The post you’ve all been waiting for. I apologize for the delay; this has been “in the works” for months now, but life and distraction and general bloggy-incompetence get in the way.
Note: As with all Sanguinary Files posts, may be disturbing to the blood/injury squeamish.
I asserted in my first two Sanguinary Files posts that the common assumption in medical and psychotherapeutic communities (and society at large) about self-injurious behavior—that it’s always rooted in emotional distress—is both inaccurate and harmful. But that raises the question: what does motivate self-injurers? Not trusting the existing medical data (for already-explained reasons), I can only answer that question anecdotally. I didn’t want to limit my answer to my own experiences, because there’s only one of me, and, who knows, I might be exceptional. I also didn’t want to suggest that a narrative based on me should replace the existing narrative (as some who gave unfavorable reviews to my earlier posts accused me of doing).
Instead, I wanted to push the idea that there are many, wide-ranging, diverse motivations for this type of behavior, and that, therefore, it is inappropriate for professionals to make any assumptions at all about motive. So I asked several people, both on and off the autism spectrum, to describe their motivations and thought processes behind engaging in self-injurious behavior. I’ve paraphrased and summarized the responses, with respondents’ permission, to preserve anonymity.
L, an autistic and ADHD woman, describes biting her tongue and cheeks to resolve mouth sores that bother her, or sometimes to relieve stress. She describes the sensation and the taste of blood as “euphoric” and sweet. She rarely bites anything outside her mouth, but occasionally bites her hand when stressed, which she says feels “victorious” because it gives her a sense of control.
G, a non-speaking autistic student, would be removed from the classroom and secluded for self-injury, so she learned to bite herself to get out of class or out of stressful social situations. She also found the numbing effect of pain a welcome relief from sensory overload.
H, a neurotypical woman, cuts herself for masochistic sexual pleasure. She deeply enjoys both the stinging pain in her flesh and the aesthetic appeal of the marks it leaves.
E, an autistic woman, became interested in ritual bloodletting. She felt that by releasing blood, she could purify herself and become healthier.
O, a non-autistic man, considers burning himself both a relief of stress and a test of resolve, wondering what it feels like and how much he can tolerate it. He classifies it as akin to an endurance sport where he competes against himself.
M, a woman with Asperger’s, used to cut herself due to depression when she was a teenager. She says, “I believe it was to feel anything other than the crushing depression I lived in every day. To have something to focus my racing mind upon. Something else to obsess about, instead of my sadness and pain.” After receiving her Asperger’s diagnosis, she realized that inability to understand and cope with her neurological differences was the root of her depression.
S, a neurotypical woman, has a sexual obsession with blood. She enjoys vampire and bloodletting fantasies, and found self-cutting an erotic experience.
P, an ADHD woman who considers herself part of the Broader Autism Phenotype, never had a physical impulse to self-injury, nor derived any physical pleasure from it, but consciously decided to do it to relieve mental distress, and was comforted by leaving marks.
Z, a non-autistic woman, finds spilling blood akin to a purging or cleansing of the body and mind, making her feel a sense of accomplishment, and relieved of worries and problems.
D, an autistic woman, describes the feeling she gets from biting and hitting herself as “Ecstasy. What normals get from chocolate and sex, I get from this.”
Y, an ADHD woman, practices scarification as an art. Marking her flesh expresses her individuality and conveys beauty.
W, an autistic man, feels an irresistible compulsion to hit and bite himself when he enters sensory or mental overload. He doesn’t enjoy it, but it’s an impulsive reaction.
B, an autistic woman, likens her practice to religious traditions such as mortification of the flesh, describing the experience as “pure pleasure” and “spiritual ecstasy.”
T, an autistic (“and overall weird”) woman, started cutting herself in visible places as a way of taking revenge on people by making them uncomfortable. She also found it physically pleasurable, erotic, and aesthetically beautiful.
R, a neurotypical woman, describes sticking herself with pins as “ghetto acupuncture,” similar to a self-massage.
C, an autistic woman, bites and pricks herself for physical pleasure, both sexual and non-sexual. She said she couldn’t describe it in more depth than “I just like it. It feels good.”
N, a neurotypical woman, tried cutting herself because she’d read about it as a means of stress relief. She found it unsatisfactory, and didn’t repeat it.
Writing in ThAutcast, Landon Bryce describes his experience of self-injury as part of an autistic meltdown (and gave me permission to cite his work by name).
Bridget from “It’s Bridget’s Word” describes her experience with autistic self-injurious behaviors (which she distinguishes from emotional self-harm) in this post.
And then, me. I usually do painful things to myself for their own sake, for the physical pleasure of it. It’s a visceral physical impulse, but one that I can choose to suppress (although suppressing it for very long makes me unhappy). Sometimes, it’s a release from stress, and sometimes, it’s a willful defiance of those who would try to control or pathologize me. But neither of those is the root motivation; I enjoy it most when I’m feeling neither stressed nor defiant.
This list is nothing close to comprehensive or scientific. It’s a very small, self-selecting, non-representative sample (for one thing, it’s very heavily skewed female) collected by a very amateur blogger with an agenda. However, I believe it does successfully convey one thing: if you’re looking for a single answer to why people practice self-injurious behavior, there isn’t one. For some, it’s an impulsive physical craving; for others, it’s a conscious choice. For some, the goal is in physical sensation; for others, the desired result is mental. Some people enjoy it and take great pleasure in it. Some people hate it, but feel driven to it by upset, stress, depression, or meltdown. Sometimes it’s sexual. Sometimes it’s not. Some people have no desire to change the behavior or “recover” from it, and some have desperately wished they could stop. And one person can have different motivations at different times, varying by her mood or circumstance, or can have multiple motivations at once. Autistics and others with atypical sensory processing may be more likely than sensory-typical people to experience physical pleasure from self-injury, or engage in it for physical reasons, but that is yet to be determined.
Intended Moral Lesson (yes, sometimes I like to drop the anvil): if someone you know is doing painful things to him/herself, make no assumptions as to why. Don’t leap to the kneejerk reactions of “cry for help” or “needs therapy.” Instead, ask him/her, and accept and believe whatever he/she answers (including “none of your business”).
If you’ve done painful things to yourself and would like to have your motivation included in this list, leave it in the comments, or email me at firstname.lastname@example.org, and I’ll edit the post to include you.