Therapy in L.A.


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August 2001
By Carl H. Shubs, Ph.D.

This excellent book is about anyone who grew up with emotional pain that was too deep and too powerful to tolerate. It is especially about people who were too young, too overwhelmed, and too hurt to be able to speak the pain. It is about intimacy, the terrible ways it can be disrupted in early childhood, and the legacy of pain and suffering that is left in its wake.

The classic scenario described as stimulating such emotions is one of physical or sexual child abuse, but Strong makes clear that other circumstances can also be just destructive. In fact, some can be even more insidious and more enduring because they leave more of an ambiguous trail and because the attack is on the mind of the child and not merely on the body. Included among such childhood origins is emotional abuse, which is a realm of experience and pain that is seriously under addressed, but which is discussed here.

The book is subtitled, "Self-Mutilation and the Language of Pain," which reflects that it is about cutters, people who self-injure, who purposefully cut, burn, or otherwise hurt themselves. However, it is much more about the pain than the self-mutilation.

It is also about people who hurt themselves in many other ways such as with eating disorders including anorexia and bulimia, with substance addictions such as drugs and alcohol, and with addictive behaviors including sex, gambling, and spending. It is also about people who hurt themselves by means of their self-images and their subsequent self-destructive ways of relating.

Strong presents a very personal and moving insight into the lives of the people she describes. She tells their stories, in their own words, and amplifies with scientific and clinical understanding and explanation. She also examines what helps and how someone can begin to rebuild a life without self-injury. She tells therapists what they need to know in working with these people, and with anyone in fact, and she tells these people about what they can look for in therapy that can help them the most.

"As the first-person stories and narratives of the cutters make clear, they hurt themselves not really to inflict pain but, astonishingly enough, to relieve themselves of pain to soothe themselves and purge their inner demons through a kind of ritual mortification of the flesh. Rather than a suicidal gesture, cutting is a symbol of the fight to stay alive." (p. xviii)

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