Cutting
From WikEd
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What is Cutting?
Cutting is the term used for the type of self-injury behavior that involves intentionally and repeatedly cutting one's own skin with a knife, razor blade or other sharp object deep enough to draw blood and/or leave a lasting mark. Other similar types of self injury behaviors include compulsively pulling out one's own hair/eyelashes, self-hitting, and burning one's own skin, often with a cigarette or lighter. For most "cutters" and others who deliberately injure themselves, the behavior is a method of coping with pain or a need for attention or and expression of self-loathing. People who engage in self-injury can be successfully treated, but it is often difficult to determine that the self-injurious behaviors are occuring. Many "cutters" become quite adept at lying about the causes of scars and other marks, and otherwise covering up their behavior. One hallmark of people who harm themselves is the attempt to literally cover up the signs of their behavior by wearing long-sleeved shirts or long pants in hot weather.
Self-injury is a term reserved for behaviors that are used as coping mechanisms. The term does not refer to pain or injury inflicted for sexual gratification. Body mutiliation (such as piercing) for appearance or some type of spiritual or cultural ritual is not considered to be self-injury. Also, "cutters" and others who engage in self-injury generally do not do so with the intent to commit suicide. In fact, "cutters" some may be cutting to relieve suicidal thoughts and feelings. There seems to be a link, however, with eating disorders such as anorexia nervosa or bulimia nervosa.
For some cutters, the act of self-injury becomes habit forming and becomes an addiction. These people begin cutting to exchange emotional pain for physical pain. However, as they continue to cut it becomes a need for them, like a cigarette for a smoker and a beer for an alcoholic. [Kids Health]
What you should know about Cutting...
About 1% of the American population is reported to engage in deliberate and repeated self-injury. Cutting is the most common form of self injury. Most sources also report that the majority of "cutters" are women between the ages of 13 and 30. Self-injury behaviors are seen in all walks of life. In fact, many "cutters" are intelligent, middle to upper-class women who seem to be well adjusted on the surface. Self-injury was thrust into the public eye when the late Princess Diana revealed in a TV interview that she had repeatedly cut herself and employed other methods of self-harm.
Cutting is often linked to past abuse, especially sexual abuse and abandonment. "Cutters" are likely to be dealing with depression and/or anxiety.
Interestingly enough, "Cutters" are generally not suicidal. The cutting can serve as a way to feel in control not as a gateway to their own death.
Cutting can be habit forming and can become a compulsive behavior. The brain starts to connect the false sense of relief from bad feelings to the act of cutting, and it craves this relief the next time tension builds. When cutting becomes a compulsive behavior, it can seem impossible to stop, almost like an addiction.
Treatment
One of the most important tasks in devising a treatment plan for someone who engages in self-injury is determiing the reason behind the behavior. Some of the underlying motives cited by "cutters" include to make people pay attention to them, to make them feel "real" or alive, or ironically, to feel pain on the outside to mitigate pain held on the inside. Once a therapist understands the motivation behind the self-injurious behavior, he or she can determine the most effective route for treatment.
Some self-injury is associated with serious psychological disorders such as [bipolar disorder]. Such cases may be treated differently than when cutting is not associated with a psychological disorder. Some options for treating non-bipolar self-injury include psychotherapy, methods used for treating post-traumatic stress disorder, hypnosis and relaxation techniques, and psychopharmacological intervention (medication). Ultimately, however, the treatment must help the patient develop coping skills that will eliminate the patient's need to engage in self-injury behaviors.
