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1. To Escape Emptiness and Feel Alive

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Nadia shared a mental picture with me to help me better understand the reasons behind her self-injurious behavior. She asked me to imagine a large airy room with sparse furniture and big, wood-framed windows that were open and letting in the soft sounds of birds. In this room, the early morning sun was shining through the open windows and the lace curtains were gently blowing in the breeze. The plaster walls were plain and white, their expanse interrupted only by an occasional ladder back chair standing nearby. The floors were rustic with wide, planked wood. There was only one door leading into the room and it was closed. In the center of the room, bathed in sunlight, was a simple, small wood table with only one object on its surface, a beautiful, cut crystal bud vase holding a single rose. The rose was just beginning to open.

As I followed Nadia’s description, the sunlit, serene feel of the room turned suddenly grey and foreboding when she told me that the entire scene was in black and white, like an old movie. She said that the rose was the only color present and it was strikingly red. “The rose is so red, that when I see it in my mind, I can feel my heart beat, like a passion simmering underneath my skin,” she said. Nadia continued the narrative, noting that as she looked at the rose more closely, she noticed beads of moisture on its delicate petals. She touched these drops of moisture, and they felt unexpectedly warm. When she looked down at her fingertips, she saw blood. “My blood is the tiny droplets on that rose and it is just as crimson as the flower,” she says.

Nadia wanted to feel the warmth of her blood in the midst of her cold, grey world. She wanted to see color again. She wanted to feel again. She says, “I want my passion for life to return. I want it to flow out of me, instead of being buried so deep inside that I am beginning to wonder if it is there anymore. I want to feel warm and red, not cold and grey.”

Nadia eloquently illustrates one of the most frequently cited reasons for self-injurious behavior. She self-mutilates to feel alive and to escape the emptiness she experiences in her daily life. It is common for individuals to comment that they do not “feel real or human,” and that the pain they elicit along with the sight of blood flowing from their body creates a sense of “being alive.” If this seems confusing, think about all the people you know who go to great lengths to “feel alive” or “feel young and energetic.”

In trying to describe this concept to others, I often share an example from the movie, Titanic. Envision the scene where Leonardo DiCaprio climbs up on the ship’s most forward railing. With the wind blowing in his face and only water beneath him, he stands up with his hands raised high up into the air and yells “I’m the King of the World!” This is a wonderful depiction of an individual who is experiencing a sense of “feeling and being alive.” Self-injurers strive to create this experience through their acts of bodily harm. Because they often do not believe that they can achieve this feeling without self-injury, they develop a pattern of its use.

What Every Parent Needs to Know About Self-Injury

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