from the incident. Abortions at the time were illegal and were provided by the same people who sold heroin. My wife had an abortion and started a heroin habit at 13. Her first consensual lover was a merchant marine 10 years her senior who told her during sex that it was OK for her to move. She thought he was very kind indeed.
Both women can say, "I was raped" and most people will politely leave it at that, imagining whatever they think the label means. I think it helps to discuss the gory details so that each can take back her power and not feel triggered by mere mention of someone else's experience. Obviously, one approach does not work for everyone, and sometimes indirection is more effective.
I am more concerned about the potential of this list promoting secrecy and taboos than I am about the possibility of someone being triggered by stories of self-injury, but that's just my opinion, and perhaps I'm wrong. I believe in the healing power of openness and communication, and the compassion and understanding they can invoke from others. We assume self-injury, by definition, is "bad." Why is that? What part is cultural? Where do we draw the line? How will we ever know without the details?
Thank you for your consideration.
Posted by bob on March 17, 2000, at 19:24:01
In reply to Re: self-injury - bob, posted by Elizabeth on March 17, 2000, at 3:24:55
> I take that as a "yes." :-) Can you tell me more about your dissociative experiences?
>... I mean, which sort(s) of dissociation can lead to self-destructiveness?For me, you're putting the cart before the horse. It's a rather vicious circle, but it begins with the self-injury. To mix metaphors even further, any prelude to my self-injurious behavior is like a baited hook, and without the right meds (or so it seems) I just can't resist a nibble....
The dissociation, for me, comes in an almost Cartesian mind-body split -- if my consciousness could somehow step out of and behind my body and get some sense of "physically" compelling me to continue, it would be all the more rewarding. I guess that's some response to the part of mind that's trying to say "HEY BOB!! This is STUPID! Stop hurting yourself!!" ... if I could separate my mind from my body, it could almost seem like I was doing it to someone else ... or, perhaps [just try to make sense of THIS], I was me and the someone else at the same time, feeling the pain AND dishing it out with a sense of disconnectedness between the two that might shut up that voice trying to tell me I wasn't doing myself any good.
Then again, the part of me that wants to inflict that pain is rather vicious, cruel, and unforgiving. From all the reports I get from my friends, that's just the opposite of how I am to others. Perhaps I just can't integrate the two me's. The "good" part of me just can't accept that sort of behavior in anyone, particularly me.
Hope that makes some sense,
bob
Posted by Kathleen on March 18, 2000, at 0:48:17
In reply to Re: self-injury - bob and his evil twin, posted by bob on March 17, 2000, at 19:24:01
I agree with you Mark for the most part, except that certain aspects of certain disorders probably shouldn't be talked about. For example, anorexics should not discuss diet tips.
I'm wondering if self injurers should discuss hurting themselves. To me, it sounds like 3 people were 'triggered' here. I don't know anything about this disorder, and believe a professional who does should decide if this is a topic for this board.
Posted by PattyG on March 18, 2000, at 9:06:29
In reply to You missed my point:Dr Bob please read this thread, posted by Kathleen on March 18, 2000, at 0:48:17
Usually, when there is a discussion about self-injury, folks will put a "warning" label with the message. That way, the people who are uncomfortable with the topic or feel triggered by the discussion can choose to skip those particular posts. I have witnessed both approaches to the topic (open and forewarned) and I have respect for both. Would that be a solution for the problem?
"Warning: Topic - Self-injury"
Posted by PattyG on March 18, 2000, at 9:11:23
In reply to Re: self-injury - bob and his evil twin, posted by bob on March 17, 2000, at 19:24:01
Then again, the part of me that wants to inflict that pain is rather vicious, cruel, and unforgiving. From all the
reports I get from my friends, that's just the opposite of how I am to others. Perhaps I just can't integrate the two
me's. The "good" part of me just can't accept that sort of behavior in anyone, particularly me.Hope that makes some sense,
bob///Isn't the purpose of therapy for some folks to help with the reintegration of the "split" personalities? (Obviously, some are to greater or lesser degrees. Some could be multiple personalities and others could be suffering from Dissociative Identity Disorder....but again, to varying degrees?) Some thoughts, anyway.
