Re: extreem self mutilation
I am 59 and have self-injured as recently as last fall. It can become like an addiction and very hard to break.
I didn't know why I did it either until I started to remember years of abuse as a very young child. When I would start to "flashback" and dissociate, I would use the self-injury to bring me back to reality. And because I was in a dissociated state, I felt very little of it so I ended up having to do worse and worse things to myself to bring myself back to the here and now. This is very common PTSD behavior and that was what I had but unfortunately, PTSD didn't yet exist as a diagnosis or even a disorder. So I was told I did it for attention. That started me hiding it and that resulted in even bigger problems as I often got infections or sick as a result. And that doc was WRONG. This is not attention getting behavior. This is my way of bringing me back to reality.
But I did realize that I was increasing the seriousness of the injuries and that I had to stop it before I died. I won't go into what I did to myself except to say I was in danger of dying more than once. So I worked really hard on finding other ways to bring myself back to reality. And I did it with no therapy....just by myself. I tried all sorts of things to help me come back to reality when I started to dissociate. Finally, I realized that I could just ride it out and I would come back no matter how bad it was so I would literally tie myself up in my sheets and stay there and cry or scream or completely disappear for a day or 2. Once I knew I had control and I could bring myself back eventually, I just let it go. and I slowly let go of the self-injury.
Yeah, like most people, I do have times when I choose to not control it and I go out and slug a tree or something.....just a little pain to push the process along. But I have given it up in 95% of the instances where I used to use it. And I forgive myself when I do use it.
It's all about figuring out what you are using it for. What does the pain do for you? You wouldn't do it if it didn't do something for you. For me, it brought me back to reality when I felt like I was drifting away. Some do it as an expression of their own pain. Some do it for attention that they really need and lack from their past. Figure out why you do it. Takes a lot of self-honesty but you can't change something if you don't know why you do it.
Once you figure that part out, then you find other ways to get the same thing.
I hope this helps you.