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This level of frustration and self-abuse is also so hard, because he is too young to fully help himself; his brain isn’t mature enough to talk to itself, leaving him feeling angry, ashamed and anxious.

His son has since gone back on medications, he said, and gone blind from self-abuse.

With “In the Valley,” Rash presents a catalog of broken people trying to survive beneath the weight of their self-abuse, often through drugs or alcohol — or just the abuses the world foists upon them.

Given all the abuse Mr. Johnson has taken, he looked almost relieved on Wednesday when a reporter abruptly shifted the subject to self-abuse.

After reading a scene in which Stevie harms himself with a hairbrush, one director Hill “really likes and respected” suggested he remove the self-abuse from the film.