2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
From the point of view of psychoanalysis and some of its offshoots, generalizations about the causes of the symptom are almost impossible. On behalf of each individual person, the symptom speaks of the intricacies of drives, events, experiences. So, outwardly, the same symptom in different people can have completely different meanings. But we can say for sure that a symptom is an individual invention of a person that helps to reduce the intensity of mental suffering, even at the cost of creating new ones, but still more bearable. Such a view presupposes the recognition of the value of creation and the creative abilities of its creator. To take away, heal, get rid of a symptom is like taking away creation from a zealous creator, it can lead either to an intensified attempt to reinvent something, or to impotence in relation to creativity. A comprehensive study of the invention, the search for its place, the discovery of its importance, and the deciphering of its symbols can be therapeutically significant. Enrichment with such hidden knowledge gives a person the opportunity not only to expand the creative repertoire, but also to acquire the ability to cope with suffering.
Of course, self-injurious behavior as a symptom will have different meanings and depending on the structure of the person - psychotic, perverse or neurotic.
The suffering of the neurotic and the non-neurotic is also different in nature and intensity.
What can we call self-harm or, using the English equivalent, self-harm? In self-injurious behavior, the person harms himself physically by using his body to deal with anxiety. This includes a galaxy of symptoms, from skin cuts and cigarette burns to deliberate alcohol abuse and bulimia. There are many ways to harm yourself. Often this brings some relief with an excess of uncontrollable feelings, or, on the contrary, makes you feel alive and real, when everything seems faded, empty and meaningless.
It may seem paradoxical that the person, instead of easing their pain, seems to increase it. However, upon deeper examination, it becomes obvious that bodily injury is a way of self-complacency, it makes it possible, albeit for a short time, to forget about exhausting emotional suffering. The external becomes more real than the internal. Pain gains boundaries, it seems possible to outline it, to master it in your own way. The external, the visible and the tangible, are easier to deal with. It can feel like the only way to express helplessness, sadness, anger (often suppressed), as the only way to control emotions that are experienced as destructive and overwhelming if not given shape. Self-harm tells us about trying to help ourselves. These are traces of the memory of past traumas, about which it is impossible or impossible to say otherwise. The body becomes a kind of means of communication, visually registering the internal dynamics of a person's relationship with himself and significant others.
The mechanism of self-harming behavior can be close to compulsion. In this case, it makes sense to talk about an unconscious feeling of guilt that torments a person and requires constant punishment. Pain, pleasure, desire, prohibition, retribution, physicality - all this is intertwined in a bizarre way in an act of self-harm. Unbearable thoughts and feelings seem to be removed from the sphere of the psychic, but imprinted in the sphere of the bodily.
According to research in recent years, psychoanalytically oriented psychotherapies are effective when working with people who commit self-harm (another effective method is cognitive-behavioral therapy). Psychoanalytically oriented work begins by creating a space in which safe and secure relationships can develop. Therapeutic assistance is primarily built around helping a person to track and name emerging emotions, as well as to find acceptable ways of expressing them. What is important is the therapist's ability to accept and contain those feelings and thoughts that the person himself cannot tolerate, as well as to understand their unconscious meaning and communicate about it in the form that the person can bear. This provides him with the opportunity to understand and express emotions and experiences that previously seemed unbearable. Memories of the origin of the pain may also appear. Gradually, it becomes possible to take care of one's own body, a kind of symbolic leap from body to thought and speech, which will allow a person to reflect on his experience, associate around him and integrate it into his life story. The word, as opposed to a self-destructive action, will acquire the ability to become a means of expressing and regulating affect. Establishing trusting and stable relationships with others is also a very important part of the job. This can be difficult and time-consuming, but it can be done.
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