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How can I hurt myself? Let me count the ways. But first let me distinguish between hurting myself and abusing myself. Hurting myself - self-harm is a term commonly used for physically abusing oneself by cutting, self inflicting blows, pulling out hair (Trichotillomania) skin or nails, starving or food misuse, extreme piercing, or purposely burning ones’ self. Abusing myself - self-abuse covers the entire spectrum of self-destructive behavior, which includes emotional and psychological abuse and unconsciously or indirectly exposing oneself to physical harm via reckless or dangerous behavior. Addiction is viewed as a symptom rather than a cause of self-abuse, but many addictions (i.e. any kind of substance abuse, unsafe sex and even gambling) can become a reckless behavior that leads to physical harm.
When people act in ways that seem abusive to themselves, we shame them. We disparage them as weak, selfish, suicidal. Sometimes we even ostracize them. Thus we are further punishing those who are already punishing themselves. But what do we gain from that reaction? Does this stop the self-abusive behavior? Does it make the underlying issues that instigated the self-abuse disappear?
Self-abuse is an acting out of negative emotions – but it is not about wanting to die or about wanting to hurt others. It is about trying to cope, trying to live. Why do people act out in this manner? It’s because the self-abuse is a recreation of abusive situations from the past that shaped these people. The feeling of being abused is familiar and connotes a way of communicating, because the people who abused them originally were probably people that either loved and took care of them or were supposed to love and take care of them. Hence, self-abusive behavior now as an adult becomes a way of them taking care of themselves.
The betrayal (social, physical, emotional) of children by trusted adults has devastating consequences. And while childhood trauma contributes to the initiation of self-destructive behavior, the lack of secure attachments helps to maintain it.
Here is a young woman’s account of why she abuses herself. “It helps me cope and is a way for me to vent the self hate I was given by my abusers, which I now turn in onto myself. I want the outside to show how I feel on the inside, because I feel I deserve it; because life without abuse is so unfamiliar it’s terrifying; because if I don’t harm myself everyone will decide I’m OK and leave me alone and I am not OK.”
(“Healing the Hurt Within”, 1999)
While self-mutilation is directly linked to childhood abuse – drug and alcohol abuse is more complex. There are those who use substances to self medicate an undetected or undiagnosed emotional disorder (i.e. Depression, Bipolar Disorder, ADD, etc). They self-abuse to relieve psychic pain – but not necessarily pain that arises from childhood abuse. And in families with a history of substance abuse, there is the genetic component - albeit many times a more complex one than susceptibility to addiction. There may be several generations of emotional disorder that led to the substance abuse – most likely Depression.
Let’s look at how self-abuse relieves the suffering. There is a cycle to this behavior, and in a way it is similar to the cycle of domestic abuse:
The person is plagued by memories of past traumatic events or intrusive, shameful and unacceptable thoughts. They are reacting to a negative or faulty self-belief (schema) that tells them that they are bad and worthless.
These feelings are trapped inside and build – just like steam in an engine.
The steam (rage) builds to a point where it has to find release – the person feels as if they will explode.
The person either self injures or turns toward an addictive/compulsive behavior that temporarily dissipates the rage. While the person is in this state they may or may not be conscious of how their behavior is controlling them. They may or may not “feel the pain”. If they self injure, they either disassociate from the feelings or may actually want to feel the pain in order to externalize and concretize the internal psychic pain that they continually experience. Once they have acted out, there is a sense of relief – almost an orgasmic sense of relief. It will not last.
How can people counteract this cycle? First they must understand and acknowledge it. They particularly need to look at the negative, faulty self-belief that tells them that they are worthless and prods them on. Where did this belief come from? Where is the evidence that it is true? Does holding on to this belief serve any purpose or does it just keep me down? Is it truly my belief or the way those around me made/make me feel? If you can reflect on it and slow yourself at this point; if you can come up with a counterargument to the one that has always led you down this path; then you can begin to take back control of your behavior.
The goal is to develop a new relationship with yourself and alternative methods for self-care. This is not an easy road. It may take time. But the first step is always a desire to change.
Roni Weisberg-Ross LMFT
2010
http://www.roniweisbergross.com
An examination of both the victim and the perpetrator.
Child sexual abuse is as much about power and domination as it is about compulsion. The object – female, male or both – is a reflection of erotic imagery and fantasy. But the action encapsulates repressed rage that treats the sexual act as a weapon against the victim. This is true of the incestuous relationship as well; although it is more likely here that the victim is the unintentional consequence, not the target, of these repressed forces.
