- SELF MUTILATION
why they cut
Princess Diana shocked the world when she revealed she
intentionally cut her arms and legs and had thrown herself
down a flight of stairs on more than one occasion.
After that interview thousands of self-injury survivors
called or wrote the media in response to that interview in
just the United States alone.
Dianne, Age 30, Canada
"I hurt myself for different reasons, depending on my state
of mind. I do it sometimes as a way to get relief from the
pain I am feeling inside. Other times I do because at the
time I feel I deserve to be punished, or I am angry at
myself, but really I think someone else. Other times I do it
to "shout out" to the world that I need help and here is the
proof. I am an incest survivor, so I think that it's some of
the pain that I have had to live with trying to escape my
WHAT IT LOOKS LIKE
Banging or hitting body parts
Interfering with wound
Hair pulling (trichotillomania)
Ingestion of toxic substances
Chrissy, Age 17, USA
"I cut myself because I feel so much pain inside that I need
a way to release it all. Cutting acts as an outlet for that
l pain, I guess, somehow. It feels like it's all running out
of me when I see myself bleeding. I know that probably
sounds gross to most people who don't do this."
Self-harm (SH) or deliberate self-harm (DSH) includes
self-injury (SI) and self-poisoning and is defined as the
intentional, direct injuring of body tissue without suicidal
intent. Older literature almost exclusively refers to
self-mutilation. ~ From Wikipedia, the free encyclopedia
THE FACT IS ….
Suicide is not the intention of self-harm.
Self-harming behavior may be potentially
life-threatening depending on the severity of
injury. There is an increased risk of suicide since
Self-harm is found in 40–60% of suicides. But those
who self-harm generally are not suicidal.
WHY THEY CUT
Self-harm is often a response to profound and
overwhelming emotional pain. Those who self-harm
cannot seem to resolve their “pain” in an
emotionally healthy way so they use it as a coping
mechanism to provide temporary relief from anxiety,
depression, stress, emotional numbness, or a sense
of failure or self-loathing. There is also a
positive statistical correlation between self-harm
and emotional abuse. Self-harm may become a means to
manage pain, in contrast to the pain of abuse they
may have experienced earlier in life over which they
had no control.
SOURCES AND RESOURCES
ESSORTMENT – Information and advice
Tattoos and Body Piercing: Adolescent
Self-Expression or Self-Mutilation?
“A Bright Red Scream: Self-mutilation and the
Language of Pain” by Marilee Strong
Includes a treatment and informational resources
HOW BIG IS THE PROBLEM?
It is estimated that one in every 200 girls in the U.S.
between 13 and 19 years old, or one-half of one percent, cut
themselves regularly. Those who cut comprise about 70
percent of teen girls who self injure.
In the U.S. up to 4% of adults self-harm with approximately
1% of the population engaging in chronic or severe
self-harm. The rates of self-harm are much higher among
young people with the average age of onset between 14 and
24. The earliest reported incidents of self-harm are in
children between five and seven years old. (TeenHelp.com)
There appears to be an increased risk of self-harm in
college students. 9.8% of the undergraduate students in the
U.S. surveyed indicated they had purposefully cut or burned
themselves on at least one occasion in the past. When
including head-banging, scratching oneself, and hitting
oneself along with cutting and burning, 32% of the sample
said they had done this.
Kids generally start cutting during their teenage years but
may begin cutting as a pre-teen. Kids who cut are not going
through a phase. They may adjust as they mature but
typically need help to stop cutting. Cutters do not cut to
attract attention since they are typically secretive about
their cutting and cut in areas that can be concealed with
clothing. Cutters are also found in every income level and
every social stratum
Treatment visits for teens that self injure continue to
increase. Numbers are expected to grow as life becomes more
complex for teenagers. Directors at self-injury treatment
programs refer to self-harm as an epidemic that reaches even
into middle schools.
Profile of a Typical Cutter
A female in her mid-20's to early 30s, and has been cutting
herself since her teens. She is intelligent, middle or
upper-middle class, and well educated. She is from a home
where she was physically and/or sexually abused and has at
least one alcoholic parent.