Posted by bob on March 18, 2000, at 9:36:54
In reply to You missed my point:Dr Bob please read this thread, posted by Kathleen on March 18, 2000, at 0:48:17
Kathleen,
First of all, your compassion is touching and very much appreciated. Thank you for caring, and for expressing it so strongly. =^)
If I'm one of the three, you can cut it back to two (no pun...okay, pun intended). As I mentioned in my last post, the right meds keep me from engaging in my own form of self-injury ... and I happen to be on them right now.
I'd also say that the "triggers" aren't necessarily so specific as to worry about this conversation. If I was hurting myself, there is somewhat of a class of triggers for it. If it's not one thing, it would be another.
Bottom line: I still have needed to talk about these issues with my therapist. It has to come out. It needs examination.
This board is perhaps an even more important forum for discussing it for several reasons:
(1) I learn from others who cut or injure themselves and it's a mirror for me. Somewhat of a funhouse mirror, at that -- definitely "distorted" from my own view of myself, but is the distortion in my mind or the mirror? Seeing a different perspective on the same sort of behavior gives me different insights than I can generate on my own.
(2) There are always the lurkers out there who read and seldom, if ever, respond. Not everyone needs to chip in their two cents to learn something from this board or find some new perspective on why they do what they do. Cutting is one particular behavior that people try to hide. It can be really difficult to expose yourself and your behaviors to others. Sometimes, it's the fear of the reactions of others -- disgust, pity, horror, or that look in their faces that says "You are really one sick mother...". What is rewarding when it's private and secret can become a great source of shame when brought out in the open. Another reason -- and this one really has a grip on me when I'm doing it -- is the sense of control over my pain. I don't want ANYONE to take that away from me; I don't want anyone to stop me. Making it public means a loss of control, since there will be at the least some social pressure to stop and, at the worst, someone pushing for involuntary hospitalization. For the cutters out there who don't want to expose themselves to public scrutiny but still NEED to have some better understanding about why we do what we do, this conversation can be very informative and therapeutic.
(3) Finally, you said you don't understand this behavior yourself.
If you have some issues with depression of your own and YOU can't understand us, how do you think we'll fare with the "normals" out there? I really appreciated Elizabeth's questions because they worked to inform me as much as they were to inform anyone else NOT into self-injury. That is our burden in general -- we need to make the "normal" public understand who we are and what we face day in and day out if we're ever going to successfully fight the stigma that surrounds the "mentally ill" and get the parity of treatment we need and deserve. Before we can do that, tho, we have to understand ourselves. We cannot be effective in our advocacy if we don't know how to communicate effectively about it.
So, again, thank you for your passion and your compassion. You're right, this thread may act as a trigger for some -- but if this thread wasn't here, they'd just find another trigger, or one would come along. I, for one, think that far more light is being spread than darkness by this coversation.
cheers,
bob
Posted by CarolAnn on March 18, 2000, at 10:10:19
In reply to Re: You missed my point..., posted by bob on March 18, 2000, at 9:36:54
Hey Bob, I haven't read the whole thread, so forgive me if this has already been covered.
Do you think that "cutting" behavior is, at least, in some part a self-punishment? I've never actually been in a state of self-injury, but I have been in situations where I am so angry and frustrated at myself that I hurt myself by hitting or biting. It's never been to the point of injury, I always manage to restrain myself just enough to avoid that(and I think the only reason for the restraint, is the knowledge of how shameful it would be to have to explain how the injury happened). Anyway, I'd love to have your two cents on this...got change for a quarter? CarolAnn
Posted by dove on March 18, 2000, at 10:46:41
In reply to Re: You missed my point..., posted by bob on March 18, 2000, at 9:36:54
This is one of those topics that I hesitate to get involved with, very serious issues. I truly believe the concept of self-injury is directly connected to control and strong emotions that the person feels unable to deal with.
In my geanology, there are at least four generations of women folk who practised a form of limited self-injury. Pulling out hair, nearly unnoticeable to those around; picking scabs, both visible and nonexistant; scratching, this one being the most noticeable and severe. The scratching was/is the biggy, scars on chest and arms and neck, and definitely triggered by any strong emotions, especially those emotions that they/we were/are trying to smother.
The self-injury does accompany a distinct personality profile. Every female in the family who practises also has struggled with major depression, hyperactiveness, volitile and extreme mood-swings, self-loathing, hopelessness, suicidal acts, in addition to being artistic (musicians/writers/painters).
