In our daily life, if we suffer a traumatic injury, resulting in a wound in a part of the body that is difficult to stop bleeding, people will go to a medical institution to treat the wound if there are conditions, and the doctor will disinfect, debride and suture the wound and the surrounding tissues, so that the wound can be effectively disposed of and the wound will eventually heal. We hardly ever see people who let their wounds bleed or even fester after they are injured. Of course, there are occasionally people who do not get along with the wound that is about to heal, repeatedly picking and tearing the scab, so that the wound does not heal for a long time, and they are mostly psychiatric skin pickers. The skin-picking behavior of patients with skin-picking disorder is characterized by certain compulsive symptoms and has an impulsive and addictive tendency. Skin picking disorder belongs to the category of obsessive-compulsive spectrum disorders, and in the new US diagnostic classification system DSM-5, skin picking disorder is included within the category of obsessive-compulsive and related disorders. Today, I am not talking about skin picking disorder, but rather the characteristic and common pattern of cognitive and behavioral responses that many people with anxiety and depression exhibit after a traumatic injury – obsessing over the responsibility of others for their injury and experiencing repeated internal pain. In everyday life, it is not uncommon for people to suffer minor traumatic injuries, and most people treat them with relative indifference and do not experience significant psychological distress. However, the cognitive and behavioral response patterns of anxious depressed people after an injury are significantly different from those of normal people and can lead to severe internal pain. For example, when someone was passing in front of a neighbor’s house, they accidentally stepped on a banana peel and fell, bumping their knee and experiencing skin abrasions, subcutaneous bruising, and painful knee joints when walking. At this point, they first think that the banana peel was discarded by the neighbor’s child, so they naturally want to name or not name the neighbor and loudly scold the neighbor for “lack of public morality”, and even think that the neighbor deliberately wants to make him look bad and get hurt in this place, and may provoke neighborhood disputes. They will then take appropriate measures according to the severity of their injuries and habits, or go to the hospital for treatment, or at home to apply medicine bandages, rarely ignored. If things stop there, it’s not a big problem. However, for people with anxiety and depression, the real pain is just beginning because of the cognitive and behavioral response patterns they acquired growing up. On the one hand, they may worry that there will be some sort of residual effects of the injured knee, or that the leg will be more prone to fractures in the future because of the trauma, etc. On the other hand, and leading to more intense internal pain, they often wonder why there is a banana peel in front of that neighbor’s house and why the cleaners didn’t sweep up that banana peel. Why did no one else step on it and fall down? Then they will keep analyzing, explaining and answering the above questions according to their own logic. Generally speaking, their analysis and explanation are often more painful for them: “The neighboring family is so poor in quality that they throw banana peels at random. I used to be blind and still be so friendly and polite to their family”. Or, “When I first moved in, the neighbor’s children liked my family’s car model that I cherished, and I rejected their request to play with it, and now they are trying to get back at me for my hard refusal by throwing banana peels on purpose. Or, “Once the janitor did not clean the floor carefully, and I could not help but make a comment at that time, now he may deliberately not sweep away this banana peel as a revenge for my comment to him”. In short, they will find one or even several reasons to feel “unhappy”, and then repeatedly and continuously feel the pain and talk about the painful experience to different people. This state of distress either persists until a new, more intense distressing stimulus or trauma replaces it, and they experience new distress again using this built-in pattern; or it persists until it causes a depressive episode that requires psychiatric intervention to resolve. For these individuals, the experience of an accidental fall actually creates two subsequent layers of pain: the knee injury and the internal pain. Moreover, their internal pain continued to flare up and torment them at times after the physical injury had healed. Such a pattern of reaction is equivalent to gouging or tearing a wound after it has been injured, causing it to bleed, fester, and linger on. Only, it is the wounds of the heart that are gouged or torn open again and again.