As with subjects I have previously written about - men abusing girls, women abusing boys, women abusing girls, older children abusing younger children and now with men abusing boys, we see that the psychological underpinnings are very similar. In fact, the sex of the offender and the sex of the victim is always a secondary consideration to the physical and psychological impact of the misuse of power by a trusted authority figure on a much younger person. That said, there are differences in the way a young person processes and is able to come to terms with childhood abuse depending on their own gender and the gender of the abuser.
Over the past decade there has been an eruption of scandals surrounding sexual abuse of boys by Priests. Despite the public glare on these scandals, abuse of young boys is still generally under-recognized, under-reported and under-treated. Just like sexually abused girls, sexually abused boys grow up exhibiting guilt, anxiety, shame and low self-esteem. Frequently, they are self-destructive and even self-mutilating.
But what is different about the abuse of boys – especially boys abused by men – is that it often precipitates crises about sexual orientation and gender identity. This is related to shameful feelings of being less manly because they were victimized; and if the abuser was a male, then they fear it has affected, will affect or is an indication of their sexual orientation. Girls who are abused by women do not automatically fear that they are Gay, but with boys it is different. It has to do with a culture of male homophobia and what it means to be “Masculine”, which has created a lot of anxiety and fear in boys over the prospect of being Gay.
Masculinity is an ideal for men. Masculinity in our culture is recognized as heterosexual. Masculine men are not victims, they are aggressors. They cannot be penetrated; they penetrate. They do not have sex with other men. They have sex with women and they procreate. Masculinity is a key part of male gender identity - the public expression of sexual orientation. So once a boy has been victimized, penetrated and had sex with another man, with or without their consent, their masculinity is compromised and therefore their sexual orientation is called into question. There is such profound shame attached to this notion for most boys that men with sexual abuse histories often have severe problems relating intimately to both men and women.
If the boy grows up to be homosexual, he might wonder if it had to do with the abuse or else rationalize that it does. And it turns sex with men into a conflictive affair of desire vs. rage that many times leaves him emotionally numb. If the boy grows up to be heterosexual, he may either become homophobic and/or have constant anxiety about his sexual functioning (sexually abused men consistently score lower than sexually abused women on sexual self-esteem measures). This sense of inadequacy can make it difficult for many men to remain sexually intimate with a woman or even enjoy sex. In contrast, there are a significant proportion of abused men who can only relate sexually, using sex as a weapon or shield from more emotionally intimate relationships. “In addition to its self-soothing aspects, sexual compulsivity represents for many men a repetitive attempt at mastery over their original sexual victimization.” (Richard B. Gartner, 1999).
What about the abuser? Traditionally, male abusers of boys have been identified as homosexuals, thereby adding another slanderous tag to the gay male population and confusing the sexual abuse of boys with gay sex. But “Virtually all male abusers of boys consider themselves heterosexual” (Gartner, 1999). Pedophiles, even if they only abuse boy children, are different from homosexuals who like to have sex with younger men. There is a profound difference between sexual abuse and gay sex – one connotes control over a child, coercion, force, exploitation and abuse, and the other connotes a sexual choice and an encounter freely entered into by two adult males.
Most sexually abused children know their abuser. But even if it’s a stranger, the profile of a male abuser is fairly consistent. He is more likely to be heterosexual than homosexual, he himself was probably abused as a child, he has unusual fantasies and compulsions, the act is more about power and control than it is about sex, and usually a current stressor sets off the abuse.
Roni Weisberg-Ross LMFT
http://www.roniweisbergross.com
2010
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Sticks and stones may break my bones but … bullying and name-calling can emotionally scar me forever. Not the original ending to the classic verse, but probably the more accurate one. It seems that broken bones will heal far more quickly than a battered soul. Does this sound overly dramatic?
Not according to a study conducted by Florida State University and published in the Journal of Affective Disorders. It states that verbal abuse has been shown to produce 1.6 times as many symptoms of depression and anxiety among adults as those who have not been verbally abused. And those adults were twice as likely to have suffered a mood or anxiety disorder over their lifetime.
Verbal abuse is only one aspect of emotional abuse - the most common form of abuse, and perhaps the least clearly understood. That’s because emotional abuse is not a single or quantifiable act. It is difficult to chronicle or identify. It is both pervasive and can be very subtle – deeply affecting but harder to prove than sexual or physical abuse.
Emotional abuse is a series of repeated incidents – whether intentional or not – that insults, threatens, isolates, degrades, humiliates and/or controls another person. Emotional abuse in childhood is particularly devastating because a child’s sense of self is still not fully formed and therefore they are very receptive to what others say about them. When they repeatedly hear negative things about themselves from people that they trust, they develop a set of beliefs that shape their future identity. It has been shown that both verbal and non-verbal communication can create a powerful message. And emotional abuse can and usually does include both.
