Table of Contents
Why do people cut themselves?
This can be caused by many different reasons than people who have cut themselves. Who is not a sign of a specific mental or physical condition but rather a symptom associated with various other issues? Sometimes, the behavior results from deep-seated emotional issues that may or not be related to physiological, mental health problems.
Therefore, we do not begin with a description of the causes of people cutting themselves but with a description of the syndrome.
Cutting as part of NSSI spectrum
There are many actions directed against oneself that, while not intended to be suicidal, are harmful to the bodily health and integrity of the practitioner. These are called Non-Suicidal Self Injuries, or NSSI in abbreviation: deliberate, self-inflicted destruction of body tissue, not intended to cause death but carried out on purpose.
Cutting is the most common form of this behavior, but it can also include intentional burning (as with a cigarette), scratching, causes bruises, or even breaking bones. The National Institutes of Health (NIH) say that approximately one in every one hundred Americans has engaged in NSSI, more common among women than men and more common among young people than among mature adults.
What is cutting?
It uses a sharp object to make marks or cuts on the body on purpose, deep enough to break the skin and cause bleeding. Usually, the area of choice will be the forearms, thighs, or bellies: places that are easy to cover up. The implement used might be a knife, razor blade, scissors, the tab from a soda can, a nail file: almost anything you can imagine that will penetrate the skin.
Almost always, secrecy and a sense of social shaming accompany the cutting. Most who have taken these kinds of actions hide the results and make excuses to explain their existence; a few individuals on the other end of the spectrum may try to draw attention.
Understanding the psychology of NSSI cutting
Cutting often begins as an impulse after the afflicted person has been exposed to it through peers or the media. But many discover that once they start to cut, it becomes addictive: they do it more and more and have trouble stopping.
Thus, it is hazardous behavior because of the possibility of infection or severe injury and the compulsive and overwhelming pattern of its occurrence.
People who self-injure report that cutting provides relief from other deep painful emotions. If it works for them, they tend to repeat it again and again.
What problems do cutters feel as if they are solving?
- They struggle with powerful emotions that they do not know how to express elsewhere and feel they cannot withstand by themselves: a loss of love, a divorce, and grief. Very often, no one else knows about their feelings or does not imagine their overwhelming power. Sometimes it is the pressure to be perfect. Sometimes it is the harm of harsh treatment or neglect by adults. Sometimes it is about feeling unloved and depressed… Cutting is a way of testing whether they can still “feel” pain, whether they can escape from feeling the numbness of their position.
- Physical pain is visible and specific and thus preferred to the vagueness and inexpressibility of emotional pain. The act of cutting gives the practitioner a sense of control and relief to know where the pain is coming from. It symbolizes the deep inner pain that is hard to acknowledge, confide in others, or verbalize.
- Many cutters describe the relief when they are in the act of cutting. The relief they describe may be related to the release of endorphins, the “feel-good” hormones that the body releases during intense exercise. It is also possible relief is experienced as just a temporary distraction from the overwhelmingly painful emotions. It is also visible “proof” of how much pain they are truly experiencing.
- Cutting is addictive, habit-forming. The more someone cuts, the more they feel the need to do it. As with many other kinds of compulsion, the brain connects the temporary relief with the physical act; and when tension builds, the brain craves that relief/release. The practice is challenging to give up without help because the urge to cut is powerful when psychological pressure is intense.
- Peer pressure can be the initial impetus. It might be an individual friend or boyfriend who wants company in practice. Or it might be part of a group ritual that a teen is pressured to join.
Are all cutters suffering from more major mental health conditions?
Serious mental health problems are not always indicated in a person addicted to cutting, but they are a distinct possibility. Some cutters are struggling with other obsessions and compulsive behaviors and may be diagnosed with an obsessive-compulsive disorder or OCD. Others may have wide fluctuations in mood that they cannot control, indicative of being depressed or having bipolar disorder.
Some with personality disorders can find themselves unable to cope with disappointment or loneliness, or anger. Alternately, a personality disorder can be responsible for compelling a person toward risky behavior, including self-destructive acts. Still, others may have experienced terrible abuse as children and are now in the midst of posttraumatic stress or PTSD.
Substance abuse is another frightening dual diagnosis. Consulting with a physician well-versed in psychology ought to be considered.
