From Syria: I’m 28 years old female, and I have intense fantasies about being physically tortured (caned, flogged, and burnt), I’ve had these fantasies since the age of 16, I also have an experience with self inflected pain (palm caning and burning to be more specific) or maybe it was my way to fulfill these fantasies, anyway I don’t do that very frequently because it leaves really bad bruises and scars that are hard to cover. basically physical pain is the only thing that makes feel excited.
So I have two questions to ask
A- Would you diagnose that as masochism or self injury disorder?
B- Should I seek professional help?
Thanks for your time

A: Yours is a complicated question. You live in a part of the world where thousands of people are experiencing both physical and emotional pain. If you are feeling guilty that you have been exempted from those experiences, it is possible that you are (unconsciously) joining with your community by giving yourself pain. That may be a stretch on my part. It just occurred to me as a possibility as I was reading your letter.

But you also said that pain is the only thing that makes you excited. I have to wonder how it is that you have separated so much from your feelings.

Regardless of the reason, I do think professional help would be useful.

I can’t make a diagnosis on the basis of a letter. But a counselor can help you make sense of your feelings, put a stop to the self-harm and find healthy ways to find excitement. If you have the option to see a counselor, I very much hope you will do so while you are still young and more flexible. Continuing the self-harm will only reinforce it as a way to put some “excitement” into your life.

I wish you well.
Dr. Marie