Age of onset is typically from 10 - 16 years old with a
major change in the teen's life (e.g., parents divorce or
death). There is typically a history of family violence,
abuse (verbal or physical), or sexual abuse and intense
feelings of fear, hurt, anger, rejection or abandonment,
feelings of loss and or need for control.
Substance abuse is considered a risk factor and cutters
typically have poor problem solving skills and are
impulsive. Those with borderline personality disorder,
clinically depressed, phobias, or conduct disorders have
increased risk. Up to four times as many females as males
self-harm. There is difficulty getting info on male self
harmers since males may engage in different forms of
self-harm which could be easier to hide or explained away.
Men typically burn and hit themselves while women typically
cut and burn themselves.
WHAT CAN I DO TO HELP?
• Don’t react with anger
• Don’t deny the problem
• Don’t assume this is a "phase" your teen will outgrow
• Don’t blame yourself (unless you know you deserve it)
• Don’t ask why they are cutting
• Don’t try to hide sharp objects. It won’t work.
• Admit you and your child need help
• Take the problem very seriously
• Understand this is not just attention-seeking behavior
• Be completely supportive and immediately seek treatment
for your child
Gender and Age Differences
The highest rate among females is in the 13–24 age groups.
The highest rate among males is in the 12–34 age groups. ~
World Health Organization
There is no difference in motivation for self-harm in
adolescent males and females. For both genders there is an
incremental increase in deliberate self-harm associated with
an increase in consumption of cigarettes, drugs and alcohol.
There is a statistical correlation between self-harm and
Gender and Age Findings
A study in 2003 found an extremely high prevalence of
self-harm among 428 homeless and runaway youth (age 16 to
19) with 72% of males and 66% of females reporting a past
history of self-harm. In 2008, a study of young people and
self-harm saw the gender gap close, with 32% of young
females, and 22% of young males admitting to self-harm.
Studies indicate that males who self-harm may be at a
greater risk of completing suicide. Common triggering
factors are low self-esteem and having friends and family
members who self-harm. Females are more likely to explain
their self-harm episode by saying that they had wanted to
In the United Kingdom, 5.4% of all the hospital's self-harm
cases were aged over 65. Rates for males and females over 65
in the local population were identical. Over 90% had
depressive conditions, and 63% had significant physical
illness. Less than 10% of these patients had a history of
self-harm. The study suggested that older people who
self-harm are at a greater risk of completing suicide.
Sadly, 1 in 5 elderly who self-harm continue on to end their
Deliberate self-harm is prevalent in prison populations. The
typical motive for prisoners is that they wish to avoid
physical confrontations and may resort to self-harm as a
ruse to convince other prisoners that they are dangerously
insane, that they are resilient to pain, or they want
protection from the prison authorities.
Common Reasons for Cutting
They find it soothing
They want to feel pain on the
outside instead of the inside
They are making an effort to cope
They do it to express anger
They do it to feel alive and real
~ ~ ~
Is Cutting A Mental
Self-harm is listed in the Diagnostic and
Statistical Manual of Mental Disorders as a symptom
of borderline personality disorder. Patients with
other mental disorders may also self-harm, including
those with depression, anxiety disorders, substance
abuse, eating disorders, post-traumatic stress
disorder, schizophrenia, and personality disorders.
Self-harm is also apparent in high-functioning
individuals with no underlying clinical diagnosis.
Cutting is used as a coping mechanism which provides
temporary relief of intense feelings such as
anxiety, depression, stress, emotional numbness and
a sense of failure or self-loathing.
Motivations of Self-Harm
Environments where parents punish children for expressing
sadness or hurt
Abuse during childhood, bereavement, and troubled parental
or partner relationships
War, poverty, and unemployment may also contribute
Some with developmental disabilities such as autism engage
in self-harm, although this may be a form of
Some self-harm to draw attention to their need for help and
to ask for assistance in an indirect way
Some attempt to affect others and to manipulate them in some
Those with chronic, repetitive self-harm often do not want
attention and hide their scars carefully
Some cutters say it allows them to "go away" or dissociate,
separating the mind from feelings that are causing anguish.
