By Walt Mueller
©1998, The Center for Parent/Youth Understanding
Kevin sits alone in his dark dorm room on a Tuesday night. To his professors and friends, this 20 year-old college sophomore is a “regular guy.” But tonight, Kevin’s academic and relational pressures combine with ongoing family difficulties in a mix that leaves him feeling angry and out of control. He’s not crazy. He’s not suicidal. But something is definitely wrong.
Kevin responds to his roller-coaster emotional state through a distressing and regular ritual that’s become his secret coping mechanism. He removes his shirt and runs a razor blade across his stomach and chest. When finished, he’s covered with a mess of bleeding cuts. Amazingly, he says he “feels better.”
What Kevin says about this habit seems absurd; “I feel like there’s something terrible inside me that I have to get out any way that I can. I think that’s part of the reason why I have to bleed. Afterwards, I feel cleansed. I feel like whatever was crushing me before has been removed. I feel calm and in control.” Beneath his shirt, unbeknownst to even his closest friends, Kevin wears the cries of his heart and soul on his chest. Because these marks are usually outward manifestations of inward pain, one researcher has called self-mutilation “the voice on the skin.”
You’re in the majority if you’re not aware of the alarming and growing number of children and teens who vent inner frustration through self-inflicted cuts, bruises, scars, and breaks. If we care at all about kids we should learn to recognize, understand, and answer these visual cries of a generation longing for spiritual truth, relational healing, and answers.
Self-mutilation has been around for a long time. It just hasn’t been talked about until recently. Nor was it as prevalent as it’s become today. But in the last few months, the curtain has been opened on this once private behavior as it’s become more acceptable for kids to share their own stories about self-abuse. One reason for this new openness is that this generation of teens and young adults has experienced a greater lack of direction and more turmoil than previous generations. Consequently, they’re more open about venting their individual and collective frustrations. In addition, this is a generation that has accepted piercing, tattooing, and other types of body modification as fashionable forms of self-expression. And then there are trend setters like Marilyn Manson, whose highly publicized aversion to scraping broken glass across his body during concerts has introduced self-mutilation to mainstream pop culture and a worldwide audience being raised by MTV.
Self-injurious behavior (SIB) or self-inflicted violence (SIV) has been defined as “the commission of deliberate harm to one’s own body. The injury is done to oneself, without the aid of another person, and the injury is severe enough for tissue damage (such as scarring) to result. Acts that are committed with conscious suicidal intent or are associated with sexual arousal are excluded.”
Experts who study SIB classify the anomaly according to three types:
Major self-mutilation is the most extreme and rare form of SIB. It consists of acts like castration or limb amputation and most often occurs where an individual is psychotic or intoxicated.
Stereotypic self-mutilation consists of regular and rhythmic acts such as head banging, eyeball pressing and arm biting and is most commonly seen in institutionalized mentally retarded individuals or those suffering with obsessive-compulsive disorders.
The type of SIB most common among children and teens is superficial or moderate self-mutilation. Kids caught in this cycle of behavior cut their skin, carve their skin, burn themselves, interfere with the healing process, stick themselves with needles, or utilize other methods of inflicting physical damage on themselves.
Since SIB is stigmatized, accurate statistics on its prevalence are difficult to find. What is known is that the average self-mutilator begins at age 14 and continues the practice, usually with increasing severity, into his/her late 20’s. Among adolescents, the ratio of boys to girls who mutilate themselves is equal. Most teens and young adults who exhibit SIB are sometimes the ones who you’d least suspect. For the most part, they are bright, intelligent, and generally “normal”.
For most self-mutilators, the act is a personalized ritual with individualized styles. They will often describe a favorite room, preferred lighting, background music, and a list of objects regularly used. In addition, there are certain ways in which they abuse themselves. Among those that cut, some slash themselves with long shallow strokes, making numerous marks per session. Others focus on making one or two very deep cuts. Those who are bone-breakers might smash their limbs against a hard wall or hit themselves with a hammer or other hard object. One 16 year-old girl describes it this way: “I close all the shades to my room, light candles on my bed, and incense (which I burn myself with too), rub my arm with alcohol, and cut away while I’m listening to Enigma.” Another writes, “Once I burned myself with my curling iron. Another time I cut lines down my face that looked like tears and a couple of times when I didn’t have a razor I stabbed myself with a very sharp pencil.” “I slam my hands/arms against something cement with corners until I hear something crack and I am convinced that I’ve broken a bone,” says a twenty-year-old. She continues, “These sessions sometimes take 3-5 hours. I have never failed to break a bone.”
