134 The Dialectical Behavior Therapy Skills Workbook
The emotional rewards that reinforce self-destructive behaviors are important to understand.
Two types of self-destructive behaviors that people with overwhelming emotions often engage
in are cutting/self-mutilation and manipulating others. Both of these behaviors offer short-term
rewards that make them likely to be repeated, but both types of behaviors are also followed by
long-term damage. (In the next section, Reducing Your Physical Vulnerability to Overwhelming
Emotions, you’ll learn about self-destructive eating and substance-use behaviors too.)
Cutting/Self-mutilation
Many people who cut, burn, or scar themselves say that their actions make them feel better
or that their actions relieve some of their pain. To a certain degree, they’re right. Cutting and
other types of self-mutilation can cause the body to release natural painkillers called endorphins
that help heal the wound. These painkillers can make a person feel physically and emotionally
better for a very short amount of time. Yet as temporary as these rewards are, these physical and
emotional feelings reinforce self-mutilation in the future. But remember, these behaviors can be
dangerous and possibly lead to death or infection. And while the pain relief is temporary, the scars,
the memories, and the guilt that often accompany these actions still remain.
If you engage in any cutting or self-mutilating behaviors, identify what those behaviors are in
the space below. Then identify what the temporary rewards might be. And finally, identify what
the long-term cost and dangers are, due to those behaviors.
The cutting and self-mutilating behaviors that I engage in areThe temporary rewards for my behaviors areThe long-term costs and dangers of my behaviors aremanipulating others
In the earlier example, you saw why Teresa picked fights with her husband when she was
feeling upset. Her actions, though damaging to her marriage, made her feel better for a short