Cutting is a general term for a variety of self-injurious behaviors. If you have never been a cutter, it will be hard for you to understand why your son or daughter would want to intentionally harm himself or herself, but over 2 million people in the United States do just that. More than 70 percent of self-injurers are women, mostly between the ages of eleven and twenty-six, and they come from all races and social classes. And according to my own observations, the numbers are on the rise among the college-age population. Here is the story of one young woman who is finding her way through this confusing coping mechanism:
I started cutting during the spring semester of my sophomore year. It would happen when I was facing a lot of emotional stimulus, and it was a way of channeling my consciousness into a physical space on my body. But it was never a suicide attempt. I'm sure it had to do with the way I hated my body and my disgust of my physical self, and part of it was both a cry for help and a desire to inflict intense pain and to show others that I could handle it.
I cut while I was alone in my room. I sat in a comfortable chair by my desk, dimmed the lights, and had tissues or a washcloth nearby. When I first started cutting, I used a switchblade or a butterfly knife. But by the summer, I had moved on to straight razor blades. The knives were fairly dull, and I had to apply a great deal of pressure before getting a clean cut, while the razor blades drew blood easily. I kept pretty neat about it; I used the tissues or washcloth to stop the blood while I was cutting, although you can do a lot of cutting without drawing a huge amount of blood.
When I cut, I assumed the role of a surgeon and imagined my body as a distant object that needed fixing. While I was cutting, I was always very rational and would think about anything from the work I had left to do that day to things I needed to do to improve myself. After I finished cutting and returned to the role of a patient, however, I sometimes felt disgust or fear at what I'd done. Some of this reaction was physical"I got very cold and sometimes couldn't stop my teeth from chattering. If I made only a couple of small cuts, I would feel energized and powerful afterward. But other times, when I would make a whole event of more drastic cutting, it was to help me release pain and then feel numb. I went back and forth between feeling a sense of pride and shame.
I never saw my cutting as dangerous or scary, and I didn't always try to hide it. In a perverse kind of way, I actually broadcast it to the people in my life I was having emotional issues with. It became a way of talking through my problems. When people reacted with disgust and shock, it was the most satisfying for me. Looking back on it, I see that most of my friends and family realized that the cutting was just a sign that I wanted to talk about my life but didn't know how to start the conversation. I know it's natural for a parent to react with panic, but it's better to be calm, ask questions, and de cide what the next step should be. I'd rather not focus on the cutting but on what was behind it.
Throughout that spring when things were really bad for me, I cut about once a day. At other times, I cut more sporadically, ranging from one to three times a week. But then as my emotional life started to get better, I really didn't feel the need to cut. I was developing a good therapeutic relationship with my on-campus counselor. I got out of some troublesome romantic relationships, and I made a conscious effort to change some difficult friendships. I made myself reach out to friends and just be myself without worrying about how they would perceive and judge me. I also started working on managing stress better. That summer, I gave myself permission to do less without always worrying about what I could be doing to put on my transcript, although I admit that that decision sometimes made me feel more guilty and inadequate and on some days led to a downward emotional spiral.
I don't feel like I am completely through with cutting. I still keep razor blades in my room and have cut occasionally this semester. But I feel that I am developing other tools for expressing my insecurities, and the cutting is much less frequent. I see cutting as being on a continuum of body issues that began with an eating disorder that surfaced when I was thirteen, and I believe that disgust at my body and a feeling of alienation from my physical self will always be part of my experience, even when I have ceased cutting entirely. I do, however, see hope for the possibility of managing my relationship with my body better in the future, and I haven't given up on the possibility that one day my body and I will be able to peacefully cohabit.
A Secret Act
Kids involved in cutting look quite normal and fit in with their peers. They are generally good students and are actively involved in school activities. Most are ashamed of their self-inflicted injuries and are very secretive about the practice, so they often injure places that can be easily hidden by clothing, such as the arms, upper chest, and upper thighs.
Their methods of injury are varied. Cutting is the most common expression of this disorder. The person will use any sharp object"a razor, box cutter, knife, broken mirror, or even the flip top off a soda can"to cut the skin, making a shallow cut just deep enough to draw blood. Burning is also a popular method of self-injury. In this case, an item such as a lit cigarette, a piece of hot metal, a lighter, or a match is used to burn the skin. Scratching is a simpler method that involves using the fingernails to scratch at the skin until a wound is opened. Less common methods of self-mutilation are self-hitting, hair pulling, and self-biting.
Most often, the injuries are superficial, but there is always the risk of going too far. Someone who cuts too deep might accidentally hit an artery and bleed to death. And if they continually pester the injured area to prevent it from healing, they may get serious skin in fections from the festering wounds.
Why?
Self-injury is a coping mechanism. It is a way to deal with life and the emotional pain it can bring. Often the first episode of self-injury is triggered by some event that causes much tension or stress (and we know there are plenty of such events during the college years). Many of those who self-injure say they do it to release pain. Fear, anxiety, anger, isolation, sadness, loneliness, or emotional pain builds up inside until they feel that they'll explode without some form of release. Self-injury serves that purpose.
Others self-injure for exactly the opposite reason: they are numb inside and feel no emotion, so they appreciate the raw pain of in jury. Finally, they can feel something. In these cases, cutting can be a way to be temporarily distracted from real feelings.
Some who self-injure feel a strong need to punish themselves for a perceived wrong. This is frequently the case with victims of child sexual abuse who believe on some level that the abuse was their fault. Filled with self-loathing and alienation, they have an intense desire to do themselves harm.
Cutting can also be a symptom of an underlying psychiatric disorder such as depression, obsessive-compulsive disorder, Gilles de la Tourette syndrome, psychosis, borderline personality disorder, kleptomania, trichotillomania (hair pulling), eating disorder, or body dysmorphic disorder.
Resources for More Information About Cutting
- Self-Abuse Finally Ends (SAFE), 1-800-DONTCUT, http://www.selfinjury.com
- Dana Sullivan, "Self-Injury: Poorly Understood Problem," http://www.cnn.com/2000/HEALTH/09/05/self.mutilation.wmd/
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