One big thing expressed by all of these women is a feeling of being out-of-control, and how the injury makes them feel safe. Also along these lines, most of their first marriages (or only marriages) was/were to violent, physically controlling men. The physical abuse seems to make them feel safe, like there's this safety net that will keep them from actually hitting the ground. The worst part is their inability to function without the physical restraints in place. It is harder to be in self-control then to be controlled by someone else, who can make all the decisions for you, and carry the burden of those decisions and resulting consequences.
Self injury is like a fake control, an act that helps free the stuffed emotions but doesn't actually help you *go* anywhere with those feelings, doesn't help the *problem* of being unable to express yourself, and doesn't empower you to act on your feelings, or make decisions with eyes wide open.
It's a false sense of security, of control, of expression. Yet, it is incredibly seductive and possibly addictive. The release is always laced with shame, and even more anger directed at self though. A sense of cockiness and superiority accompanies the behavior, at least for me. Like, I've got all this control and power and a storm in my soul that needs to rage, rage against something, so why not me, all nice and private, no one to apologize to, just me.
I can remember being in the throws of a severe depression (with agitated anger and hopelessness) and I was trying to tell my dad what was wrong. Everytime I opened my mouth to speak, my tongue froze, and my dad just got angrier and angrier. Finally, overwhelmed and thoroughly unable to speak, I sprinted across the room and threw myself into a window. It hurt, but at the same time, it didn't. My dad was not exactly impressed with my enlightening *expression*, his own mother expressing herself in the same manner dozens of times throughout his own childhood. Short story long, he told me to get some self-control, and speak, not act on those feelings.
What have I learned? I know what triggers the behavior, feeling overwhelmed, feeling out-of-control, and feeling detached from myself. I know it's not the same as suicidal tendencies. Although, in itself, it can trigger or fuel that downward spiral. And, its call is very hard to ignore, and meds definitely lend strength to the battle, significantly. I've really rambled long, if you made it to the end, I hope it was worth your time.
dove
Posted by kellyR. on March 18, 2000, at 17:34:44
In reply to Re: self injury, posted by PattyG on March 15, 2000, at 22:02:30
> Are any of you folks diagnosed with Borderline Personality Disorder?
I was told by 2 different Dr.'s that i was BPD.
kellyR.
Posted by bob on March 19, 2000, at 1:07:15
In reply to Re: Self control, posted by dove on March 18, 2000, at 10:46:41
CarolAnn asked:
>Do you think that "cutting" behavior is, at least, in some part a self-punishment?I mentioned elsewhere that my therapist does a lot of work with young women who engage in self-injury -- this group being the majority of folks who do this. She tells me there are a variety of reasons people do it but, as dove pointed out so clearly (it definitely was NOT a ramble, dove), it is often an issue of control.
What struck me most in what dove had to say was this:
> Self injury is like a fake control, an act that helps free the stuffed emotions but doesn't actually help you *go* anywhere with those feelings, doesn't help the *problem* of being unable to express yourself, and doesn't empower you to act on your feelings, or make decisions with eyes wide open.
>
> It's a false sense of security, of control, of expression. Yet, it is incredibly seductive and possibly addictive.So, to the extent that humans punish in order to control -- yes, there is undeniably an element of self-punishment in it.
All the same -- in my own case, at least -- self-punishment is not the primary motive. I do it to control the pain, when the pain in my life becomes unbearable. I've been cursed with a pretty agile mind and I learned at an early age that there was no logical, rational cause for my pain. Being a kid, I did what most kids do -- I blamed myself, conjuring reasons that made the sort of sense that eight year-olds make of the world.
By the time I got to college and away from my family, finally in a place where I could question what had gone on for the previous ten years of my life, the old reasons stopped making sense. Nothing did. Without a cause, without a reason, I had lost all hope that the pain would ever go away. What I learned, tho, was that I could drown that pain out by hurting myself. It was an extremely powerful discovery for me. It created a sense of order to my pain, and I was in control of it.
The bottom line about it for me gets back to the tremendous amount of guilt that's bound up in my condition. Being punished, having pain inflicted upon me by some unknown other didn't make sense. Hurting myself, in my mind's twisted logic, brings about some sense of justice ... even though I really can't give any specific reason why, when I'm into it I *know* I deserve it, and I enjoy dishing it out as much as I hurt in taking it.
But I don't think the self-punishment itself would be such a strong draw if it wasn't for (1) my belief that I was in control of it and (2) the extreme sense of satisfaction I get from making me pay for imagined sins.
