Trigger warning: Tasteful but detailed discussions of self-injury ahead.
“And this little masochist, she’s lifting up her dress… guess I thought I could never feel the things I feel.” – Tori Amos, “Hey Jupiter”
In this article I define masochism, self-injury, and self-harm as the acts of hurting yourself on purpose with the aim of decreasing mental pain and/or increasing pleasure, whether it’s through cutting, burning, banging your head against the wall, or anything else that deliberately hurts.
Once, when I was a patient in a psychiatric hospital, another patient noticed my wrist and asked,
“So what’s the worst thing you’ve ever done to yourself?”
The hospital staff member sitting across from us overheard the question, sensed a possible imminent crisis, and took charge of the situation.
“That’s an inappropriate question,” she snapped. “People come to the hospital to get better, not to talk about what brought them here in the first place. This ward is about moving on from your bad experiences, not reliving them.”
But I had something to say about that.
“That’s not true,” I argued somewhat impatiently. “I want to talk about it.”
And so I did. And god, did it feel good.
Borderline personality disorder, the disease I’ve had since the age of about 11, includes in its definition the sufferer’s overwhelming desire to hurt themselves. Which isn’t to say that those with other diagnoses aren’t masochistic; they do hurt themselves, quite frequently. I’ve known many different flavors of people with self-placed scars on their bodies. Those with BPD, however, are more impulsively self-injurious than most.
So, understanding that, the reasons why a person (mentally ill nor not) might want to hurt themselves in dark moments are not mysterious to me. I’ve been there many, many miserable times. What’s mysterious to me are the awful, over-the-top ways in which other people react to finding out about those wounds.
Among the mentally healthy, the general consensus seems to be that each and every one of us who hurts ourselves plans to commit real and actual suicide. They look at us like hand grenades with the pin pulled out, ticking time bombs about to explode. They take away our access to prescription medications and kitchen knives and generally throw a fit. I’ll never forget the first time someone noticed the marks on my arm; their reaction stung more than the cuts did, or the depression that drove me to put them there. I was 13.
In some cases, that panic is warranted, as some masochists really do want to die – but what so many people don’t seem to understand is that many of us don’t. In fact, we want more than anything to feel alive. Hurting ourselves is just one of the few ways we know how.
And yet, beyond the in-group of people who self-injure, few seem to understand exactly how that reasoning works.
Of course, I can only speak for myself when it comes to discussing the reasons people cut, burn, bruise, or hurt themselves in any other way. But if 10 years’ experience with a chronic, serious mental condition has taught me anything, it’s that I’m never alone in my experiences. If I have felt the urge to bleed, as I most certainly have, so have countless other people – and probably for similar reasons. That’s why, though I can’t exactly speak for anyone else, I don’t take issue with generalizing my experiences to the masochistic population as a whole. Just realize, of course, that the ritual of self-induced pain differs among all people in idiosyncratic ways, as diverse and countless as the sufferers themselves.
This is not a comprehensive list of reasons why people hurt themselves. There are many, many motivating factors behind the act – so many that no one can truly know all of them. Addiction to pain can be involved, and brain chemistry, and, and, and; my aim is simply to introduce a few of the more commonly experienced (and less commonly discussed) motivations for being masochistic that I have felt personally, in the hopes of clarifying why this seemingly perplexing behavior occurs.
I know that the idea of masochism sounds counterintuitive to our Darwinian instincts, but consider this. There are a million and one reasons why people choose to self-harm, but one of the less talked-about explanations is that the despair of mental illness demands to be physical. It goes like this: psychological pain is overwhelmingly, undeniably real, but also completely invisible. No one can look at you and tell if your neurons are firing properly, even if they were to open up your head and watch your brain work. The godawful internal sensation any kind of mental illness creates stems from a place only the sufferer can feel, like a lens in our retinas that filters every source of clear light into a shade of ugly brown only we can perceive (I call this the shit filter of depression). Sometimes no one around us understands. Oftentimes, no one even tries to. But that pain really occurs, and it gets restless, trapped under the skin. Pent up, chronic, and unbearable where no one else sees it, that misery demands to come out.
So it does, through the skin. Mental pain likes to manifest as countless forms of physical distress, where it can live as tangibly as broken bones and cancer and every other “real” malady that no one seems to have as much of a problem exorcising with talk.
The desire to externalize internal suffering can be completely overwhelming and extremely impulsive. The pain tells its victims to hurt ourselves so it can escape the confines of our brains, then tortures us until we conform. Even if a self-injurious person sincerely has no intention of letting another soul know about the injury that happens in private, the pain wants to exist in the realm of the physical, where it’s just as real looking as it is real feeling.
There’s a very morbid comfort to be taken in seeing that chronic, imprisoning misery appear on the body. In this world, even small physical cuts are sometimes granted more respect, attention, and urgency than the worst mental hemorrhaging. Psychological despair deserves that respect. But that fact seems to be shrouded in doubt until the pain becomes tangible.
Physical pain is another player in the demonic masochistic game. Although many people claim not to feel the sensations of self-harm, for others it’s the whole point of the act. Pain is rejuvenating, piercing, and sharp, unlike depression, which is numbing, apathetic, and mind-rottingly dull. Voluntarily breaching the skin is never the best way to cope with any situation in the long run, but for the sake of understanding why it’s performed, it’s important to realize that it makes many of us feel present and alert. That quality of pain is invaluable for those of us who feel chronic dissociation; for example, a sense that the world is not real (derealization) or that we ourselves are not real (depersonalization).
