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On the last track, we discussed the ways in which cultural pressures have a direct effect on the adolescent self-injurer: the idea that pain is achievement; and the "tough guy" stereotype
As you know, attachment is a vital part of human relationships. Self-mutilators suffer from severe deficits in the ability to form personal attachments.
On this track, we will
examine different aspects of a self-mutilator's ability to form a relationship
which includes: a lack of a workable medium for relationships; the factor of low
self-esteem; keeping friends at a distance; and the result of shame of past abuse.
# 1 - Lack of a Workable Medium
Barbara responded, "Myself. It's stupid and weak to depend on others because they always let you down." Barbara's response indicates that some event, circumstance, or personality has thwarted the development of the restorative mechanisms of trust and dependency.
# 2 - Low Self-Esteem
Barbara had come from a very violent childhood. Her father was an alcoholic and beat her regularly. Her mother, apathetic to her daughter's abuse, ignored Barbara's complaints. An explanation of this is that security and pain have become fused. The idea of home, which most people associate with warmth and safety, had never been true for Barbara. Consequently, she had never known what true security meant and sought relationships that closely resembled what she was most familiar with.
# 3 - Keeping Friends at a Distance
In this way, Jenny was able to feel some nurturing benefits from her relationships, but could keep the others at a distance from herself to guard against any kind of betrayal. Jenny said to me, "I like having a lot of people around me and liking me. I feel loved. But that doesn't mean I have to just throw all of myself out there. That personal stuff is mine to keep." By harboring a nest of admirers, Jenny was able to gain some self-approval, but by not sharing her inner anguish with her friends, these relationships did not benefit her to provide emotional support.
# 4 - Shame of Past Abuse
Elizabeth, age 18, used to cut herself with the buckle of
the same belt her father had used to beat her as a young child at the age of 8.
For 7 years, Elizabeth concealed information about her self-injury and her shame
only accumulated over that amount of time. This sense of shame spread from the
specific act of cutting to a general sense of shame about herself.
Elizabeth responded, "I want to get rid of my guilt. Whenever I even think of that aspect of myself, I cringe. It's so ugly and because it's a part of me, I'm ugly too, inside and out. I really wish I could change the ugliness into something beautiful or at least cover it up so I can't see it or sense it, but it doesn't work that way. I realize that I have to start recognizing that just because a small piece of me is repulsive, that doesn't mean that all of me is ugly. I need to stop degrading myself."
Through the use of this exercise, Elizabeth could start to pinpoint those behaviors and self-attitudes that drove her to self-mutilate. While addressing her abuse will take extensive time, I feel that by identifying and educating her about her symptoms Elizabeth can reach a more positive self-image and cease her cycle of shame.
On this track, we discussed four aspects of a self-mutilator's ability to form a relationship which includes: a lack of a workable medium of relationship; the factor of low self-esteem; keeping friends at a distance; and the result of shame of past abuse.
On the next track, we will examine the various methods by which self-mutilators avoid discussion in therapy: a blank slate; deflecting; and a false self.
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