By Jennifer A. DuBos, MA LPC
The subject of self-injury, or cutting as most people generically refer to it, is something that can turn any parent’s stomach. We think “What could have happened to my child that would be bad enough to make her want to cut herself?”
Cutting, or self-injury, has seen a dramatic rise in occurrence and awareness over the last five years, but the practice of self-harm is by no means a new phenomenon. Historically, human beings have been self-injuring for millennia – commonly as expressions of relational or tribal loyalty, or religious devotion, as a way of solidifying an oath, or as a form of grief expression.
In our contemporary society, the advancement of modern medicine, psychology, and a growing movement towards diplomacy versus violence, has rendered self-injury an antiquated and unhealthy way to cope. Though cutting is the most common form of self-injury I currently see in the clinical setting, the practice of self-harm as a coping mechanism takes many different forms; some more severe than others. Burning and piercing are also widely used and among the more physically dangerous behaviors because of the risk of infection. Skin picking can also be quite harmful and is often less reported because it can appear to be just a harmless habit, like popping pimples or over-scratching one’s skin or bug bites. Even behaviors like biting your nails or pulling out your hair can be considered self-injury if the harmer is inducing a pain response to distract, calm, or release unwanted energy through pain instead of emotion.
Similarly to how the purpose of self-harm has changed over time, the motivation for self-injury has also evolved. Rarely in modern North American society is self-injury still promoted as an acceptable symbol of relational fidelity or religious conviction. Instead, self-injury is typically used to either convert emotional numbness to physical expression, or suppress emotional expression through dissociation (or avoidance).
In the first instance for the use of self-injury, the harmer adopts physical harm as a way to feel something or as a way to release intense emotional pain in what seems like a more tangible and effective way.
In the clinical world, we often hear the expression “I just needed to feel something; I needed to know I was still alive.” This is typically a sign that the patient is self-injuring as a way of coping with intense grief, emotional numbness due to shock, or profound depression. The absence of emotion or what seems like emotional paralysis leads to the desperate move of activating the sensory system manually by jarring the physical nerves. If this description matches how you or a loved one is living, seek professional assistance immediately. There are many effective treatment options available through your primary care physician, Stenzel Clinical, or through the direct care of your local emergency room.
The second circumstance for self-injury is as an avoidant behavior utilized to cope with the presentation of a complex array of emotions.
Cutting oneself can be a way of interrupting an unwanted or potentially overwhelming emotional cycle that the injurer deems to be more dangerous than actual physical harm. By activating the peripheral nervous system through physical pain that is anticipated, the self-harmer causes an adrenaline dump into the bloodstream which effectively cancels out any other preceding emotion with a sort of high. The unpleasant emotion or fear of being overwhelmed is thus avoided and a sense of release is still achieved- though the relief is only temporary and the unresolved emotion is still in backlog, waiting for the next time an opportunity to express comes about.
It is important to examine one’s state of mind at the time of self-injury and what was happening prior to the event, in order to determine what has triggered the self-harm response. Once these “triggers” have been identified, we can begin to see where the emotional cycle is being interrupted, incorporate new coping skills and self-soothing techniques, and allow the emotional cycle to finally resolve itself. The longer an emotional cycle is interrupted and denied the ability to run its course through to resolution, the more complicated the suppression ritual becomes and often the more self-injury intensifies.
Fear is the dominant emotion that drives the impulse to self-harm.
Just as a coyote will gnaw off its own limb to avoid capture, people will both emotionally and then physically try to cut away parts of themselves they are terrified of facing. But this response is illogical in the end, because like the coyote, we are terrified of what we have never actually experienced. The trap could have been left by mistake, in which case the arrival of a human would involve at best, care and rehabilitation, or at worst- at least release. But even if what we fear most does come in to view, we still, like the coyote, have other effective ways of protecting ourselves. Emotion is very powerful, but it is not magical. Fear is real, but it cannot actually harm or kill you. No emotion can. But emotion can cause us to feel like we are out of control and that can be very scary. Sometimes people cut just to feel grounded again. Thankfully, there are other less traumatic courses that are more effective in the long term.
The most important thing to do in overcoming a habit of self-injury is to remain in community.
It is easy to get lost in ourselves and our internal landscape, and the perspective of others helps us regain a wider view of the world and ourselves in it. Shame keeps us isolated with our fear. People keep us grounded in reality. Before you feel an overwhelming emotional cycle coming on, choose several friends or family members you can trust and share with them your struggle. Make a commitment with them that when you are beginning to feel emotionally overwhelmed or out of control you call them and they’ll be there for you. Community can help you weather the worst of storms, even internal storms, but they have to know what is going on and they need to be prepared before the storm hits.
Secondly, remember that your body is a part of you and it deserves the same respect you would give any other person.
You would not cut or burn or puncture or scratch a stranger on the street, or a grandma, or a puppy, or your best friend. You do not deserve that kind of treatment either. Christian theology says our bodies are a temple of the Holy Spirit, and that we are made in God’s image. Whatever your belief system is, I think this is a very appropriate way of thinking of, and honoring, your physical self.
If physical release is an effective way of expressing emotion for you, there are healthy ways of doing that as well.
Consider painting, drawing, clay work, or collage (no artist ability required). If you need a more strenuous stimulation, try massage therapy, acupressure, or acupuncture. Physical exercise is also an acceptable form of holistic release, so long as it does not become a replacement behavior and cause injury. If your self-injury behavior centers around over-grooming like excessive nail biting or skin picking, replace these behaviors with an alternative physical behavior that soothes rather than harms. Manicures, painting your nails, applying lotion to your skin or taking warm baths are all acceptable alternatives.
Finally, if reading this article reminds you of yourself or someone you know, seek the help of a professional who can help you through the complex emotional process you’ve either been unable, or unwilling to complete. You can find relief and we are here to help.