Why Non-Cutters Should Worry Less: In Defense of Self-Mutilation, part four
How Much Should Cutting Worry Non-Cutters, as Opposed to, Say …
I don’t know. What are they worried about?
Cutting or any other act of self-mutilation is worrisome, of course, because it means that the person in question is not at peace with his/her world, that his/her emotional and psychological turmoil is not relieved by any socially acceptable means, and that s/he does not feel s/he can trust the coping skills endorsed by his/her parents, healthcare providers, teachers, etc., to take the place of self-harm. It means that the person probably feels a degree of lostness, loneliness, emptiness, sadness, anxiety, hatred, self-loathing, confusion, anger, and lots of other difficult emotions that may far surpass any negative emotion you have felt in your own life. It means that this person, in some sense, is exploring his/her own mortality and is, statistically, more likely to attempt suicide than a random person from the general population. If it were my friend of sibling or child, I would worry too, about the overall condition. (You should realize, of course, that freaking out, yelling at the person, imposing a Nazi-like set of rules, demanding sweeping changes right away, and/or inviting the person into a sweetly sanitized version of your world where everything will just be all right … These interventions are more likely to make things worse than better.)
But the cutting itself … What are you worried about?
Infection? That is a real concern, but it can be minimized with clean razors or knives, some rubbing alcohol or another antiseptic, and some gauze pads. When a cutter accepts the impulse to self-injure as a way of coping without burdening it with moral labels, the cutter will be more likely to do it safely.
Suicide? Cutting is not suicidal behavior, and does not necessarily indicate suicidal ideation. I sincerely doubt cutters are any more at risk for suicide than other depressed people with other less-than-ideal coping mechanisms like excessive drinking. Worry about the depression
Cutting as the New Teen Craze? No. There is a study published in summer 2007 claiming that 46% of teens have deliberately injured themselves (as opposed to 4% of the general population) and a 2008 Canadian study claiming 17.6% (or “one of six”) young people age 14 to 21 has done so. I suspect these studies are flawed and their numbers inflated, however. There is an enormous difference between generations in terms of what behavior would be reported in a psychological survey and how.
Teens today live in a more open culture in terms of psychological and psychiatric issues, and an arts and entertainment culture that often wears its pain on its sleeve (see emo). My guess is they are much more likely to report (and possibly more likely to overreport or falsely report) self-injury. Older cohorts, on the other hand, are less likely to admit to self-injury even on an anonymous survey—and this is increasingly true as we go back to older and older generations.
Categories of self-injury in these studies may be troublesome also. The articles linked above do not give sufficient detail to seriously examine this issue, but the numbers seem ridiculously high to me, so I find it suspicious. Behaviors listed in the articles include “cutting or burning skin, … biting or hitting oneself,” “scratching, … and minor overdoses of drugs (… prescription drugs [or] street drugs) and alcohol.” So every kid who pukes or passes out on drugs or booze is a self-injurer? Does hitting oneself include slapping oneself to stay awake? Does hitting or banging one’s head against a wall count (even though that probably would have been an expression of rage in older generations, not a deliberate self-injury)? Do injuries from Jackass-style pranks, backyard wrestling, or extreme sports count?
Don’t worry about the “fad”—the real fad is emo, which is essentially the same as that folk-singer-songwriter-confessional-poet-david-bowie-joy- division-robert-smith-morrissey-sad-grunge thing we all grew up on. It is no more dangerous now than it was then.
Cutting itself is not as dangerous as the hype suggests. I’d place it above habitual overeating, but below thrill-seeking extreme sports-type stuff on the danger scale. The risk is manageable. Like most addictions or habitual maladaptions, it will at some point cease to give the cutter what s/he wants, at which point a decision must be made, help must be sought (in my opinion), and recovery must begin.
Until then, friends and family of cutters, especially if you are non-cutters, need to focus on harm reduction and the underlying depression, anxiety, frustration, and/or stress lying under the self-injury. If you fuck this up by freaking out, moralizing, pontificating, accusing, etc., you will be much worse for the kid than the razor itself.
How I Lost Thirty Pounds in Thirty Days said,
May 4, 2009 at 9:21 am
Hi, good post. I have been thinking about this issue,so thanks for writing. I’ll definitely be coming back to your posts.
Tammy said,
June 10, 2009 at 4:15 am
I have to say I disagree with this. I am a former cutter. Cutting can be very dangerous. There were many times that I could not get the bleeding to stop because of how deep the cuts were. If you disassociate when you cut it an be dangerous because you lose track of time. You cut for hours and you are not carefull. Depending on where you cut you can accidently cut to close to a major vain. I was carefull about using clean blades and I still got a blood infection. If you have a person in your life who cuts it is ok to worry about them. Don’t freak out on them but let them know that you are there for them whe they need you. Love them and reach out to them. If they are wanting to stop cutting suggest that they be accountable to them. Urge them to seek counseling. Help them come up with other outlets for their anger and self loathing. Cutting is dangerous and even when you stop cutting the scars don’t go away. I haven’t cut in 3 years and my arms, legs and stomach are still very scarred. Wearing short sleaves is still hard because people always ask what happened. So please be concerned and take interest if you know someone is cutting.
f15h said,
July 7, 2009 at 11:58 am
Thank you, Tammy, for your comment. As I research and reflect upon self-mutilation, I’m coming to realize that it is more complicated than I have led myself to believe. My point in these posts is that we must begin to understand self-mutilation from the perspective of the self-mutilators, especially the active ones: unconscious and conscious, metaphorical and concrete, psychological and physiological. It is a coping mechanism that works to an extent, especially when no other coping mechanisms are available that subjectively alleviate acute agitation, anxiety, depersonalization, and other phenomena. Like alcohol, the relief is temporary and over time can lead to greater degrees of use, destruction of the body, reduced capacity to cope, even death. But it does protect the self-mutilator from what s/he sees as a traumatic situation or toxic environment, for a while, at least. It also connects to historical and cultural practices that have been used across time and across the world to provide structure to communities and to individual psychological development. In a time that lacks such social structure, I believe that self-mutilation may be an unconscious personal way of providing oneself that structure. The problem among clinicians, healthcare workers, parents, and peers is often that revulsion and fear get in the way of the necessary empathy and understanding. Often what they offer self-mutilators are threats to take away the only coping mechanism that has worked for them, new mechanisms that seem foreign and suspicious, and implicit judgment that increase feelings of alienation and anxiety. But you are right, it is dangerous, especially when it escalates, and active efforts are needed to treat it. The question is how can we treat it effectively? How can we help active self-mutilators to make a transition to recovery? I don’t know the answers, and from what I have seen and heard and read, no one else knows the answers either. As a recovering cutter myself, I would love to continue this discussion with you and work toward a solution.