Cutting and Self-Mutilation: A Detailed Look into the Lives of People Who Live by the Blade

There are about 300,000 individuals in the United States that self-injury. The majority of the population in the United States does not acknowledge the people who self-injury. Those who do not understand the process that leads the individual to this act look down upon the behavior of people who self-injure.

My first incident of self-injuring occurred when I was only thirteen years old. My family had moved and I started a new school where I knew no one. I had trouble finding where I belonged in school and adapting to this sudden change. I began taking my mothers sewing needles and carving shapes into the skin around my ankles and feet, places that were easily covered by clothes.

Though it was painful at first the numbness that engulfed my confused body and mind quickly dulled the sense of pain. Once a small line of blood surfaced from the torn skin, a strange feeling of calmness settled my nerves. Then the feelings of scary confusion stopped as quickly as they started.

Professionals have different names for this type of self-inflicted violence, such as self-injury, self-harm, delicate cutting, self-abuse, and self-mutilation. The later reference to this behavior particularly offends the individual that self-injures. The reference of "self-mutilation" makes the already lowered self-confidence of the confused individual, feel even worst about them self. The word mutilation carries a negative connotation that is universal.

Self-injury is the act of attempting to change a mood by inflicting actual physical harm that is serious enough to damage the skin and can be severe enough to damage the inner tissue of the body. The American Academy of Child and Adolescent Psychiatry has discovered several methods that self-injurers choose to use in order to self-harm.

· 72% cut themselves

· 35% burn themselves

· 30% hit themselves

· 22% pick wounds

· 10% pull out their hair

· 8% break their own bones.

There are two types of behavior among those who cause self-harm. The impulsive or episodic self-injurers are the individuals that occasionally harm themselves. The second type of behavior is the compulsive self-injurer. This individual commonly inflicts harm upon himself or herself by pulling locks of hair out, biting fingernails until they bleed, and not allowing wounds to heal because he or she picks at the scabs, instead of allowing them to heal.

The individual that self-harms relates to the scars from self-inflicted wounds, it is a reminder of what he or she has accomplished. Dr. Wendy Lader, PhD, co-author of the book Bodily Harm, agrees with this and says that an estimated 1% of the U.S. population or 300,000 people, resort to physical self-injury to cope with extreme emotional distress, but that rate is much higher among adolescent females. "It's harder for kids to get noticed as individuals, and they don't have the words for it," says Lader, who is also clinical director of the SAFE (Self-Abuse Finally Ends) Alternatives program at Linden Oaks at Edward Hospital in Naperville, Illinois. "So they show it, even if it's just to themselves because it makes it real for them. It's almost like their body becomes a bulletin board on which to notch their pain."

The typical self-injurer is a female, in her twenties, and has generally been inflicting self-harm since her adolescence. This is not to say that men do not self-injure, but it is very rare for men to admit this behavior to others. Self-injurers are from any financial and educational background. In at least half of the cases of people who self-injure, professionals have found a form of physical or sexual abuse in the individual's younger years.

Dr. Armando Favazz, professor and vice chairman of the Department of Psychiatry at the University of Missouri-Columbia, whose research received the Creative Scholarship Award from the Society of Psychiatry and Culture, is a fellow of both the American College of Psychiatrists and the American Psychiatric Association. Dr. Favazz claims that there are particular situations that can cause an individual to feel like they must result to self-injury, such as:

· If an individual is rejected or denied by a family, friend, or person of authority.

· If a person is blamed for something, that he or she did not do or have any control over.

· If a person feels inadequate or is proven wrong.

The act of self-injury reduces the physiological and psychological tension rapidly, allowing the person to feel like he or she has a sense of control over the situation and emotions. Some individuals cannot cope with stressful situations and do not necessarily deal with them in ways that society can relate. Self-harm helps people deal with irrational feelings, express anger, and it can be a way of communicating what they need or want, but cannot find the words to express. The act of self-harm is not a failed suicide attempt. Self-harm is a coping mechanism that helps people feel alive from the numbness that has consumed their mind and body.

If a family member, spouse, or concerned friend decides to help, it must be understood that there is no quick fix and it takes a long time to help a person that has lead a life of self-harm. If a person decides to confide in another person that they trust or a loved one, concerning secrets about their problems or feelings, it is essential that the confidentiality be kept.

Nighttime is especially hard for a person that self-injures; it is always a wise decision to check on the person in the later evening hours. That contact with another person, even if it is by phone, can help a lot and give back a feeling of worth.

In my early twenties, after marriage, I would get especially sad and lonely when my husband would leave and the house would be alone. Once the sun would set the engulfing, feelings would rise and the emotions would start to fly out of control. Then for hours, I would set in the floor of the bathroom; tears in my eyes and steak knife in hand. After my husband discovered the patterns in my behavior, he would make it a point to call me often and check on me. This small interaction stopped my urges from self-harming.