In this way, self-harm might make us feel focused, corporeal, and in-the-moment when using medicines and therapies is trying, slow, or downright ineffective. Using masochism to feel real again is like sniffing poisonous smelling salts to wake up from a nightmare: you may feel better in the short term, but in the long term you’re still abusing your body.
Masochism is also a form of control. When life is filled to the brim with suffering and our brains feel overwhelmingly complex and impossible to regulate, masochistic blood flow and other self-injurious processes may seem like the only parts of our overflowing selves we can release and staunch at will. The intensity and duration of the pain are controllable, and are determined by no one but ourselves. Doctors mitigate medicine, teachers and bosses mitigate work, friends and family mitigate social responsibility – but we have full dominion over how much we hurt, which introduces a temporary modicum of control back into our lives.
As to whether or not masochism is a cry for help, I don’t feel it’s my place to say. Among professionals, the debate rages on; among sufferers, it seems to vary widely. Some of us do hurt ourselves, at least in part, to attract others’ attention, especially when that attention is difficult to obtain otherwise. Many of us do it only for our own private benefit. What I can say for sure is that the motivations that drive a person to masochism are never simple, always valid, and cannot be responsibly guessed at by those who don’t suffer.
Overwhelmingly, healthy people don’t understand this choice, this urge to feel pain, wherever that urge may come from. Countless sufferers learn very quickly to hide fresh injuries and old scars alike under long sleeves, sometimes even on blisteringly hot days. Cuts get blamed on cooking accidents, or the cat. Burns and bruises appear in places that no one else can see. This can go on for years.
To outsiders, the signs that self-injury leaves behind seem to inexplicably denote an instability of character (which is a myth), and evoke massive quantities of judgement. So the wounds heal, but the shame festers. Those of us who hurt ourselves are made to feel, by virtue of own loved ones’ condemnations and overhyped concern, that we are committing a sin.
And perhaps the harmful act itself should be treated the way it is – like a toxic, anti-productive, potentially life threatening problem. But the person who indulges in it certainly shouldn’t be treated like a criminal. Instead (like many actual criminals) we should be viewed through a lens of sickness, not one of sin, in the sense that we likely have a mental disease that requires treatment, as any other kind of disease would.
So how do you stop a person, especially if that person is yourself, from picking up the self-destructive weapon of choice? Many people’s instinct is to discourage the emotional impulse of masochism itself – in other words, to get us to not want to hurt ourselves. However, this is a pointless strategy. Whether through compassionate coaxing or fiery condemnation, we masochists cannot be persuaded to stop feeling what we feel, even if we’re trying to persuade ourselves.
The actual act of masochism can be diverted to something more healthy with the aid of therapy and companionship – but the urge can’t be talked out of existence. To demand that we renounce our desire to injure ourselves is just downright unrealistic, which makes it an incredibly unhelpful approach.
If you are tasked with supporting a self-harming person in any way, it’s critical that you understand this point. You will never talk us out of our desire to hurt. Trying is fruitless and frustrating and it can damage everyone involved. The masochistic whispers in our brains are probably very ingrained and stem from a much deeper thicket of problems, the treatment of which should be everyone’s priority.
Which brings us to another basic but tragically overlooked fact about self-harm: It is not the fundamental issue. Let me say that again: Whatever is causing a person to self-harm is the real problem, and it needs to be addressed. Cutting us off from our means of hurting ourselves without treating our deeper illness or problem is like putting a Band-Aid on a severed limb: it may look prettier, and you can say you tried to help, but it’s going to do pitifully little good for the person bleeding. Self-injury is the outcome of a greater problem, not the basic problem itself.
It bears repeating: Masochism is not an illness. It is a symptom of illness.
What will make a masochistic person feel better, though, is expressing our pain in any other proactive way besides hurting ourselves. Talking about it – with a trusted family member, a journal, the wall, whatever works – provides a means for that pain to become external through communication before it comes out through the skin. Many of us choose not to talk about our masochistic habits out of shame: fear that our character will be judged. However, like most fears, this particular issue can be assuaged through exposure, which in this case is conversation. Talking about it is both the opposite of, and the treatment for, shame.
It also decreases stigma on the part of the concerned listener. So when both parties are able to air their feelings and beliefs about self-harm, everyone is better off.
Unless, of course, the sufferer has no willing audience. Many uninitiated friends and family members fear the concept of self-harm because it’s so foreign and counterintuitive to their own personal experiences, and that fear can express itself as rage or even hatred of the act and its participants. That’s when support groups, therapists, and diaries become essential. It doesn’t even matter if a person’s only listener is a painting on the wall – talking about the urge to cut, burn, or self-injure in any way is the first step toward not indulging in that behavior. It’s only the first step, of course; many come after. But it’s a start.
The takeaway here is that as unreasonable and unprovoked as self-injury may seem to be from the outside at times, it is actually a deeply complex process that is often rooted in tangled psychological problems. The reasons for it exist. They may not be good reasons, or healthy ones, but they’re incredibly convincing to the person experiencing them (I can speak to that personally). The rational process is there: Hurting myself will make me feel alive on the outside because right now I think I might be dying on the inside or I can’t keep this pain inside for another second are pits of thought that I have had to climb out of, tooth and claw, many times over many years.
However, there is a way around the pain that doesn’t involve physical scarring, and it begins with talk. Tell someone who can hold you back the next time you’re moved to harm yourself. Tell someone who inspires you not to cause yourself harm in the first place. Just tell someone.
“Thought we both could use a friend to run to –