Even though most self-mutilators can’t explain it, they somehow know when to stop a session. Their need to inflict damage is satisfied. Feeling peaceful and relieved, they pick up and move on with life until the need to damage themselves surfaces once more.
Prior to an act of self-mutilation, most mutilators feel a mounting range of negative feelings and emotions. As those feelings become more than they believe they can handle, many self-mutilators “report feeling numb, withdrawn, and unreal. As the negative feelings become intolerable, the self-mutilator engages in self-injury . . . cutting typically occurs in the absence of painful sensation.” If there is pain, it is usually felt minutes or even days after the injury. Those who do report feeling pain, say that pain is “fulfilling” – it’s the sensation they are actually seeking.
Some experts theorize that cutting and other SIB releases beta-endorphins (aka the brain’s “feel-good” chemicals) which act as the body’s own opiates, leading to feelings of pleasure or being high. As a result, some believe SIB is physically addictive. As in the case of drug addiction, the longer the habit is practiced, the more frequent and intense the “dosage” must be to achieve the desired physical effect.
Whenever a young person willingly inflicts damage on his or her own body one wonders “Why?” The story of one grown woman who used to practice self-mutilation sheds some light on this bizarre ritual:
“During my late childhood and adolescence I experienced prolonged emotional stress. My parents went through a messy divorce, using us kids as pawns to hurt each other. I was sexually abused. My mother died. My best friend died . . . for me, (these events) were overwhelming. At the age of 13, I found that self-injury temporarily relieved the unbearable jumble of feelings. I cut myself in the bathroom, where razor blades were handy and I could lock the door. The slicing through flesh never hurt . . . it never even occurred to me that it should. . . the blood brought an odd sense of well-being, or strength. . . sometimes I rubbed the blood on my face and arms and looked at myself in the mirror. I did not think how sick I must be. I did not think. With a safe sense of detachment, I watched myself play with my own flowing blood. The fireball of tension was gone and I was calm. I learned to sooth myself this way.”
This one example is similar to most stories. Typically, the first incident occurs during early adolescence and the self-mutilator describes an overwhelming desire to inflict damage that seems to come out of nowhere. Self-mutilation is not something they’ve heard about elsewhere nor is it something they initially discuss with others. In fact, many are surprised to learn there are others who do the same. But further examination of those who mutilate themselves and those who examine self-mutilators shed light on the “whys”.
Those who tell the first person stories say they harm themselves because “it makes me feel better.” They describe periods of incredible emotional turmoil, anger, hate, and stress that are calmed by the cathartic act of mutilation. “As I cut deeper, my mind began to feel relieved of the torment,” says one self-mutilator. “My body eased of the tension, and I began to feel comforted.” While SIB is definitely wrong and abnormal, it becomes an effective coping strategy for individuals who have not learned healthy and correct ways to deal with the problems and pressures of life.
In addition to release, others say the practice helps them feel “alive”. They are reassured by their capacity to feel physical sensation. They describe a desire to escape “numbness” and by feeling “something” they know they are still alive. “There have been times when I don’t even feel like I’m alive,” Jane says. “I’ll do something to feel – anything. And that’s usually cutting. Just seeing blood. . . I don’t know why.” This poem from one self-mutilator describes the same sensation:
Blood wounded hand bleeds
Red blood makes me feel real
I am alive I feel pain otherwise numb
I may as well be a plastic baby doll
I cut myself and bleed and see the blood bleeding from the body
Not plastic after all . . . but human babydoll.
Still others resort to SIB as a way to gain control of a chaotic existence. “Sometimes I just feel out of control,” says a 19 year old college student. “All the hurt and confusion, the loss and emotional pain, is transferred into something I can control and feel.” This is especially true for kids who have experienced abuse. They see SIB as a way to exert their own power in the midst of feeling powerless. “What better way (at least that’s the way the thinking goes) to gain control than to do something to myself. I’ll beat you to it. You won’t hurt me anymore. I’ll do it to myself.”
Researchers who study the phenomenon of SIB have discovered that there are several factors common to the backgrounds of those who self-mutilate repetitively. Not surprisingly, most of those factors relate to the breakdown of family. Chaotic family conditions during childhood, physical and emotional neglect, and exposure to physical or sexual abuse have all been found reliable predictors of SIB. Those who cannot remember ever feeling “special” or “loved” by anyone as children were least able to control their SIB.