When a person is physically or sexually abused, they recognize that something wrong (bad) is happening to them. With emotional abuse, that might not be the case. Therefore, the person may be taking in hurtful and debilitating information without any filter. That is, their psyche is not defending them from the onslaught. In fact, they may even be telling themselves that they deserve what they are experiencing and that they are bad. This type of abuse consequently turns into a potent form of self-criticism. Survivors of emotional abuse are self-critical because they have internalized years of negative messages and they now believe it. Adults who have been emotionally abused as children are among the most self-critical – hence the degree of depression and anxiety found among this population.
Emotional abuse has classically been under-reported and its effects minimized. But this form of abuse cuts to the core of a person, attacking their very being. It can leave them feeling unworthy, undeserving, unlovable and insignificant. People who have been emotionally abused may have a hard time recognizing the importance of the abuse. Not only does our culture minimize it, it suggests that the victims themselves are weak, further victimizing them. Most abusers are not clearly identifiable bullies/abusers, and so it’s hard to point a finger or charge them with a crime. How then do we recognize and deal with emotional abuse?
Trust your own instincts and the instincts of others who claim to have been abused. If you/they feel it or can name it, attention must be paid. Respect your emotions. This abuse is insidious and can be very subtle. But it wears away at your self-esteem and sense of self. If someone has or is continually making you feel bad about yourself, scaring you or making you feel as if you are crazy, then even if they aren’t fully aware of it, they are abusing you. Just because emotional abuse is not treated as a crime doesn’t mean it isn’t serious.
Identifying your abuser and recognizing that nothing you did or did not do was the reason they acted the way they did, is an important first step towards healing. And if it is still going on in the present, remember that “trying harder” will not stop an emotionally abusive person’s behavior. You are not the problem! If you feel safe enough, you can confront them with the truth and see if they are ready to acknowledge their problem. If you don’t feel safe, then remove yourself from the situation – perhaps permanently.
Roni Weisberg-Ross LMFT
2009
http://www.roniweisbergross.com
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Over the years I’ve discovered that a significant proportion of adult clients who present with depression have a history of childhood abuse. The abuse may have been sexual, physical and/or emotional. At first I attributed this to the fact that I specialize in abuse and many clients who come to me saying they are depressed are using that as a presenting issue because they aren’t ready to discuss the abuse. But what I now understand is that not only do most adult survivors of childhood abuse suffer from some form of clinical depression. but that most adults with prolonged depression have suffered some form of childhood abuse. An article in Psychology Today published in 2003 stated that, “In almost every case of significant adult depression, some form of abuse was experienced in childhood, either physical, sexual, emotional or, often, a combination.”
Depression runs in families. So does abuse. “Studies show that one in four girls and one in eight boys are sexually abused before the age of 18, and one in twenty children are physically abused each year.” But sexual and emotional abuse, in particular, is woefully underreported. Most abused children grow up in an atmosphere of denial – denial by the adults around them and, for the most part, denial within themselves as a means of survival. Ultimately it is the secrecy around the abuse that helps to foster the depression. Additionally, neurobiology has expanded our understanding of how emotions affect brain chemistry. Traumatic events – such as any form of childhood abuse (sexual, emotional, physical) or neglect, changes the chemistry of the brain. These events can reshape wiring patterns and reset responses to them so that even a small degree of stress can produce an overabundance of stress hormones that in turn create anxiety and depression.
Depression has been recognized as both a chemical imbalance in the brain and a turning of more aggressive feelings – i.e. anger – inward. Self-criticism is anger turned inwards. In a recent study by Florida State University researchers, people who were verbally abused as children grew up to be self-critical adults prone to depression. Verbal abuse includes insults, swearing, threats of physical abuse and spiteful comments or behavior. “Over time, children believe the negative things they hear, and they begin to use those negative statements as explanations for anything that goes wrong.” And while neither sexual nor physical abuse necessarily supply the critical words, the non-verbal communication of these actions say that the child is worthless. In fact, the non-verbal communication of these acts is even more powerful than the spoken words, but that in no way diminishes the fact that verbal abuse creates lasting damage as well.
As clinicians, it is our job to help the depressed client recognize the abuse; recognize the effect it has had on them and help them find an avenue back to self-love through understanding.
Roni Weisberg-Ross L.M.F.T.
2009
Los Angeles therapist specializing in the treatment of sexual abuse, emotional abuse, major depression and social anxiety