Inpatient mental hospitals are not appealing places for those who need them the most. An individual, who is involuntarily admitted into a hospital, may feel like personal freedoms, liberties, and rights have been violated and taken away. An alternative to this severe decision is an outpatient therapeutic program. These programs offer therapy only a few hours a day for an extended time period, while allowing the individual an opportunity to still posses a feeling of freedom. The sessions of group and individual therapy are generally led by a certified therapist and supervised by a board certified psychiatrist. The psychiatrist that closely monitors the individual's progress can prescribe medications that stabilize the person's mood, ease depression, and calm anxiety, which reduce the urges to self-injure.

However, there are some problems with seeking professional help. Dr. Tracy Alderman, PhD., a licensed clinical psychologist from San Diego, a director of research at the University for Humanistic Studies and a staff psychologist for the California Department of Corrections, has written extensively on the subject of self-injury, supports the suspicions of possible problems when seeking help from some professionals. People in society have uncomfortable feelings about those who inflict harm onto themselves. Dr. Alderman suggests that the professionals who are unable to cope with their own feelings should refer their patient to someone that is specifically trained to deal with those who harm themselves.

In some severe cases, the self-injurer cuts a little too deep; he or she will need medical attention to administer medications, sutures, and possibly plastic surgery. It is common for the self-injurer to be treated not as deserving as others are for medical treatment, because they caused their own injury. Because people have mixed emotions about the individuals who self-injure, this can make the visit to the hospital that much worse.

Around the age of twenty-three, I cut myself a little to deep and went to the local emergency room for treatment. After an incredibly long wait in the sitting area, the triage nurse called me back to check my vitals. The blood soaked kitchen towel that was knotted tightly around my wrist, was forcefully unwrapped. Once the pressure was released, the blood had begun to rush out again. The nurse looked at it and asked me why I had done it. I pleaded with her that I was not suicidal, it was a coping mechanism and I had accidentally gotten a hold of my husbands newly sharpened kitchen knives.

This particular incident was the worst that I had ever experienced, though I never felt a pain from the cut. I had severed all five of the tendons on my left wrist. The nurses in the emergency room stood outside of my room and the doctors questioned my husband, as though it were a domestic violence case. The nurses took my clothes, refused to return them, and neglected to explain to me of their intentions. They sutured my wrist without any sedation or pain reliever.

A psychiatrist drilled me for about ten minutes and claimed that I needed to me admitted to the psychiatric unit, because he believed that I was a danger to myself and to others. Once I was admitted, I was explained to me that I would be there until I was better. I was not allowed to contact my husband or family. This only hurt my feelings and made me depressed, that much more.

Hospitals are supposed to be comforting places that serve as a nice recovery, not a place that a person is afraid to go because they are treated bad or are not allowed to leave. Actions of the professionals in hospitals will determine if a person decides to seek help or not. If a professional refuses to give anesthesia for stitches because the professional does not consider the entire situation and determines that, the patient can handle the procedure without giving the regulated anesthesia. When a caretaker makes a disparaging remark and treats the patient as though they are solely to blame for their visit to the hospital, it can defeat the purpose of the patient seeking help in the first place.

This type of behavior from professionals simply furthers the feelings of invalidation and unworthiness that the self-injurer already feels. If a person has a bad experience in the emergency room like being forced to stay 48 to 72 hours for a psychological evaluation or being mistreated by the physicians or the nursing staff, this rude behavior can prevent a person from seeking medical assistance for future wounds that can cause infections or other complications.

Specialized treatment programs allow people to deal with their harmful coping mechanisms. In a specifically designed program with people who are educated and trained specifically for the gentle care that is required when dealing with people who have such critical problems, the environment is secure, comfortable, and welcoming for the patient. There are many different contacts that can provide educating information about programs that are ideal for the treatment and recovery of self-injurers.

Hartgrove Hospital's Program for the Treatment of Self-Injury at

520 North Ridgeway, Chicago, IL. 60624: (312) 722-3113

Self-Abuse Finally Ends (SAFE) 1-800-DON'T-CUT, or 1-800-366-8288
A national information line with referrals to therapist led support groups around the country.

The Cutting Edge, A self-injury magazine.

P.O. Box 20819, Cleveland, OH. 44120

As a recovering self-injurer, I have attempted many different methods in my recovery. The most important aspect in my recovery has been the support and compassion of the individuals around me. My family and husband have played a large role in my recovery from self-harming. The goal of the self-injurer is to stay alive, not to commit suicide or get the sympathy of others. The desperate methods that self-injurers employ are upsetting to those who deal with their own problems in a more tranquil manner. Not everyone is aware of the disorder that turns people to self-injure, and when a friend, family member, or other loved one has discovered it, the person may tend not know how to react or treat the self-injurer. Self-injurers want what everyone else wants: an ordered life, spiritual peace, and a healthy mind inside of a healthy body.