Introduction
Self-harm is a growing phenomenon in many developing and developed societies. There are many forms of self-harm, namely burning oneself; banging oneself; pulling one’s hair, or picking one’s wound to prevent it from healing.
Some would suggest that having a tattoo or carving words or symbols on one’s skin is a form of self-harm.
A common occurrence of self-harm, however, is self-cutting. It is quite prevalent among teenage girls.
This is not to say that it does not occur among boys or older people. Research show that a significant number of those who do self-injury are females in their teenage years (Journal of the American, 2022).
There are specific insights that could help understand the phenomenon of self-harm, particularly of the self-cutting type. Here are five of these helpful insights.
Five Insights in Understanding Self-Cutting
1. Self-cutting is often an indication of unresolved emotional pain.
It is important to understand that self-cutting by itself is not the problem. It is a symptom of a deeper problem that causes severe emotional pain. It is not unusual for one who gets lured to self-harm to have had an experience of shame that has left one heavily traumatized.
A typical example of this shaming experience is an abuse of some type: physical, emotional, or sexual. The abuse has left a deep emotional scar in the psyche that emerges whenever there are triggers to the traumatic experience.
Another example is severe parental neglect during early childhood. When a child’s basic needs are not met appropriately, it results in trauma against one’s personhood.
Basic needs include food, clothing, shelter, affection, and validation. When a parent is often absent for one reason or another, these basic needs are inadequately provided.
The common message received by the child as a consequence is something like this: “I must not be important to warrant attention from my parents!” Or, “Something must be wrong with me as to why my parents do not take good care of me!”
The message directly attacks the personal significance of the child, which will leave a lifelong scar. Consequently, the child personalizes the matter.
A third example of an experience that could potentially cause trauma to a child is abandonment for a prolonged period of time for whatever reason. When one or both parents leave the child for a long period, the child is traumatized.
A prolonged period is defined as three months or more. The reason for the parents’ departure may vary – immigration, job promotion, marital separation, incarceration, or institutionalization.
To the child who has been abandoned, the matter of personal worth is attacked. This situation leaves trauma to the child.
2. Self-cutting is a form of coping mechanism.
It is important to realize that from the vantage point of the self-cutter, it is not done to hurt oneself, but to relieve the self of unbearable pain.
Self-cutting is a form of psychological deflection. Instead of dealing with the source of the pain, the cutter distracts oneself from the emotional pain by focusing on the immediacy of the physical distress.
It is an escape from inner pain through self-inflicting of physical pain.
Through life, due to trauma that left a huge scar on the psyche, the growing child has learned to bear the pain silently instead of letting others know of its presence.
And a quick way to deal with this deeply embedded emotional pain is to self-cut. The immediate relief from self-cutting is followed by intense guilt and continuing shame.
These, in turn, result in added inner pain, which could blossom into quick physical pain through self cutting. It is a phenomenon that keeps spiraling down until a more lasting resolution is embraced.
3. Self-cutting is often associated with mental illness.
There are specific mental illnesses that are often associated with self-cutting. Common illnesses linked to self-cutting are Major Depression, Anxiety, particularly Post-Traumatic Stress Disorder, Personality Disorder, specifically of the Borderline type, and Eating Disorder.
All the preceding forms of mental illness leave a large scar on the individual that cries for immediate emotional pain relief.
Self-cutting offers such longed-for quick relief. In time, it becomes a pattern, and sooner or later, it develops into a monster by itself. People can suffer fatal injuries to the point of untimely death from the unintended outcome of self-cutting.
After having said this, it is significant to comprehend that self-cutting is not a suicidal attempt. It is a way of coping with the challenges of life.
The problem with this mechanism is it prevents the healthy confrontation toward a positive resolution of the illness.
It offers quick relief but prolongs the illness’s occurrence and the symptoms it is trying to avoid.
4. Self-cutting is closely linked with alcohol and drug abuse.
Self-cutting could be classified as an Impulse Control Disorder. This refers to a lack of ability to regulate or control one’s urge. Thus, the individual succumbs and acts upon the urge.
There are specific stages identified in an impulse control disorder, namely: an impulse, growing tension, pleasure from acting, relief from the urge, and finally, guilt, which may or may not arise (https://rockfordanxietyclinic.com/ retrieved 17 October 2022).
When individuals abuse drugs and alcohol, the abuse pattern directly impairs the capacity to regulate or control behavior. Impulsivity is extremely high during active addiction to any mind-altering substance, alcohol.
Consequently, the lure of instant relief becomes all-consuming and powerful. No wonder addiction becomes an intensifying trigger to self-cutting through the impairment of capacity for control.
5. Self-cutting can be treated.
The good news is this: self-cutting can be treated effectively. If you or someone you love suffers from self-cutting behavior, the following suggestions would be helpful.
Take note that the first four suggestions are offered by NAMI – National Alliance on Mental Illness (https://www.nami.org/ retrieved online 17 October 2022).
- Tell a trusted someone. The trusted individual who could offer help could be the family physician, church minister, or school teacher. Any of these individuals could suggest essential steps for the recovery to become comprehensive.
