Self-Injury Hurts! When it comes to pain, I am a wimp. If I accidentally hit my thumb with a hammer I'm ready to call an ambulance. Like many, I had a hard time understanding how those who self-injure report experiencing little or no pain when hurting themselves. It could be that there's a huge conspiracy among self-injurers to state that the act of hurting themselves is not painful in an attempt to recruit more self-injurers. But it seems more likely that there are psychological and physiological processes that help to mask the pain associated with the physical injury.

Self-injury is cyclic in nature with factors preceding the actual act of physical injury and factors following the behavior. Dissociation is one of the factors that comes into play immediately prior to the act of self-injury. Everyone dissociates to some degree. At a benign level, dissociation may be described as "zoning out" and may result in driving past the freeway ramp on which you intended to exit. At the extreme end of the dissociative spectrum is dissociative identity disorder, a psychological phenomenon in which an individual develops, typically as the result of chronic, severe trauma, two or more distinct personalities. When people self-injure they are typically in a dissociated state, allowing them to feel little or no pain while they injure themselves.