Many people reading this blog about cutting will understand just how others feel who cut. They may have cut themselves in the past, have a friend or family member who cuts, or be contemplating the next cut at this very moment.
Cutting is the act of deliberately inflicting a wound, of self-harming and differs from a suicide attempt per se. It could be said that while cutting serves many purposes it is often a way of coping, a way of dealing with emotional distress. It may be that the person cutting feels deep sadness, acute anxiety or emotional numbness. Sometimes cutting can be a way of relieving stress or trying to feel in control. For some, “X” marks the spot, just like a cross on a map, it can signify the presence of something hidden or buried deeply. For some cutting can be a “ritual of purification.” This type of “blood letting” can release perceived “badness,” and it may be a way of inflicting punishment on oneself.
The term “Cutting Club” might be a good metaphor for what young people look for – a “connectedness” with others who may feel alienated from family, peers or society. Cutting becomes a statement and others may identify with them, perhaps forming a friendship group Alternatively, it might be the entry requirement to joining the group itself.
It is not just cutting itself that bonds members of this club together, other forms of self harm serve the same currency. Scratching, burning, picking, tearing at skin, pulling out hair, swallowing poisonous or toxic substances, even breaking ones own bones, all share the same characteristics with often the same painful underlying themes.
In my experience as a therapist, cutting is frequently linked to underlying child abuse, in particular sexual abuse. It is more common in girls, but boys cut too. While I have seen boys and girls as young as 12 cutting, in my opinion the vast majority of those who do so, are in the 16 plus age group.
It may also be related to depression and anxiety. Quite often those, who cut may also turn to eating disorders or drugs as a way to cope. Sometimes it can be linked to conditions such as post-traumatic stress disorder. Sometimes, perhaps as a result of trauma, individuals feel ” dissociated” or ” numb” and this can be a way of feeling. For some people who have difficulty in regulating their emotions, cutting can be a way to cope when they do not have the personal resources to do so. It is not unusual for people to think about suicide when they are cutting, but it is not often meant as a suicidal act. The biggest danger is that the person cuts through an artery accidentally, seriously endangering their life.
I have seen cutting in all parts of the body including breasts and genitals, however, the most common injury sites are wrists, arms, thighs and sometimes stomach. I would not regard tattoos and body piercing as self- harm, unless of course, it is done deliberately to cause harm.
In most cases cutting is done secretly, often in the privacy of the home and mostly it is done where it can be covered up, perhaps by pulling down sleeves and hidden beneath layers of clothing.
Frequently, people who self- harm tell me that no one knows about this behaviour.
It can be very difficult for parents to deal with because they are so emotionally involved. Often they may blame themselves, sometimes they become angry, often because they feel both helpless and worried.
In my clinic I go to great lengths to try to understand what it is that underpins this behaviour. I know that it often signifies s deep emotional distress. It is a way of coping and I make sure to tell the person cutting that they are not bad and that this is not bad behaviour but merely a way of coping.
I explain that I am not judging them and neither am I going to take away this means of coping. Instead, I suggest that either working together to resolve the underlying conflict and/or providing them with a wider range of coping skills is really the best way to help.
It is very difficult to stop cutting because it can become a habit and ultimately an addiction. The very act of cutting releases “feel good” hormones known as endorphins, or to use the full medical name endogenous morphine.
Identifying the triggers is a key task and then teaching coping strategies other than cutting. Sometimes the addition of medication such as an antidepressant can help greatly. Having an opportunity to talk about the deep problems to a professional within a safe and confidential setting can really help. Sometimes having access to clean dressings and medical help may be needed, particularly if wounds are more than superficial.
If you are concerned about yourself or someone you know,make an appointment to see your doctor. Alternatively you may find that there is a young persons counselling service near you, and if you are at school or college there may be someone you can talk to in confidence. Please feel free to email me in confidence via my website and I will try to find help in your area.
Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.