Self-injury and self-harm behaviors are still hidden and stigmatized within the mental health profession. Many professionals are afraid to talk about them with their clients, and family doctors rarely ask their young patients — who are most likely to engage in such behaviors — about them.
They are a continuing hidden epidemic among teens and young adults today.
But self-harm behaviors such as cutting don’t have to remain in the dark. Best of all, if a person can find a way to talk about them to someone they trust — such as a friend, a family member or a teacher — they may also find help for them.
In this video, Psych Central’s Ask the Therapists Daniel J. Tomasulo, Ph.D. & Marie Hartwell-Walker, Ed.D. discuss why some people turn to self-harm (such as cutting), and what can be done to help them.
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The video raises some good points. Could be a little clearer on the real dangers of cutting/self-harm (such as unintended suicide), which are mentioned, but perhaps not strongly enough. The self-harm spectrum needs to be brought out of the shadows so people can get the help they need without feeling shame.
When I was depressed I tried to suicide by injecting air into a blood vessel. I couldn’t get the needle into the blood vessel so I cut my skin open over a blood vessel in my inner elbow. To my surprise, I suddenly felt better. That was the start of my cutting. I did not cut because I felt nothing, I cut because I hurt emotionally and got relief from it.
Dan, I’m a therapist who just started working with a 13 year old girl who cuts. It made a lot of sense about OTHER people having control over this girl’s life, and plan to work this into our sessions. Thank you for a different perspective!
As a former self-injurer myself, I can say that my reasons for SI had absolutely nothing with wanting to feel something or distract myself from pain. My reason was a release of rage. I would get extremely angry and I would either have to punch or throw an object or be violent towards another person, neither of which I wanted to do and neither of which were effective anyways. I don’t know if it was the pain or just the act itself, but SI released that built up energy.
As far as trying to talk to self-injurers, they aren’t going to listen to you if you make them feel like you think they are some sort of freak. It is just an addiction and should be treated as such. Instead of telling them to stop cold-turkey, offer them alternatives to help them cut back (no pun intended), such as flicking a rubber band on their wrist or punching a pillow, mattress, or anything else real soft. Then they can get the release in a safer way.
Lastly, do not assume that you know their reasons for cutting or other SI because it’s really annoying and they won’t want to listen to you about anything. Plus, as in my case, you might be wrong. This could also potentially confuse them about their reasons, and if they don’t know why they are doing it, then they are going to have a much harder time getting past it. They have problems that they themselves have to work out. Don’t try to work their problems out for them, just encourage them to figure out how they feel and ask them if this is something that is truly benefiting them or making things worse.
It felt good to hear a non-sensational discussion on cutting. I started cutting after a fight with my husband when I felt rejected. Now I use it for many reasons…I could definitely relate to that anger one. Fortunately I am phasing it out and save it for emergencies. I have also given up alcohol which removes some of the risk.
I know most cutters are young, but I started in my 40′s. I have never heard of any reference to that
I started hurting myself when I was 9. I never sought attention and was able to keep it a secret until about 3 years ago when a stupid therapist decided to tell my folks everything. He came to know of it accidentally 3 years prior to that. I was 27 at the time but a suicide attempt provided him with a faulty rationale to disclose my secret and from then on, I have been kept on close watch by my folks. I still hate him vey much for that.
I certainly don’t injure myself for controlling others because I have been lying since the discovery so that my folks think I’m no longer hurting myself. I only do it because I’m utterly enraged at everything, because I feel unloved, hurt, worthless, empty, numb, and seriously out of control.
Why do I hide it from my current therapist? Just because she thinks it’s disgusting. As a psychiatrist, I thought she should be okay with wounds and scars but she reacts so terribly, I automatically lie to her. She’s good on other things and that’s why I still see her. Beyond that, I have no one else to talk to; no friends, no partner and family is certainly not an option in my case.
The downside to the act is the freaking scars; you do develop techniques or hiding them but since they rarely disappear completely, their presence initially provides you with so much anxiety; the what-if question of being found out never leaves your side. It also makes a liar out of you which in the long term causes you to feel disgusted at the person you became and the desperation to do it more leads to even greater anxiety and depression. You have to be prepared to be looked down by people as some kind of freak that they don’t want to be around if you’re ever found out, hence, you get more and more isolated. Sadly, you get to a point that it no longer works; this leads to more frequent self-harm, different methods of it and more and more scars. You’ll essentially arrive at a spot where at times you no longer have an unhurt spot to injure. Believe me, at that time you’re more desperate for it than ever. You lose friends, avoid loved-ones and unless you’re prepared to live your life in the company of imaginary friends, you should either never take this route or simply STOP it. I tried to be as clear as possible and I have been completely sincere about the stuff I said. You may count me in as an expert self-injurer since I’ve been a member for over 21 years. Think about all I said. Don’t be the chicken I was in asking for help. It’s not worth it.
I hope this information helps those at the start of their path to self-injury.