Nonsuicidal Self-Injury, Pain, and Self-Criticism: Does Changing Self-Worth Change Pain Endurance in People Who Engage in Self-Injury?

People who engage in nonsuicidal self-injury (NSSI) endure physical pain for longer periods than do noninjuring individuals. Pain endurance is also predicted by the presence of highly self-critical beliefs. We tested the hypothesis that changing beliefs about the self would change pain endurance in NSSI individuals. NSSI (n = 50) and control (n = 84) participants were randomly assigned to hear positive music, to receive a brief cognitive intervention designed to improve feelings of personal self-worth, or to a neutral condition. Pain endurance was measured before and after the experimental manipulations. As predicted, there was a significant Group x Condition x Time interaction. After the cognitive intervention, NSSI participants showed a 69-s decrease in pain endurance compared with a 9-s decrease for control participants. For NSSI participants, improvement in self-worth was also significantly correlated with decreased willingness to endure pain. Cognitive approaches that focus on self-worth may provide a new treatment direction for NSSI.