More threads by David Baxter PhD

David Baxter PhD

Late Founder
"Cutting" or Deliberate Self-Harm
by Merely Me
Monday, January 05, 2009

"I hurt myself today
To see if I still feel
I focus on the pain
The only thing that's real"


Trent Reznor's words to the song entitled, Hurt, was ultimately about his own heroin addiction yet the universal message it sends is about any act of self destruction or injury. When I was in my teens and early twenties, this song would have spoken to me because I was a cutter. I didn't know what the fancy names for it were such as (SI) for Self-Injury, self-harm (SH) or deliberate self-harm, (DSH). All I knew was that it was something I did to (and I know this doesn't seem to make any sense) stop the emotional pain.

What exactly is deliberate self-harm?
Usually it means cutting oneself with sharp implements including razors, pins, knives, scissors, glass, or anything which might do the job. It can also include burning oneself, picking at wounds so that they don't heal. I am sure there is a lot more one could include here but you get the picture.

How many people do this?
According to stats I found on a web site devoted to helping those who self injure:

"It is estimated that..."1.9 million Americans do these things, and do them repeatedly, some for years at a time, according to one conservative estimate. Another source says 750 of every 100,000 people in the U.S. self-injure." And in one study of undergraduate students in the United States, 9.8% of those students surveyed, said that they had self injured by cutting or burning themselves at least once.
Who engages in self injury?
Individuals who self-inure are not usually suicidal. The psychological portrait of the person who engages in self harm is most commonly a person who has been abused in some way as a child. Sexual abuse survivors are quite common among the population who inflict self injury to themselves.

The literature is fairly consistent that it is usually females who are between the ages of 13 and 30 who engage in either cutting or self-injury but it is a syndrome which also affects men, older people, and everyone in between. Even the famous are not immune to self-injury.

People such as Angelina Jolie, Fiona Apple, Johnny Depp, Courtney Love, and Christina Ricci have all admitted to the press that they have engaged in self injurious behaviors. I remember when Princess Diana startled the world with her confession that she would engage in cutting herself. My point is not to glamorize this. It is to show that the willful act to self injure crosses all boundaries. Even the rich and famous have issues which can lead them to engaging in self harm.

I feel that cutting and self injury is growing in our society. It has become ingrained even in our popular culture. You see it in movies. The films Girl Interrupted and Secretary come to mind. I hear about it more and more and especially here on-line. I have seen many questions coming in to this forum about cutting and it was a wake up call to me that this was a topic I did wish to write about despite the fact that this is emotionally difficult for me to do. It was a part of my life that I would just as soon forget. But if my story and experiences can help someone else, to tell you that you are not alone, then it is all worth it.

Why do People do this?
I suppose that from an outsider's view, the likely response might be to say, "Oh they are just doing it for attention." Actually this is usually the furthest scenario from the truth. Most people who engage in self harm try to hide their actions from others. Quite often the cutter will choose areas on the body hidden from view by clothing. I know one woman who would cut her upper thigh or behind the knee. There are many people who self injure who keep it a secret. There can be a feeling of deep shame and guilt involved.

There are times when it is used as an act to cry out for help.

When I was a teen and young adult, I was living in a very traumatic home situation. My mother was raising me by herself and she had a severe mental illness, paranoid schizophrenia. I am not sure when I began to cut myself but it was definitely in my early teen years. I would do it in response to stress, usually brought on by my mother's wild and sometimes violent mood swings. In a chaotic world where I could not control much of anything, the cutting gave me a means of power and control.

It was my way of stopping the world. When I felt that physical pain, it brought everything else to a screeching halt. The world was reduced to those thin red lines. It was a release for everything inside of me, the perfect symbol for my emotional pain. When I was numb, it was a way for me to feel something and to know I still existed. And when I didn't want to feel the magnitude of my anger or despair, it was a way to project those feelings outward into this small but controlled act.

I didn't wish to kill myself. I simply wanted the emotional pain and trauma to stop. And I didn't know how to ask for help. I didn't know how to cope with what was going on in my world, so cutting was a secret refuge. I did not truly want to do it. But it was all I knew how to do. It became a ritual behavior that I engaged in when I was feeling great stress.