This is an extremely important step to many because it breaks the pattern of secrecy that self-cutters tend to observe.
Remember that self-cutting is not an attention-seeking behavior. That is why most self-cutters will go all way to hide their struggles.
Seeking help from someone trusted breaks this shame-based secretive behavioral pattern.
- Have a thorough evaluation. This process should be performed by a psychiatrist, clinical psychologist, professional counselor (psychotherapist), or clinical social worker.
There will be questions about one’s health, family history, and development of the illness being evaluated – in this case, the self-cutting behavior. Usually, this process will last an hour and a half and the outcome will be explained to the person seeking help.
A thorough evaluation is essential before the start of actual treatment. Knowing the root of the problem is a major step toward its resolution.
The self-cutter is strongly encouraged not to make a shortcut by ignoring this vital step for a full and stronger recovery.
- Medication Management. As a result of the evaluation, a medical practitioner would prescribe an appropriate medication. This is warranted when the symptoms adversely impact one’s sleep, appetite, and thought process.
For example, if there is major depression upon evaluation, the physician may prescribe antidepressants to stabilize the individual.
When the symptoms are quite severe, the medical doctor may refer one for inpatient hospitalization for a few days to ensure personal safety and adequate care.
In many contexts, only the medical practitioner can prescribe medication. Therefore, it is significant to respect this part of the therapeutic process.
Equally significant is promptly reporting any adverse reaction experienced after taking the prescribed medication to the medical practitioner.
- Professional Counseling. It is not unusual for whoever evaluates to refer the person for individual professional counseling or psychotherapy.
This process would assist effectively in understanding the development of the disorder. Here, the individual is encouraged to be honest to take advantage of the process.
Aside from assisting in finding the root cause of the self-cutting pattern, professional counseling will also introduce a proven and healthier way to cope, along with a change of lifestyle that will strengthen one’s recovery.
- Support Group. Participation in a supportive group can enhance recovery from self-cutting.
Being with a group of like-minded individuals offers assurance that one is not alone in the journey to recovery. It also provides the presence of emotionally supportive individuals.
An additional benefit of being a part of a support group is the development of accountability and integrity.
It is a proverbial saying that people who suffer from the same ailment tend to provide better empathy, but they also discern more quickly if one is faking it!
Therefore, honesty is a major component of the group process.
- Nurture of healthy spirituality. This is another important component of recovering from self-harm behavioral patterns.
Recall that the behavior of self-cutting is really an attemp to be relieved of the psycho-emotional pain.
The nurture of healthy spirituality encourages one to establish a vital relationship with the Divine Higher Power, who promises the abiding presence of steadfast love.
This could result in a profound sense of peace beyond human comprehension. The insight, in turn, offers hope that the positive resolution to the internal pain will be relieved.
Meanwhile, the important lessons derived from suffering and pain can become precursors to developing virtue.
As the individual continues to recover due to regular observance of more positive coping mechanisms, healthy spirituality encourages the recovering person to share the wisdom derived from experience with others.
This will become a channel to make a difference in the lives of others which is therapeutic in nature by itself.
It will also assist in moving away from a self-focused pattern of thinking and secretive lifestyle common in self-cutting illnes.
The well-accepted 12 Steps ofAlcoholic Anonymous, encourages one to participate in the lives of those who need help toward stronger personal recovery (12th Step of the 12 Steps of AA, Public Domain).
Conclusion
Self-harm, more specifically self-cutting, is a growing phenomenon quite common among young females.
The prevalence rate, however, does not preclude others from this unhealthy pattern of behavior.
It is developed early as a result of relieving oneself of the pain embedded through time due to traumatic experiences in childhood. It is also associated with many other mental illnesses which plague societies.
As difficult as the illness is, there is good news.
Self-cutting can be treated with the help of professionals who will provide thorough psychological evaluation, medication therapy, and professional counseling.
Participation in a support group offers a sense of belonging, emotional support, and the development of accountability. It also breaks the pattern of secrecy and moves towards a life of honesty and integrity.
Moreover, the development of healthy spirituality offers inner peace and hope that the situation will be resolved in time.
It also encourages the recovering person to participate in the lives of others as part of continuing therapy and the development of a stronger recovery.
I trust that this article is helpful to those who may struggle or knows someone who struggles with self-cutting behavior. Shalom, everyone!
References
Journal of the American Academy of Child & Adolescent Psychiatry, Volume 57, Issue 10, October 2018, Pages 733-741 https://www.sciencedirect.com/science/article/abs/pii/S089085671831267X, retrieved 22 Octob r 2 22
Thank you for the insightful article Dr Val, this is helpful in so many ways. Do you think sudden scratching on part of the body followed with sudden misdemeanors in certain span of time, would this classified as part of self-harm cluster? The scratching left open wounds as the act itself was heavily done and repeated during the timeframe.
Yes, it is definitely included. When you have opportunity look for Theravive’s article on “Non-Suicidal Self Injury -DSM-5.
Regards.
Dr Val here.
Thank you Dr Val, will do.
Thank you!