From the Sanguinary Files, Part Three: The Anecdata of Pain

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, and I’ll edit the post to include you.

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8 Responses to From the Sanguinary Files, Part Three: The Anecdata of Pain

  1. This is interesting. As I was reading, I thought of eating disorders, something I am intimately familiar with, having been both bulimic and anorexic at various times in my life. The idea of self harm is certainly a part of any eating disorder, though people may balk at that suggestion. Vomiting, after eating massive quantities of food is most certainly a violent act and one that can be physically painful. When I was bulimic I didn’t see it that way, but I have come to, now years later. Both binging and vomiting were ways of expressing what seemed to me to be inexpressible rage. I was furious with the world and my life and at the time the bulimia was a perfect outlet for that, or so I thought. That it also had an addictive aspect to it and was almost impossible for me to stop was not a concern until many, many years into it. Thankfully I was able to stop with a great deal of help, but even now almost twenty years later I must be vigilant about my emotional state or I could easily revert to that behavior.
    I appreciate you writing about this because there is a great deal of misunderstanding around self injurious behaviors. Telling someone who is engaged in self harm not to, is unhelpful at best and can even exacerbate the desire to self harm more. (I am speaking from personal experience and as the mother to a daughter who also bites herself when frustrated.) I have no answers about any of this other than to say, the common perception of horror and the kind of societal taboo around these behaviors in no way helps. Glad you wrote this [Adkyriolexy]. Really appreciate your sharing about it.

    • adkyriolexy says:

      That’s interesting; thank you for sharing it. Do you think there’s such a thing as a way to indulge the desire to vomit in a way that doesn’t cause the long-term harm to the body and teeth?

      • I don’t know. Certainly with my own behavior is wasn’t a possibility as there was the addictive/ OCD component and so it was all or nothing. If it was all I was throwing up many times in a single day, so ultimately I chose to go for stopping the behavior entirely. However with my daughter, and people may get extremely angry with me for saying this, but I do not try to intervene. I ignore that she’s biting herself and try to talk very calmly and with tremendous love while she’s hurting herself. The biting or punching herself is a result of feelings that seem overwhelming to her, they are not the problem, they are the manifestation of an underlying problem. I prefer to try and work on the underlying problem. Almost always it’s from frustration, so I try to help her with that. But I also know that this is a longer process than I might like. But in the end this isn’t about me, this about her. And I think that becomes confusing to a great many people, because of the stigma attached to self injury. It’s fine in our society to be self deprecating and even to say, I’m such an idiot, or God, how stupid was that, etc. But to actually take those words and do an action that illustrates that thinking is NOT okay. For someone who struggles with language, particularly when stressed, the self harming behaviors seem like a logical action. (Or at least they do to me.)

      • adkyriolexy says:

        I think your approach is admirable and should be adopted, really, by all parents… but one reason it isn’t is that allowing a child to engage in such behaviors is often perceived by authorities as child neglect, and grounds for state intervention. We must Get Them The Help They Need at all costs—no matter how unhelpful or actively harmful that “help” may be.

    • adkyriolexy says:

      One of the messages I’m trying to get out to people with these tendencies is that it’s possible to indulge yourself safely, and it doesn’t mean there’s anything wrong with you. I’m not sure that applies to vomiters though.

      • Right. I heard that in what you wrote. I think it’s a really important discussion to have. Because the common assumption is – self harm=bad and must be stopped. But the focus is all wrong, or so it seems to me. Again from my own history, having well meaning people tell me – You have to stop binging and puking – was useless, unhelpful and even made it worse. I already felt I was a horrible person, I didn’t need more disapproval! I don’t know how “addictive” these other self injurious behaviors are or if they even are. With Em, I don’t think it’s addictive as much as it’s the only way she can gain control and therefore comfort from situations which feel impossible. To add to her distress by expressing my anger, disapproval or whatever is only going to increase her upset.
        My friend, Ib, (she has told me it’s okay for me to use her name) talks about how “mean” it is when someone says – You may not hit – after she’s just punched someone. That it’s illogical. And I get that. The documentary Wretches and Jabberers was a great film to watch for just this idea regarding self injury. Larry hits himself in the head when frustrated and no one intervenes. I was grateful to see that. It was ignored. Just as someone who has angry self talk is not told to be quiet. I see it as a similar issue. So while we are coming at this (perhaps) slightly differently I think the end message is a powerful one – There is nothing wrong with you. That’s key and I am so glad you’ve written about it!

  2. kezziness says:

    This is fantastic! Very though provoking blog series. Thank you so much for writing it. As an Autistic woman who self-harms, this is very refreshing to read. I have not ever heard of self-harm described this way. I have written a blog post about why I self-harm and what I do. It is just a short piece describing my story. You are welcome to use it in your blog series. I have added your blog series as a link in my self-harm blog post. Reading your blog series has inspired me to write another blog post about self-harm and explore it in more depth.

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