Sorry, CarolAnn, no change for that quarter,
bob[... I'm saving up to buy a hairshirt]
Posted by Noa on March 19, 2000, at 12:29:43
In reply to Hopefully, some harmony to dove's eloquence ..., posted by bob on March 19, 2000, at 1:07:15
Michael Gold, MD, in his book about medical advances in treating depression, says that people who engage in self injury might have a deficiency in endorphins such as oxytocin, the release of which is stimulated by injury (it helps to heal), and that this might lead to a better understanding of why people cut themselves.
Posted by PattyG on March 19, 2000, at 13:13:53
In reply to Re: Throwing in a bit of biology..., posted by Noa on March 19, 2000, at 12:29:43
deficiency in endorphins such as oxytocin
//Okay, how does one go about replacing this/these? Is that possible? I've never heard this theory. Intersting.
Posted by Mark H. on March 20, 2000, at 15:47:35
In reply to You missed my point:Dr Bob please read this thread, posted by Kathleen on March 18, 2000, at 0:48:17
> I'm wondering if self injurers should discuss hurting themselves.I think Kathleen has asked a good question. I've given it a lot of thought in the last several days, and I still have to say my opinion is, "Yes."
From my point of view, the purpose of this forum is to share personal experiences, to ask questions and to offer perspective, and especially to have a safe place to discuss aspects of life and mental health that we may be afraid to discuss elsewhere, even with our closest family, friends, colleagues and medical advisors. This forum is not a replacement for professional care and therapy, but it can be a valuable adjunct and source of information and support.
Kathleen and I would probably agree that there are topics and modes of presentation that would be completely inappropriate, especially expressions of cruelty and encouragement of behavior that is illegal and/or dangerous.
But as long as the intention of the person posting is one of healing (or self-revealing) rather than harming, I think everyone should be welcomed and encouraged to discuss their experiences in as much detail as they wish.
I realize that intentions can be masked and also misinterpreted by others, but that still gives us an enormous amount of room to discuss taboos and behavior that cause people private shame and suffering and the possibility of relieving some of that suffering through better understanding and mutual support.
Let me use a relatively unemotional example from real life. I've known two people in our community, one profoundly schizophrenic, who were triggered by information about the Holocaust. Nevertheless, I don't suggest we remove books on the topic from the library, or that people should be required to prove their sanity before reading them. On the other hand, if I had a therapeutic contract with the person -- he or she asked for my advice -- I wouldn't hesitate to say, "Don't read that stuff! It doesn't help you!"
And I guess that's where I draw the line here. If a person says, "Don't read threads about self-injury if you're going to be triggered to hurt yourself," then that is good advice, and readers are free to take it or not. That's different, of course, than saying, "No more posts about self-injury." (Please note that Kathleen did NOT say that; she just asked the question.)
I have learned a lot from this thread, and I think the benefits outweigh the risks. I'm still open to changing my mind as I read more, but these are my thoughts thus far. I've ordered the recommended book from Amazon and look forward to learning more.
Many thanks to all who have contributed to this thread.
Posted by PattyG on March 20, 2000, at 17:01:44
In reply to Re: You missed my point, posted by Mark H. on March 20, 2000, at 15:47:35
I guess my thinking was that Kathleen was concerned that some folks wandered into this discussion and only then realized that they were feeling triggered by the topic. I agree that just about everything should be fair game with regard to discussion. However, I still do wonder about the useage of some "warning" labels when we drift into conversations regarding self-injury. It seems to me there are people who are more easily bothered by such talk, but they also have the right to be "protected" with a warning, of sorts. Thoughts?
Posted by Lizfromphoenix on January 25, 2001, at 9:44:36
In reply to Re: Throwing in a bit of biology..., posted by Noa on March 19, 2000, at 12:29:43
> Michael Gold, MD, in his book about medical advances in treating depression, says that people who engage in self injury might have a deficiency in endorphins such as oxytocin, the release of which is stimulated by injury (it helps to heal), and that this might lead to a better understanding of why people cut themselves.
BINGO! This theory makes more sense to me personally. Since I have been on antidepressants for 5 years, I noticed almost immediately the change in my body's ability to heal. The process was much much slower. That was also the time I began my skin picking behavior, and unfortunately, those wounds take much much longer to heal! I will research this information, but in the mean time, does anyone know how the body can produce more oxytocin?
This is the end of the thread.
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