What Is Cutting?
Emma's mom first noticed the cuts when Emma was doing the
dishes one night. Emma told her mom that their cat had scratched
her. Her mom seemed surprised that the cat had been so rough, but
she didn't think much more about it.
Emma's friends had noticed something strange as well. Even
when the weather was hot, Emma wore long-sleeved shirts. She had
become secretive, too, like something was bothering her. But Emma
couldn't seem to find the words to tell her mom or her friends
that the marks on her arms were from something that she had done.
She was cutting herself with a razor when she felt sad or
upset.
Injuring yourself on purpose by making scratches or cuts on your
body with a sharp object - enough to break the skin and make it
bleed - is called cutting. Cutting is a type of
self-injury
, or SI. Most people who cut are girls, but guys self-injure, too.
People who cut usually start cutting in their young teens. Some
continue to cut into adulthood.
People may cut themselves on their wrists, arms, legs, or
bellies. Some people self-injure by burning their skin with the end
of a cigarette or lighted match.
When cuts or burns heal, they often leave scars or marks. People
who injure themselves usually hide the cuts and marks and sometimes
no one else knows.
Why Do People Cut Themselves?
It can be hard to understand why people cut themselves on
purpose. Cutting is a way some people try to cope with the pain of
strong emotions, intense pressure, or upsetting relationship
problems. They may be dealing with feelings that seem too difficult
to bear, or bad situations they think can't change.
Some people cut because they feel desperate for relief from bad
feelings. People who cut may not know better ways to get relief
from emotional pain or pressure. Some people cut to express strong
feelings of rage, sorrow, rejection, desperation, longing, or
emptiness.
There are other ways to cope with difficulties, even big
problems and terrible emotional pain. The help of a mental health
professional might be needed for major life troubles or
overwhelming emotions. For other tough situations or strong
emotions, it can help put things in perspective to talk problems
over with parents, other adults, or friends. Getting plenty of
exercise can also help put problems in perspective and help balance
emotions.
But people who cut may not have developed ways to cope. Or
their coping skills may be overpowered by emotions that are too
intense. When emotions don't get expressed in a healthy way,
tension can build up - sometimes to a point where it seems almost
unbearable. Cutting may be an attempt to relieve that extreme
tension. For some, it seems like a way of feeling in
control.
The urge to cut might be triggered by strong feelings the person
can't express - such as anger, hurt, shame, frustration, or
alienation. People who cut sometimes say they feel they don't
fit in or that no one understands them. A person might cut because
of losing someone close or to escape a sense of emptiness. Cutting
might seem like the only way to find relief or express personal
pain over relationships or rejection.
People who cut or self-injure sometimes have other mental health
problems that contribute to their emotional tension. Cutting is
sometimes (but not always) associated with depression, bipolar
disorder, eating disorders, obsessive thinking, or compulsive
behaviors. It can also be a sign of mental health problems that
cause people to have trouble controlling their impulses or to take
unnecessary risks. Some people who cut themselves have problems
with drug or alcohol abuse.
Some people who cut have had a traumatic experience, such as
living through
abuse
, violence, or a disaster. Self-injury may feel like a way of
"waking up" from a sense of numbness after a traumatic
experience. Or it may be a way of reinflicting the pain they went
through, expressing anger over it, or trying to get control of
it.
What Can Happen to People Who Cut?
Although cutting may provide some temporary relief from a
terrible feeling, even people who cut agree that it isn't a
good way to get that relief. For one thing, the relief doesn't
last. The troubles that triggered the cutting remain - they're
just masked over.
People don't usually intend to hurt themselves permanently
when they cut. And they don't usually mean to keep cutting once
they start. But both can happen. It's possible to misjudge the
depth of a cut, making it so deep that it requires stitches (or, in
extreme cases, hospitalization). Cuts can become infected if a
person uses nonsterile or dirty cutting instruments - razors,
scissors, pins, or even the sharp edge of the tab on a can of
soda.
Most people who cut aren't attempting suicide. Cutting is
usually a person's attempt at feeling better, not ending it
all. Although some people who cut do attempt suicide, it's
usually because of the emotional problems and pain that lie behind
their desire to self-harm, not the cutting itself.
Cutting can be habit forming. It can become a
compulsive behavior
- meaning that the more a person does it, the more he or she feels
the need to do it. The brain starts to connect the false sense of
relief from bad feelings to the act of cutting, and it craves this
relief the next time tension builds. When cutting becomes a
compulsive behavior, it can seem impossible to stop. So cutting can
seem almost like an addiction, where the urge to cut can seem too
hard to resist. A behavior that starts as an attempt to feel more
in control can end up controlling you.
