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Jill, for instance, reported no pain when she self-mutilated, only a sense of somehow taking charge of her life. Another patient in the same program, whose name was given as Jane, had made a list of more than thirty reasons for cutting herself. The word that recurred most frequently in the list was "power": "I cut right in the fold of a finger.... It was so sharp and so smooth and so well hidden, and yet there was some sense of empowerment. If somebody else is hurting me or making me bleed, then I take the instrument away and I make me bleed. It says: `You can't hurt me anymore. I'm in charge of that.'"(10) Although Jane had suffered sexual abuse at a young age and Jill had not, both were the victims of powerlessness, having been dominated by the wills of others.

Few self-mutilators report intolerably high levels of pain. A typical experience is the following claim by an anonymous internet writer, who describes self-mutilation in great detail and with a professional level of sophistication: The slicing through flesh never hurt, although it never even occurred to me that it should."(11) This portrayal raises the question of the conflation of injury and pain in common usage, or in the way most people think about both pain and tissue damage. As we shall see in a later section of this article, the two phenomena are far from identical, and this relationship must be a central theme for those who wish to understand sacred pain. At any rate, the self-mutilation of some comtemporary patients, regarded phenomenologically, may not be entirely different from that of mystics or saints. The heuristic concept of pathology, which differentiates the patient from the saint, might actually distort an important insight. Both types of self-injury seem to revolve around a sense of empowerment and affirmation. In this article I will look at a case of religious self-hurt and then consider a psychological theory that could explain both "pathological" and "sacred" pain.

* Sacred Self-Mutilation: The Torments of Maria Maddalena de' Pazzi

The interior landscape of individuals who injure themselves seldom matches either the traumatic shock that clinicians and reductionists attach to injury, or the theories of the neurological and psychological sciences. If anything, in their complexities and ambiguities, these individuals' interior landscapes more closely resemble the mental terrain of saints or mystics who acquire, or claim to acquire, spiritual power by austerities and self-flagellation.

The following is a description from Vincentio Puccini's (1619) biography of Maria Maddalena de' Pazzi:

On the eighth of September in the same year of 1587...going into a room where the wood was kept, and there having first bolted the door, she gathered together rugged sticks, and thornes, etc., she tumbled therein....Sometimes she would afflict her [self] with disciplines of iron, and gird herself about with a most terrible girdle, which in coursest canvas, she had imbordered with piercing nails, in such sort, that in truth the only sight thereof maketh them shrink and even tremble who look upon it.(12)

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