One self-mutilator’s journal includes this entry: “Tonight I’ve done everything to distract myself from thoughts of cutting. . . I feel angry and I’m not very good at that feeling. They say that behind anger is always fear. So I ask myself: ‘What are you afraid of?’ Well, what do you think?! I’m afraid my father will jump right through my skin and scare the silence right out of me. When I put down this pen, who’ll get me first? My daddy or me? I’d rather get there first. This belongs to me! Cut, cut, cut.” To this woman, her body is no one’s but her own and the marks on her skin are there to prove it as she struggles to “reclaim stolen territory.”
What should we make of this disturbing practice? First, we must come to an understanding of the path this trend looks to take. We can be sure that the stigma associated with SIB will continue to disappear as this generation’s bloody cry of confusion and self-hate appears on individual bodies and collective soul. Consequently, SIB will become more pervasive as a “normal” coping mechanism. If that happens, chances are good that SIB might move so far into the mainstream of youth culture that kids who exhibit none of the classic SIB precipitating factors will cut themselves simply because it’s fashionable. In addition, we can expect that increased “publicity” for cutting will plant the idea in younger and younger minds. Eventually, we might expect SIB experimentation among curious and impressionable young elementary school aged children.
Second, we must consider how to respond in a loving manner. We could shake our heads in disgust, right it off as another link in the chain of “typically bizarre adolescent behavior”, then walk away hoping that the next generation of children and teens will somehow get their act together and make more out of their lives. But if that’s our approach, we haven’t truly heard “the voice on the skin” for what it is. Rather, we will have added another ugly link into the chain of ignorant and inappropriate responses to young people today. Our ignorance will only serve to remove opportunities for kids who cut to hear a message of healing and love.
Third, we must institute preventive measures that will keep kids from getting to the point where their problems are so intense that SIB becomes a coping option. Simply stated, the key is a home where kids grow in an atmosphere full of parental time, affection, attention, love, discipline, grace, and open discussion about the deepest issues of life.
Finally, we must diligently work to exert a redemptive influence on those who resort to self-mutilation. Their cries must be answered through counseling and long-term relationships with mentors who speak andlive an example of redeeming love. For many, it will be the first time someone really cares.
Judged by appearances, 19 year old Renee is your typical college freshman. What nobody knows is that she’s been damaging herself since she was 11 years old. “I use a needle,” she says. “I jam the needle down as far as I can, and then move it back and forth until I have a long cut on my finger. I repeat this until I’ve slashed up both my hands. I almost want someone to notice, to ask me what happened. But I’m so much of a loner that no one’s ever even noticed. I wonder if people DID notice, if they would care.”
WHAT THEY’RE DOING TO THEMSELVES
Here are the injurious acts self-mutilators say they’ve done to themselves:
Cutting: 72 percent
Burning: 35 percent
Self-hitting: 30 percent
Interference with wound healing: 22 percent
Hair pulling: 10 percent
Bone breaking: 8 percent
Source: Study conducted by A.R. Favazza and K. Conterio as reported in “The plight of chronic self-mutilators,” Community Mental Health Journal, Vol. 24, 1988, 22-30.
IN THEIR OWN WORDS – REFLECTIONS FROM YOUNG SELF-MUTILATORS
“During, I don’t feel anything. I look and it begins to come out of me and I let it. After, I’m most always mad at myself, and really self-conscious. But immediately after I feel relieved of that really restless – desperately restless – feeling.”
17 year old female – ranked first in high school class
“I feel like there’s something terrible inside me that I have to get out any way that I can. I think that’s part of the reason why I have to bleed. Afterwards I always feel cleansed. I feel like whatever was crushing me before has been removed. I feel calm and in control.”
20 year old male – college sophomore
“Enraged, sad, lonely, stupid, worthless, irrational, crazy. I can’t stand what I think because I sound like such a whiner, so self-involved. During I feel very focused and full of anticipation. I purposely hold my breath as I cut and let it out when I’m through – so I breathe out as the blood runs out. I feel so calm . . . all the noise and stupidity in my head is gone. . . I feel like I’m floating.”
15 year old female
“I get any self-esteem or sense of self-worth I might have developed ripped to shreds by my parents on a regular basis. There’s a sort of internal pressure – like I can only keep the mask on for so long – be obedient and meek and perfect for so long before I think I’ll explode.”
16 year old female
“I feel sometimes numb, but usually am enraged about something. After (cutting) I admire my work and am proud of myself. My cuttings symbolize certain things, which I like. I love looking at my scars. They are an important part of me that I know will always be with me even if nothing else is.”
18 year old female – pre-med college student
‘I go to the bathroom and close the door. I look in the mirror and think about how much I hate myself and how ugly I am. I start usually with my face or arms, then move to my breasts and abdomen, then to my upper legs. Sometimes when I think about God, I stop.”
29 year old female – health care professional
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