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Self-Injury: Cutter's Pain is More than Skin-Deep

The opinions expressed by columnists are their own and do not necessarily represent the views of

Recently, our twelve-year-old daughter came home from junior high with a strange story. At least it was strange to us until we began extensive research on this most bizarre topic. Her story was about a girl at school who had a problem. This girl was cutting herself, inflicting herself with repeated bloody cuts on her arms and legs. Our daughter then said something that shocked us. She said, “Lots of kids do it.”


We share the results of our research in the hope that if you know someone with this problem you will help them seek help. This is a budding epidemic that we can stop with concerted effort. Why would anyone intentionally hurt himself or herself?

When she was only 12 years old, Lisa Bayen began cutting her own stomach and arms with razor blades. In a television interview, Princess Diana confessed to cutting her legs and arms with penknives and razor blades. Not only did actor Johnny Depp admit to injuring himself, but also 2 to 3 million less well-known Americans inflict cuts into their skin. They call themselves “cutters” and the trend is growing.

“[F]or people who do injure themselves by cutting or other means, self-injury offers a momentary sense of calm and a release of tension. Unfortunately, that's usually quickly followed by guilt and shame and the return of other painful emotions,” according to the Mayo Clinic.

"I felt so much anger inside and I was so upset that I wanted to have my feelings expressed," says Bayen, who is now in her twenties and no longer cuts herself. "I couldn't discuss them with somebody, so I felt like I had to put a mark on my body. I felt so relieved afterwards that I continued the behavior every time I was sad or angry, upset or depressed."


People who deliberately harm their own bodies are trying to find a way to deal with overwhelming emotions but do not know a healthy way to cope with them. Like Bayen, they usually begin between the ages of 10 to 16. These highly charged years of volatile emotions and “drama” are a time when young people are beginning to deal with peer pressure and conflict with parents, besides feelings of loneliness.

Nearly 50 percent of cutters come from backgrounds of physical, sexual or emotional abuse and most are female. Social isolation, eating disorders, problems with intimacy, a history of loss or self-injury in the family, marital violence and divorce are often common factors. A family where the discussion of feelings is frowned upon puts one at risk. One thing cutters have in common is a lack of good problem solving skills.

The Mayo Clinic reports that for these troubled young people, “Physical injury distracts them from painful emotions or helps them feel a sense of control over an otherwise uncontrollable situation. For those who have feelings of emptiness or little emotion, self-injury is a way to feel something, anything, even if it's physical pain.” Some say when cutting themselves they finally “feel something” because they have shut down their strong emotions of anger, depression and suffering low self-worth.


Not only do psychological reasons come into play, but also physical factors are involved with the self-injury disorder. “One theory holds that during self-mutilation, the body releases chemicals called beta-endorphins, which have a powerful analgesic property and provide an instant feeling of calm," says Lynn Ponton, M.D. The behavior can become addicting. "When someone hurts emotionally but can't express it, a physical injury will redirect that pain to the physical realm,” explained Ponton.

"It's a physical expression of anger," says Wendy Lader.

Lader and Karen Conterio are early pioneers in dealing with people with self-injury problems. The psychologists are directors of SAFE (Self-Abuse Finally Ends) Alternatives Program in Chicago. Together they wrote the book, “Bodily Harm: The Breakthrough Healing Program for Self-Injurers.”

Cutters are people with deep psychological pain."The self-injury isn't the problem," says Lader. "It's the feelings that lead to it, the anger and the abandonment."

However, help is available: People seeking information can call SAFE at 1-800-DONTCUT.

Prevention and treatment are similar. Two important factors help stop self-injury according research. Developing an ability to identify and express feelings verbally is one factor. The other contributing factor which ceases self-injury is for cutters is to learn and use positive alternatives to self-mutilation. In therapy, writing their feelings in journals and talking with friends are encouraged as healthy outlets for emotions in addition to learning good coping skills.


"Therapy teaches them to think about their self-injurious behavior by making them ask, 'What feelings am I trying to avoid by thinking about cutting?'" says Conterio. She believes that once people understand the emotions that motivate their harmful behavior, it is easier for them to stop.


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