Rekker was nearing 30 years of talking about his mental health with people and well over 20 in therapy. He'd learned to be frank so people knew exactly what he was facing because otherwise they couldn't help him in the moments when he was no help to himself.
"I feel pain." Rekker mentioned between sips of coffee. "The wiring is wrong in my head. Pain feels better to me than it should." He wasn't going to say any more than that because it got into territory that he thought might make Isamu uncomfortable. "You're not the only one who's mentioned that. I've been through most of the psychiatric treatments available at some point. I've found a combination that keeps me functional about 90% of the time."
Which Rekker was pleased with now that he recognized there were moments, sometimes long stretches, where he was close to non-functional as a person.
“I do not mean to suggest that you do not feel it. I should have specified that I was not referring merely to the sensory processing of pain intensity. There is compelling evidence to suggest the affective processing of pain - its unpleasantness - may be different in individuals who participate in self-harming behaviors.” He corrected himself. “Not to mention the fact that pain is modulated by contextual stimuli, such as emotions, social factors or other perceptions.”
And that didn’t even begin to analyze the potential role of abnormal feedback in the striatal dopamine system, or dysfunctions of the hypothalamic-pituitary-adrenal axis and its altered secretion of stress hormones and affect on serotonin.
"Some people think that's how it works, you hurt yourself because you don't feel it." Rekker had heard that line of thinking more than once in his rounds with the media. "Sometimes I think I do it because I can feel it. I've heard theories that because the pain and pleasure receptors and areas are so close that it's easy for the wires to get crossed in brain development or the alterations to the brain from trauma."
Rekker considered that last statement for a long time and then nodded. "I like to be in control of the pain that's happening to me. I want to cause it directly or indirectly. I don't like when other people hurt me." He started laughing. "Except when I'm in a fight."
“I dare say wires being crossed is quite an appropriate metaphor, as fMRI studies have documented masochists activating brain areas involved in sensory processing rather than affective pain processing when they receive painful stimuli within that particular context.” He nodded. “But through involvement of the parietal operculum, which suggests additional cognitive evaluation, not the ventral striatum, which would suggest the processing of rewards.”
In other words, it was less about pleasure and more about memory and cognitive reevaluation. Which seemed to fit with Rekker’s desire to remain in control of his pain. At least partially.
"I don't understand all of that." Isamu had forged past Rekker's understanding of the medical terminology about his condition. While being curious he wasn't a scientist, though he did understand many of the scientific terms when it came to mental health.
"I know it feels like an addict getting a hit after being off for a long time." He could speak to that having both had a time of wrestling with drugs and alcohol. "I don't always realize how much I've done until I come out the other side. Things can trigger it starting too, like when a cokehead sees cocaine and can't resist. Sharp objects can trigger me the same way, especially if I'm already down."
“Hmm… That runs counter to what a number of studies have found, but that does not mean it cannot be ruled out. After all, opioid and dopaminergic systems and the HPA axis can both be activated either by psychoactive drugs or by behaviors. So it is still plausible that for a subset of cases, the same biological mechanisms support the development of addiction as well as self-harming behaviors.”
Rekker gave a non committal shrug. "I'm speaking as someone who was an addict and is still suicidal. Studies are only as good as the questions they ask."
Rekker had been in enough studies by this point but still stifled a laugh. "I don't just like pain when I'm trying to off myself or feel like shit."
He left the implications of what he was talking about unsaid for now, unless the twin asked.
Isamu’s eyes widened for a moment, though he felt no need to ask for clarification. He could easily read between the lines, and scoffed a hasty, “whatever releases dopamine in your nucleus accumbens, I suppose…”
That sort of thing was not a turn-on for the scientist. And unfortunately, very little scientific literature actually existed on that particular subject to fill in the gaps.
Rekker just shrugs and laughs at the reaction because what else can you really do? It takes all kinds of people and relationships were built on the right kind of strange coming together.
"When you're angry and depressed healthy outlets are important." Which was a more scientific approach to the shocking unspoken. "How's the number crunching going?"
It was time to change the subject even if he was amused and would, if it were one of the band, continue to harass.
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carisma_sensei
no subject
Date: 2022-03-14 08:56 pm (UTC)"I feel pain." Rekker mentioned between sips of coffee. "The wiring is wrong in my head. Pain feels better to me than it should." He wasn't going to say any more than that because it got into territory that he thought might make Isamu uncomfortable. "You're not the only one who's mentioned that. I've been through most of the psychiatric treatments available at some point. I've found a combination that keeps me functional about 90% of the time."
Which Rekker was pleased with now that he recognized there were moments, sometimes long stretches, where he was close to non-functional as a person.
no subject
Date: 2022-03-14 11:07 pm (UTC)And that didn’t even begin to analyze the potential role of abnormal feedback in the striatal dopamine system, or dysfunctions of the hypothalamic-pituitary-adrenal axis and its altered secretion of stress hormones and affect on serotonin.
no subject
Date: 2022-03-15 03:09 am (UTC)Rekker considered that last statement for a long time and then nodded. "I like to be in control of the pain that's happening to me. I want to cause it directly or indirectly. I don't like when other people hurt me." He started laughing. "Except when I'm in a fight."
no subject
Date: 2022-03-15 12:03 pm (UTC)In other words, it was less about pleasure and more about memory and cognitive reevaluation. Which seemed to fit with Rekker’s desire to remain in control of his pain. At least partially.
no subject
Date: 2022-03-15 06:00 pm (UTC)"I know it feels like an addict getting a hit after being off for a long time." He could speak to that having both had a time of wrestling with drugs and alcohol. "I don't always realize how much I've done until I come out the other side. Things can trigger it starting too, like when a cokehead sees cocaine and can't resist. Sharp objects can trigger me the same way, especially if I'm already down."
no subject
Date: 2022-03-17 12:01 pm (UTC)“Hmm… That runs counter to what a number of studies have found, but that does not mean it cannot be ruled out. After all, opioid and dopaminergic systems and the HPA axis can both be activated either by psychoactive drugs or by behaviors. So it is still plausible that for a subset of cases, the same biological mechanisms support the development of addiction as well as self-harming behaviors.”
Comorbidity at its finest. Wires getting crossed.
no subject
Date: 2022-03-17 06:46 pm (UTC)Rekker had been in enough studies by this point but still stifled a laugh. "I don't just like pain when I'm trying to off myself or feel like shit."
He left the implications of what he was talking about unsaid for now, unless the twin asked.
no subject
Date: 2022-03-19 01:31 am (UTC)That sort of thing was not a turn-on for the scientist. And unfortunately, very little scientific literature actually existed on that particular subject to fill in the gaps.
no subject
Date: 2022-03-19 01:51 am (UTC)"When you're angry and depressed healthy outlets are important." Which was a more scientific approach to the shocking unspoken. "How's the number crunching going?"
It was time to change the subject even if he was amused and would, if it were one of the band, continue to harass.