The physical pain acts as a distraction from the emotional
The paradox is to harm oneself to obtain relief
For some the relief is psychological. For others relief
comes from the beta endorphins released in the brain
Endorphins act as painkillers, induce pleasant feelings, and
act to reduce tension and emotional distress
Many report feeling very little to no pain while
self-harming and, for some, deliberate self-harm may become
a means of seeking pleasure
What else should I know?
who self-harm sometimes describe feelings of emptiness or
numbness (anhedonia), and physical pain may be a relief from
these feelings. A person may have feelings of detachment
from self, detached from life, numb and unfeeling which may
trigger a need to feel real again. As a coping mechanism,
self-harm can become psychologically addictive because it
works to block stress. The patterns sometimes created by it,
such as specific time intervals between acts of self-harm,
can also create a behavioral pattern that can result in a
craving to fulfill thoughts of self-harm.
Self-injury is usually kept secret, and the "cutter" often
feels deep shame and guilt. Many who self-injure wear long
pants, long-sleeved shirts, and turtlenecks even in warm
weather to conceal the marks they've left on their bodies.
Many self-harmers fear being discovered.
Cutting is the most common type of self-injury. Cutters use
whatever they can find to make repetitive slices on their
arms, legs or other body parts. Many people who self-injure
say cutting helps them to feel alive and/or have a sense of
control. Most say their incidents of self-injury are
triggered by stress and anxiety. Self-harm is most common
among people who have been sexually abused as children,
molested as children, or are survivors of incest. Self-harm
can be traced back to a serious assault on one or more of
our five world views
World Views / Core Values
Our belief in a just and fair world
Our value in trusting others
Our need for self efficacy / self esteem
Our need for safety
A belief in God or some supreme being
How Our World Views and Core Values are
Self-harmers believe what was done to them
was not just and fair
It is difficult for them to trust others
An assault on self efficacy and self esteem can result in
insecurity and self loathing
They may believe they will never be safe
They may have no interest in God because God did not (or
does not) protect them from their abuser
What to Look For
80% of self-harm involves stabbing or cutting the
skin with a sharp object. Self-harm methods may
include burning, self poisoning, alcohol abuse,
self-embedding of objects and forms of self-harm
related to anorexia and bulimia. The locations of
self-harm are often areas of the body that are
easily hidden and concealed from the detection of
It may be accurate to define self-harm in terms of
the intent, and the emotional distress that the
person is attempting to deal with. They may give
verbal and/or behavioral suicide type clues that
indicate that they are distressed. It may be
accurate to define self-harm in terms of the
emotional distress that the person is attempting to
Common Triggers for Cutting
rejected by someone who is important to them
Being blamed for something over which they had no
Real or imagined guilt over some incident
HOW CAN I HELP?
Parents who discover their child is cutting typically are
shocked and immediately blame themselves for failing as a
parent. Therapists say that parental self-blame is NOT
helpful. Cutting is a behavioral sign of a deeper underlying
problem. The goal should not be to get your child to "stop
cutting," but to treat the deeper problem so your teen
develops more mature coping skills and no longer feels the
need to self-injure.
Talk to your doctor or your local public health department
to find a mental health treatment program that can help.
Understand that treatment probably won't simply be a matter
of medication and/or a few visits with a therapist.
Understand that treatment often includes medication combined
with individual and family therapy over a sustained period
of time. Understand that a therapist may use
psychotherapeutic drugs during treatment.
Don't assume that your child is "okay" once he or she is in
treatment and making progress. Understand that setbacks are
not uncommon. Understand that episodes typically become less
and less frequent the longer a teen is in treatment. Provide
a card that allows sufferers to make emergency contact with
a friend or a counseling service.
Suggestions for Self-Help
Hold an ice cube in the palm of your hand
as an alternative to cutting
Wear a rubber band around your wrist or ankle that can be
“snapped” to induce a sharp sting
Try journaling, taking a walk, participating in sports,
exercise, or being around friends when you have the urge to
Get rid of objects used for self-harm to make it more
difficult to find a way to harm yourself
Tell somebody - a sibling, a friend, a parent or relative,
anyone you can talk to
Overcome your shame by admitting your problem
Let a mental health counselor help you identify what
triggers your cutting behavior
Ask for help from your parents, a medical professional, a
school counselor, or any adult you trust and tell them you
want to stop cutting
Stay with it; breaking your cutting habit will not be easy
With treatment, you can learn more healthy way to deal with
stress and negative emotions
© 2002, Ron Richardson