Personal Testimonies
I did not know much about cutting until I had a student who cut. She is a great kid who is very smart and social with adults. She had such a hard time dealing with peers because she was interested in different things. She was diagnosed with bipolar disorder and has undergone treatment. However, she still cuts but it has become less frequent. She understands how it effects others and the pain she is inflicting on her mother. She truly is a great person who just needs an ear to listen and someone to understand. j. Melhouse (Feb 2009)
I did not know much about cutting until a family friend went through it. The girl who was fifteen at the time had just undergone a major surgery. She was in the hospital for several weeks and it took about a month before she could even stand up. Even though her physical wounds began to heal it caused her great mental anguish. She got into drugs and alcohol to ease the pain that she was going through. She also started hanging out with friends who were involved in cutting. They would challenge each other to see who could make the most cuts. This went on for almost a year. With a lot of love and care from her friends and family she has been able to overcome her drug, alcohol, and cutting episodes. She does have 10-15 scars on each arm. These will be permanent reminders to her and others to the problems cutting can have. She is very embarrassed by these scars and tries to keep them hidden under long sleeves whenever possible. Some positive has come out of this and she has done several presentations to show other students the dangers of cutting. I luckily have not seen any of these tendencies in my students, but it is definitely something that I have started looking for. B. Moore
I read the book Cut with my 8th grade students. This book features a girl who is in a mental hospital receiving treatment for her cutting. She ends up making some friends who have other problems. The students really enjoyed hearing about things that they can relate to. Although no one in the class, as far as I know, cut, they saw the real life connection to teenagers and others who suffer. I would recommend using this book to help students see what some people experience. After we finished, each student picked a problem that teenagers face and researched it. Afterwards they made informative brochures. They really enjoyed the unit and learned a lot about different issues that they were interested in. J. Cappa
In my school I had a child that was cutting herself. This was the hardest conversation I have ever had with parents. When I realized what had been happening and the young lady admitted to me what she had been doing; I told her that this was something I had to tell her parents. For her safety I had to let them know so that we could get her help. She went to live with her dad after our parent conference and I have no way of knowing if she has received the help that the parents and I discussed. I can only pray that she did.
The school I teach at has a section that is for behavioral disorder students. Many of these students are mainstreamed into my classroom. Over the years I have seen many students who have cut themselves to gain attention or show their acts of aggression. Bret Helms
Are there any studies that show a correlation between "preventative education" and self-inflicted wounds such as cutting? This was something that no one had even discussed up until recently, and I can't help but think that all of the hype on MTV and in the books has something to do with it. I have two friends who are school psychologists, and their 8th grade team read this book with the class without discussing the effects of hurting yourself or without any reference to the help team at school. Sure enough, they psychologists were bombarded with girls in their office either cutting themselves or talking about it. Were they informed on how TO, or simply informed about the situation? How much does this education really help middle school students? -M. Hanes
This is such a difficult issue to address as an educator because the reason this happens deals with deep psychological pain which we, as educators, are not really equipped to deal with. I have come across this with some of my students and felt badly that I couldn’t do more except to refer them to the counseling office. It makes me sad to know that so many people are suffering on such a deep level. –J. Blanken-Webb
When I was in high school I clearly remember an acquaintance of mine showing me her wrists that she had cut just a minute earlier with a pair of scissors. It was at school and there were numerous people around at the time. As a few years went by I began to hear of more and more girls cutting themselves. I definitely think this is a bigger problem than anyone realizes and it is definitely something to be on the watch for as an educator. - C. Cyrus
I have encountered students that cut themselves at the middle school. The group of students that refer to themselves as "Emo," because of their identification with "Emotional Rock" music, wear black, dress rebelliously, mock traditional pop culture, and often times wear sweatbands on their wrists. The sweatbands are to hide the scars from cutting themselves. "Emo" and cutting go hand in hand. Many of these students are involved in cutting for the above mentioned reasons, but others also wear the wristbands to portray the image that they are involved in cutting. If students are wearing sweatbands on their wrists, teachers and parents should take notice and many schools do not have official dress code rules concerning these wristbands. jjakob
