The singer is expressing how hard he fell for her, and then she hurts him by words. Quoting the lyric "Your words cut deeper than a knife." He feels like he's being pulled down without her, and he wants to stop thinking about her. What he's trying to get through the people who are reading the lyrics right now is that "Not everyone is as they seem." The term called "catfishing". Catfishing is used quite often in Social Media cases. It means to lure somebody in with a fake or phony personality. They make people believe that they actually have that personality, and in some cases, they meet in real, and they're not what they seem. Like the girl in this song, he wants her back, but he knows what her true colors are, and knows not to get hurt again by the same person. "Needle and the thread, gotta get you outta my head. Needle and the thread, gonna wind up dead." is trying to express that he wants to get her out of his mind, but if he doesn't, it's just going to hurt him even more than he is hurting now. The singer sings to us, "Oh, you lured me in; I couldn't sense the pain." Which supports the catfishing deal. She lured him in with a fake personality.