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Extreme (more extreme than paintball, skateboarding, etc.) sports can give the same rush with more of a chance for death or harm, and you get a much larger endorphine rush when you inevitably break a bone or end up with your face mashed into something that's harder and less mobile than your nose.
I think what bothers most people about cutting is the connection in their minds to death. They assume that cutting deeper will kill you, so you're just working your way up to suicide.
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