A patient came in depressed and anxious.  After our initial interview he disclosed that he and his girlfriend were playing around with sadomasochism and it was scaring him.  We discussed that to help him get healthy, he would need to do healthy things for himself.  Anything directly harmful or potentially life-threatening doesn’t fit in to that.  We agreed not to formally engage in therapy until he had thought this through and what he was going to do with his sex-practices.  He came back wanting treatment, and spoke like this whole S&M thing was old history.  “Oh that!  I talked it over with my girlfriend and she understands.”  Ok.

Why do we scare ourselves on purpose?  Like watching horror movies, or even movies that are more mainstream but have suicide scenes, abuse, car accidents or other freaky things.  Some are thrill-seekers through extreme sports like sky diving.  Others cut themselves or do other forms of self-injury.  This may seem like an odd bundle but they all share volitional fear experiences.  Even as do team sports like tag or football when getting happy from being chased like a rabbit from a fox.

When we scare ourselves on purpose, our bodies release a number of wonderfully feeling chemical messengers.  There is adrenaline, dopamine, cortisol and more that give us a rush, a lift.  It is positive feedback.  (Dopamine is the main pleasure molecule that all addictive drugs target as does food or even a back scratch.)

Psychoanalytically one might say, like Boston College professor Peter Gray, PhD

…our greatest real fear becomes, in play, our greatest joy.

When this goes wrong is when we hurt ourselves in the process.  “Look out!” is what I say.
Other examples that are more common are film, television and video games.  We now have data that supports evidence of primary emotional illness induced and driven by watching violence – such as post traumatic stress disorder.  Post traumatic stress disorder is a bummer.  It is the only primary emotional illness that has no clear genetic origin but comes after a life threatening event either experienced by yourself or observed by you.  Just don’t get it on purpose for crying out loud!

When I am hankering for a good thriller movie, I try to use this understanding to steer me.  I try to remember that I am extremely valuable.  Along with the obvious but not so obvious good advice,

…whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.

Self Care Tip #48 – Scare yourself if you must, with caution.  Be a friend to yourself.

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• National Poetry Month Spotlight: Jennifer Garcia – Post Traumatic Stress Disorder (dangerouslee.biz)
• The hurting and healing of Rachel Karr (journalstar.com)
• Author Talks About Post-Traumatic Stress Disorder In Wake Of Boston Bombing (foxct.com)
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