I’ve worked in the mental health and social services field since 2001 and now I currently work as a mental health therapist. I’ve worked with teens and adults in various settings, I like to think that I am a highly knowledgeable and well rounded therapist with a diverse range of experience. Cutting and self-mutilation is a behavior I’ve seen hundreds of times. Self-mutilation comes in many forms though cutting is the most common. Some people will also self-mutilate by burning their skin or pulling their hair out but the bottom line remains the same, the purpose is to cause immediate physical pain. Here are some of the points I’ve learned about it.
1. Self-mutilation is not a suicidal act or attempt
Don’t assume that cuts on an arm or near the wrist is connected with suicide. In fact, it’s actually quite difficult to die from cutting your wrist horizontally, across your arm. I’m not trying to give tips on how to successfully commit suicide here but often people do so to self-harm. More often, when someone cuts their wrist, it’s a cry for help, they need you to help them and they don’t know how to ask for it. I honestly think, at this point, that committing suicide by cutting your wrist or arm is more of an urban legend than a reality. Cutting is its own thing, it falls into its own category.

2. Self-mutilation is a often a sign of severe emotional distress
Part of being human is that we look at people through our own lenses based on our own experiences and sometimes we forget that some people really experience horrific things. In my experience, people who self-harm have gone through some kind of abuse or experienced some kind of trauma as a child. That doesn’t necessarily mean the person cutting has been traumatized, they may have a severe mood disturbance. They might be extremely depressed, anxious, or a combination. A big emotional factor is shame; there is a big difference between guilt and shame and people who experience deep dark shame need to cope with it in extreme ways. When someone is in the act of cutting, it may have been triggered by an event that sent them spiraling downward in their emotions. It may have been losing a job, getting a bad grade or having a conflict with a loved one. Their shame around events runs deep and cutting may be the only way for them to deal with it in the moment. Which raises the question, why does cutting help someone feel better?

3. Cutting helps that person feel in control
I know this is a foreign concept to many, I had to wrap my head around it as well. Let’s take it from the angle of feeling out of control. Well, first that comes from childhood. Children are real victims when bad things happen, they are just there, they are in the way and never have a choice when there is sexual abuse, violence or traumatic events. This can lead to feeling a loss of emotional control which basically causes intense fear, they don’t want to be in that victim position and they want control back. The act of self-harm causes physical pain and gives them a sense of being in control. It allows them to suddenly and radically banish their feelings of powerlessness. One thing I have learned is powerlessness, in its truest unadulterated form, is the absolute worst place to be. And along with that…

4. Self-mutilation snaps people back into reality
The nature of trauma is that it interrupts daily life, even years after the event has occurred. It sometimes fascinates me that something that lasted only minutes has such a profound effect on a person’s daily living. Sometimes, memories of those events literally takes over and the person feels as though they are reliving it again. The act of cutting is a very effective way to snap that person back into the present moment where they are safe. Instead of being mindful of the trauma, they are suddenly mindful of the physical pain and the present moment.

5. It’s an emotional release
When a person cuts, the emotional intensity they are experiencing seems to be released through physical pain. Feeling intensely shameful, depressed and anxious can be quickly alleviated through a painful wound. This is the part of self-mutilation that is a little harder to understand but the bottom line remains true; it works. And it works well. People who cut often report that after doing so they just feel better. They feel more calm, stable and in control.

6. Many who do this want to stop
In my experience, most people who cut want to stop. They don’t necessarily want to do it, they may not even like it. So why do they do it? You may be asking, simple, it works! It’s highly effective for accomplishing its intended purpose. They are aware that it sometimes leaves gruesome scars and that other people look at them in a certain way and want better for themselves.

If you or a loved one struggles with overcoming self-harming behaviors, a good therapist can help. There are answers and change is possible. As a loved one, you can help simply by being a caring listener. Seek to understand them instead of telling them what they should do. They need to feel loved and understood.

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