Self-Harm Treatment: So if people are cutting and engaging in self-harm so as not to feel and express the “dark emotions”, then we can logically conclude that the treatment must necessarily involve helping people to embrace emotional pain. It has once been said that the goal of psychotherapy is not to help people feel better, but to help people better feel! Feeling is Healing!
Self harm : Feeling is healing
The following case example shows how a therapist can utilize the techniques of Integrative Mindful Exposure to help lead people directly into their avoided emotional pain so as to alleviate the desire and functional urges to cut. I often use the procedure of what I term Emotional Surfing, a synthesis of eastern mindfulness and behavioral emotional exposure approaches to harness and direct attention squarely into avoided emotions, memories, thoughts and other cues that often serve to produce mental and behavioral avoidance.
In this particular example from a recent encounter, a young woman was experience profound panic and a strong desire to complete a cutting event that she had commenced the night before. At this point, her wounds were superficial but she felt she didn’t “get it all out” and needed to cut more and deeper. She was unable to describe what it was she needed to get out. During the session she kept digging into her upper thigh where felt a desire to cut.
I simply asked her to close her eyes and focus intently on her sensations of panic and the feelings in her thigh.
I first had her focus on the sense of panic she she was able to locate in her chest (it is always important to locate a physical source of emotion).
I then asked her what emotions she was feeling in her xhest. She answered “fear and confusion”.
I then asked for any thoughts, memories or images that accompany the fear and confusion in her chest. She responded that people in white are quickly running around her bed. She quickly recognized that this was from a memory when she was hospitalized and near death from a pulmonary embolism.
After helping her to further focus on this memory, she reported feelings of fear and helplesness since she felt out of control of the circumstances and didn’t know what was going on.
She was helped to focus on these sensations and the feelings of panic quickly dissapated.
She still has the feelings in her leg that she needed to cut.
I asked her to intently focus on the feelings in her leg.
She immediately responded that she felt a heaviness in her chest. It then quickly morphed into a feel of power in her hands. Then she exclaimed I am ANGRY! This anger was directed at a former boyfriend who assaulted and raped her some years ago. I asked her if she wanted to do anything with her hands. She said, yeah, I want to beat the shit out of Sam (not his real name).
After a moment of this, she opened her eyes and stated that the urge to cut was completely gone as was the panic.
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—– So, OK, it is fairly evident from the above as well as a lot of other history not reported here, that her life was characterized by multiple forms of feeling victimized and helpless. She never felt able to express her feelings and needs for a large variety of reasons that operated through her life. And so feelings stay on the inside which drive autonomic arousal (panic/anxiety) as well as urges to cut due to undischarged anger and other emotions.
Now, one of these exercises will not permanently eradicate the desire to cut, but over time, she and others steadily learn to lose their fear and shame regarding their dark emotions and these feelings of self-harm can and often do rapidly diminish.