Over time I let my secret out. I tested the waters to see if someone might help. I remember I had this poetry class in college. I wrote some rather dark poems about cutting and my elderly teacher was both disturbed and frightened by my writings. She even told me not to come back for the subsequent poetry session. Sometimes you take the risk of exposure and it doesn't work out.

Later, when I sought therapy, I did share my secret with my therapist and this was ultimately my salvation and road to recovery. The trick here is to tell your secret but to someone you can trust and who will help you.

Five Primary Reasons People Self-Injure:
  • The physical pain is used as a distraction from great emotional pain.
  • It is a way to feel something when you are feeling emotionally numb.
  • There is a psychological release one feels which may come from the endorphins released due to physical injury. These endorphins are natural pain killers and are a way to reduce stress.
  • Even though it is usually done in secret, it may be a way to communicate that you need help.
  • It is a way to deal with great anger by directing it at oneself.
There are possibly many other reasons why people engage in self-harm but these are the ones which I have consistently heard from both the literature and first hand accounts from people who hurt themselves.

What can be done?
I feel that what helped me the most was the professional help I got from a therapist. Having someone to talk to and to let out all those emotions was a tremendous relief. Also having other outlets to meet the need is essential. Basically you need to replace the cutting or other self injurious behavior with a more healthy way to cope. Artistic expression offers a huge realm of possibility for those who self-injure. When I discovered the power of journaling and writing, this did decrease my need for other measures to cope. Some people draw or paint. Others turn to physical activity like martial arts or running. You need something to get all that volcanic emotional activity out of you but in a way that won't hurt you.

Short term solutions are to immediately call or write someone when that urge is strong to hurt yourself. Distract yourself as long as you can from doing it until the mood passes. Do rote things like type a thousand X's, recite a poem over and over, march in place, snap a rubber band, anything which is rote and methodical to get you over the worst of it.

Self-injury can become an addiction of sorts. Some of the methods and treatments can be helpful here as well. Remove the instruments in your home which you use to self-harm or instruct someone else to keep watch over them.

There truly are no easy solutions. It is an incredibly difficult process to break free of this behavior. And it makes me weep to think that there are so many people out there who struggle with this.

I am going to leave you with a lyric from a song by Kimya Dawson as well as some resources. If you need help with this, please do reach out to a trusted friend, therapist, or write a question or post here to this site.

These lyrics are from Dawson's song, Loose Lips and when I first heard them I cried:

"so if you wanna burn yourself remember that I LOVE YOU
and if you wanna cut yourself remember that I LOVE YOU
and if you wanna kill yourself remember that I LOVE YOU
call me up before your dead, we can make some plans instead
send me an IM, i'll be your friend"


Resources:
 

NicNak

Resident Canuck
Administrator
I suppose that from an outsider's view, the likely response might be to say, "Oh they are just doing it for attention." Actually this is usually the furthest scenario from the truth. Most people who engage in self harm try to hide their actions from others.

I hid it. I wore long sleve sweaters in 40 degrees celcius weather to hide it. I did tell my doctors though. My GP listened to me and went and got a Tetnus shot immediately and gave it to me right there and then.


Five Primary Reasons People Self-Injure:
  • The physical pain is used as a distraction from great emotional pain.
  • It is a way to feel something when you are feeling emotionally numb.
  • There is a psychological release one feels which may come from the endorphins released due to physical injury. These endorphins are natural pain killers and are a way to reduce stress.
  • Even though it is usually done in secret, it may be a way to communicate that you need help.
  • It is a way to deal with great anger by directing it at oneself.
There are possibly many other reasons why people engage in self-harm but these are the ones which I have consistently heard from both the literature and first hand accounts from people who hurt themselves.

Can a disassociative state go along with the impulsive urge? Like the urge is there and I tried to fight it, but I couldn't release what ever it is inside, until I cut. Not sure what that would be called.

My psychiatrist had said it was impulsive. After the "episode" I was left exhausted. The more I faught the urge, the more exhausted I was. I remember after fighting it for an hour, sweating, called the doctor got advice, I couldn't fight it, so I cut anyway. I think over 3 days I was awake for 18hours in total.

When one is feeling impuslive, does a disassociation go along with it?

I no longer cut, but I still can't understand what was happening then, when I did.

I really hope I don't trouble anyone with these questions.
 
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