Discovery of the cutting
A few of those who cut may do so to call attention to themselves and get help as a result. If medical attention is sought for severe injury, that can also be a way of discovering that a loved one or friend is practicing this kind of risky relief. However, many people can cut for a long time before they are discovered.
They wear long-sleeves and other cover-ups so that no one can see the scars. Some of them may eventually confide in someone who will help them get help, although they may fear being misunderstood or worry about others being disappointed or angry.
If a family member or trustworthy friend suspects the behavior, confrontation is a good idea. Different people will respond differently. Some may deny or refuse help; others may be relieved to know that someone cares and will help. For those who may have a more entrenched psychiatric condition, a hospital stay may be necessary.
Some people can stop cutting on their own if they can find within themselves a motivation. The first step is for the person to realize that their behavior is connected to deep unshared emotions, and then they will recognize that they need to find an alternate way to deal with their problems and pain.
They need to learn how to regulate feelings that seem to be overwhelming through practices like talk therapy or meditation. It will take courage and strength, and support from others to break the habit.
When a friend or loved one self-injures
If you are the one who has discovered that a friend or a loved one is injuring themselves, you may not know what to do. Perhaps looking online for answers is the first place you have turned. First of all, know that it IS important to take self-injury seriously even if it does not at first appear to be life-threatening.
It is risky behavior that becomes increasingly dangerous, not only because of the possibility of injury but also because of the escalation of the feelings that led to the behavior itself.
Although you may worry about tattling on something that your friend has asked you to keep in confidence, it is too big a problem for you to hold by yourself. Here are some things you can do.
If the victim is your child…
Begin with talking with your pediatrician or family doctor. If your child is willing, make an appointment for an initial evaluation and, if needed, referral to a mental health specialist. Do not yell at, cry or accuse your child. Remain calm, listen, and invite them to see the doctor.
If it is your friend/peer
It is hard, of course, not to be considered a tattler. The best way around this is to talk with your friend and suggest a friendly, sympathetic adult with whom they might speak. Hopefully, this might be one of their parents, grandparents, or uncle or aunt. If not, help them think of another adult who could help: a school counselor, teacher, coach, or pastor.
If it is another adult
Listen for as long as it takes, and then firmly persuade your friend to seek appropriate help from a doctor or mental health professional.
If there are no direct discernible causes for cutting behavior, what are the factors that increase its risk?
- Being female. As we have already said, females are statistically more likely to cut than males.
- Being young. Who is most common among young people
- Having peers/friends who self injure.
- Larger life issues. Many people who self-injure have been neglected or abused as children. They may still be in the same unstable home environment, questioning their identity and their sexuality.
- Mental health issues. Cutters are likely to be impulsive, explosive, and self-critical. The behavior is often associated with more serious mental health disorders, such as borderline personality, being depressed, anxiety, eating disorders, and posttraumatic stress disorder (PTSD).
- Excessive alcohol or drug use. Those who harm themselves often do so while under the influence of alcohol or illegal drugs.
Coping tips for the helper or loved ones
First of all, educate yourself. Learning more about NSSI will help you understand why this self-destructive behavior occurs. More knowledge will help you be compassionate and firm in helping the person stop the behavior and seek help. You need to try not to judge or criticize, especially by raising your voice. That may lead to more of the behavior.
Make sure they understand that you love them and care about them no matter what and that you are always available to listen and talk and work with them to find help and create non-injurious coping methods. Give them ideas about how you cope with stress and offer to teach them how to implement it.
And lastly, find support for yourself: talk with other parents or friends who have dealt with this, especially if you can find a support group through references from your local health providers or through NAMI or other mental health organizations. Make sure to take care of yourself while caring for your loved one: get exercise and rest.
What are some alternate ways of relieving stress and balancing emotions?
Again, there are as many alternatives as there are individuals. One vital process to put into motion is helping the afflicted person use their words instead of their actions. Perhaps that sounds like advice for a raging toddler, but in fact, learning to talk openly with others and writing in a journal is an essential first step in learning how to cope with strong emotions.
Another meaningful learning is that exercise –moving the body and taking in extra oxygen to the lungs – will increase well-being feelings. Singing works well in this regard, and vigorous participation in their art form or sport of choice: playing a musical instrument, dancing, painting, sculpting, etc.
The hope is that eventually, the cutter will find ways to use self-reflection to explore and cope with the range of human emotions that seem to come under control. With the cutting behavior.