Cutting

Most people have heard of cutting, but many don’t know that this type of self-injury is often linked to other emotional disorders.

Cutting is the act of intentionally inflicting harm on oneself, usually without suicidal intent. While the term is often used broadly, cutting is really only one form of what is known as “self-injurious behavior” or “non-suicidal self-injury.” Other types of self-injury include scratching, burning, ripping or pulling skin or hair, swallowing toxic substances, self-bruising, and breaking bones. While cutting may occur on any part of the body, it is most common on the hands, wrists, stomach, and thighs. Tattoos and body piercing are not typically considered self-injurious behavior unless undertaken with the intention of causing harm.

Not everyone who cuts does so for the same reasons. Some people report overwhelming sadness, anxiety, or emotional numbness to be common triggers. Other reasons include a need to feel in control; relieve stress; create visible and treatable wounds; purify one’s body; reenact a trauma in an attempt to resolve it; or protect others from one’s emotional pain. Although not always true, cutting is frequently linked to childhood abuse (especially sexual abuse), depression, anxiety, eating disorders, post-traumatic stress disorder, borderline personality disorder, and substance abuse problems. Regardless of the cause, self-injury may best be understood as an unhealthy coping mechanism.

Detecting and intervening in self-injurious behavior can be difficult, since the practice is often secretive and involves body parts that are relatively easy to hide. Expressing a willingness to listen to a friend who engages in cutting behaviors, while reserving shock or judgment, may encourage them to use their voice rather than their body as a means of self-expression. It is important to realize that cutting is a sign of significant distress and that seeking help is crucial for this and other reasons. People who cut can frequently hurt themselves more than intended, sometimes so badly that they require medical attention. Also, people who share instruments used for cutting increase their risk of infection from viruses such as HIV and Hepatitis B and C.

Although cutting is rarely meant as a suicide attempt in and of itself, it is not uncommon for people who cut to think about suicide; it is important to seek help immediately if you or someone you know is having suicidal thoughts.

Fact or Fiction?

If I believe that a friend of mine is cutting, I shouldn’t ask about it.

FICTION: Not knowing how to bring up the subject, and feeling uncomfortable with the topic, may keep concerned friends or family members from asking questions. However, concern for their well-being is often what people who engage in cutting need most. Evasive responses are common, but persistent, neutral questioning may eventually elicit honest responses.

There are healthy alternatives to cutting.

FACT: Cutting is a way for some people to cope with their emotions or outside stressors. Treatment for cutting focuses on enhancing people’s awareness of the stressors that trigger cutting and on helping them identify, practice, and use more productive and positive means of coping.
The immediate effects of cutting, and the overall practice, can be addictive.
Fact: Some people liken the addictive feeling toward cutting to an addiction to drugs or alcohol. They talk about needing increasingly more or deeper injuries to feel the same effects.

Cutting occurs mostly among women.

FICTION: While it is commonly assumed that women are more likely to cut than men, recent studies suggest that women are only slightly more likely to engage in cutting behaviors. Similarly, available evidence suggests that self-injury is practiced in all ethnic groups and among people of all socio-economic backgrounds.

Understanding Cutting

Cutting often begins between the ages of 12 and 15, but studies suggest that 30-40% of college students who cut begin at 17 years or older.
Because cutting often occurs in private, it is difficult to gauge how commonly cutting occurs. It is estimated that cutting occurs in anywhere from 4% to 38% of the population.
An estimated 1/2 to 2/3 of people who cut also have an eating disorder.
Over 1/3 of the respondents in a college study who reported cutting indicated that no one knew about the behavior.
Studies have shown that individuals with a history of cutting are over 9 times more likely to report suicide attempts and nearly 6 times more likely to report having a suicide plan.

What to Watch For

Unexplained burns, cuts, bruising, scars, healing or healed wounds, or similar markings on the skin
Implausible stories which may explain one, but not all, physical injuries
Dressing inappropriately for the season (e.g., consistently wearing long sleeves or pants in summer)
Constant use of wristbands, large watchbands, or large bracelets
Frequent bandages or other methods of covering wounds (e.g., make-up)
Odd/unexplainable paraphernalia (e.g., razor blades)
Unwillingness to participate in activities that require less body coverage (e.g., swimming)