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They must enjoy it
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You must enjoy it, or you wouldn't do it.
Everyone - whether you self-harm or not - has a different pain threshold. Some people can endure the most intolerable levels of pain, whilst others may have a hypersensitivity to even the slightest injury or ache. When someone has the urge to harm, they may feel as though they are numb and not able to feel pain - this is because of the emotional intensity they are experiencing.
Once the act of harming has taken place, they will realise they are not numb, and feel the pain as much as anyone would. It will be at this point in the process that someone may be receiving treatment, and consideration needs to be given as to whether or not pain relief is needed. There have been reports of young people having stitches without local anaesthetic, after professionals assumed the process of having stitches would be 'enjoyable' for a self-harmer.
Everyone hurts, self-harmers included. It's not an enjoyable way to cope, but it may feel necessary at times.