How Does Cutting Start?
Cutting often begins on an impulse. It's not something the
person thinks about ahead of time. Shauna says, "It starts
when something's really upsetting and you don't know how to
talk about it or what to do. But you can't get your mind off
feeling upset, and your body has this knot of emotional pain.
Before you know it, you're cutting yourself. And then somehow,
you're in another place. Then, the next time you feel awful
about something, you try it again - and slowly it becomes a
habit."
Natalie, a high-school junior who started cutting in middle
school, explains that it was a way to distract herself from
feelings of rejection and helplessness she felt she couldn't
bear. "I never looked at it as anything that bad at first -
just my way of getting my mind off something I felt really awful
about. I guess part of me must have known it was a bad thing to do,
though, because I always hid it. Once a friend asked me if I was
cutting myself and I even lied and said 'no.' I was
embarrassed."
Sometimes self-injury affects a person's body image. Jen
says, "I actually liked how the cuts looked. I felt kind of
bad when they started to heal - and so I would 'freshen them
up' by cutting again. Now I can see how crazy that sounds, but
at the time, it seemed perfectly reasonable to me. I was all about
those cuts - like they were something about me that only I knew.
They were like my own way of controlling things. I don't cut
myself anymore, but now I have to deal with the scars."
You can't force someone who self-injures to stop. It
doesn't help to get mad at a
friend who cuts
, reject that person, lecture her, or beg him to stop. Instead, let
your friend know that you care, that he or she deserves to be
healthy and happy, and that no one needs to bear their troubles
alone.
Pressured to Cut?
Girls and guys who self-injure are often dealing with some heavy
troubles. Many work hard to overcome difficult problems. So they
find it hard to believe that some kids cut just because they think
it's a way to seem tough and rebellious.
Tia tried cutting because a couple of the girls at her school
were doing it. "It seemed like if I didn't do it, they
would think I was afraid or something. So I did it once. But then I
thought about how lame it was to do something like that to myself
for no good reason. Next time they asked I just said, 'no,
thanks - it's not for me.' "
If you have a friend who suggests you try cutting, say what you
think. Why get pulled into something you know isn't good for
you? There are plenty of other ways to express who you are.
Lindsay had been cutting herself for 3 years because of abuse
she suffered as a child. She's 16 now and hasn't cut
herself in more than a year. "I feel proud of that,"
Lindsay says. "So when I hear girls talk about it like
it's the thing to do, it really gets to me."
Getting Help
There are better ways to deal with troubles than cutting -
healthier, long-lasting ways that don't leave a person with
emotional and physical scars. The first step is to get help with
the troubles that led to the cutting in the first place. Here are
some ideas for doing that:
-
Tell someone.
People who have stopped cutting often say the first step is the
hardest - admitting to or talking about cutting. But they also
say that after they open up about it, they often feel a great
sense of relief. Choose someone you trust to talk to at first (a
parent, school counselor, teacher, coach, doctor, or nurse). If
it's too difficult to bring up the topic in person, write a
note.
-
Identify the trouble that's triggering the
cutting.
Cutting is a way of reacting to emotional tension or pain. Try to
figure out what feelings or situations are causing you to cut. Is
it anger? Pressure to be perfect? Relationship trouble? A painful
loss or trauma? Mean criticism or mistreatment? Identify the
trouble you're having, then tell someone about it. Many
people have trouble figuring this part out on their own. This is
where a mental health professional can be helpful.
-
Ask for help.
Tell someone that you want help dealing with your troubles and
the cutting. If the person you ask doesn't help you get the
assistance you need, ask someone else. Sometimes adults try to
downplay the problems teens have or think they're just a
phase. If you get the feeling this is happening to you, find
another adult (such as a school counselor or nurse) who can make
your case for you.
-
Work on it.
Most people with deep emotional pain or distress need to work
with a counselor or mental health professional to sort through
strong feelings, heal past hurts, and to learn better ways to
cope with life's stresses. One way to find a therapist or
counselor is to ask at your doctor's office, at school, or at
a mental health clinic in your community.
Although cutting can be a difficult pattern to break, it is
possible. Getting professional help to overcome the problem
doesn't mean that a person is weak or crazy. Therapists and
counselors are trained to help people discover inner strengths that
help them heal. These inner strengths can then be used to cope with
life's other problems in a healthy way.
Reviewed by:
D'Arcy Lyness, PhD
Date reviewed: March 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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