I had been informed of cutting when it became known. I encountered something similar to it a few years ago at the school I teach at. I had noticed that a large number of my students had weird burns no their skin. I asked one of them how he had gotten burnt and he told me. Students were taking erasers and rubbing their skin with them to create burns. The main difference between this and cutting was that the rubbing was to get attention. Also, the longer you rubbed, the more prestige you earned. I reported this to the school nurse and she had to contact the parents. Many of the students had developed infections from these burns. ~J. Herrmann
When I worked at a group home, we had a resident who cut herself repeatedly. She was removed from her home after she had run away repeatedly and was hospitalized for attempting to commit suicide. She was diagnosed bipolar, and then with depression, and then with anorexia, and then...well you get the picture. We worked with "Lisa" using group therapy, incentive plans, contracting, , and a lot of room and backpack searches. After Lisa had been there six months, she began cutting herself frequently after she was introduced to it at school. She related to me that she did this to get attention from adults in her life. She felt she just blended into the scenery in school and life; but when she cut, we all made a big stink and completely altered our program in order to keep her safe. This is not about "EMO" music either. Back then (mid 90's), it wasn't Emo that was the big scary stigma'd music, it was Goth, before that: punk. "Lisa" listened to none of these, actually we shared an affinity for grunge music at the time. This doesn't lessen the severity of cutting behaviors, but attaching it to a subculture masks the real issues behind the cutting itself, young people can easily feel disenfranchised from others (peer groups, parents, society at large) and turn to negative and sometimes harmful behaviors to cope. Cutting can lead to accidental suicides, and this scares adults and parents, but awareness of what cutting is and why it happens can help parents, teachers, and professionals treat the behaviors and their cuases for what they are. -Dave Melone
Years ago, before I was even aware of the practice of cutting, one of my students was diagnosed with this. One of the brightest students in my class was cutting herself. Luckily, the student was successful in receiving treatment. "Cutting" practice seems more talked about today. In the early 1980s, it was not even covered in teacher training classes. Hopefully since there is more awareness of cutting, people will get the help they need. - Ann Harty
The other day I had a parent call me about their child and proceeded to tell me that the child had attempted to cut his/herself. I immediately reported the incident to the school letting them know as much as I knew. This is a very scary issue. Don't ever hesitate on this issue, even if the parent is scared or say that they will handle it. Children in situations such as this need all of the help they can get and it is important that you do everything you can to save the life of a child. ~ R. Hayes
I recently had a student in class that wrote a disturbing account regarding her and her teen sister contacting and meeting with a young man they met over the Internet (for an narrative essay assignment). One thing led to another and her sister was taken advantage of. I was shocked that the student chose my 9 week long class to get the event "off her chest", especially when I learned that all adults in her life were aware of what happened and that her sister did not want this information shared with students at school. After talking to the student's counselor I learned that the student(author of the essay) was also a "cutter". I was really disturbed to learn this and talked about "cutting" with my adolescent step-son and his girlfriend who informed me that "cutting" is pretty common among their peers. Is it possible that "cutting" can be a fad?
I have two students who were close friends. One girl was a cutter and got the other one involved in cutting as well. I believe that it is more common than we think. These kids become very good liars and it's hard to tell that anything is wrong. Thankfully both of these girls have stopped cutting. One girl asked me if she could sit in the hallway a few days ago. I let her take a short break from class. When I went into the hall to see how she was doing she said that she really wanted to cut. She wasn't even feeling sad, she just felt like she needed it. It had been 90 days since she last cut herself. She still has not cut again. But these students need our support as they try to break this addiction and find other ways to cope with life that are more healthy. -R. Fruin
The trend with this disorder seems to be that people don't really know about it until it happens to someone they know or until they start doing it themselves. Looking at some of these statistics it is interesting that the people I know who have engaged in this fit right into that profile. It is scary how quickly the cutting can escalate and how they try to hide the marks. The addiction factor seems to be an extremely powerful draw as it becomes almost second nature. I believe more educators need to be aware of the signs that are mentioned in this page and should be better trained to not only spot the signs but also take appropriate action to aide in treatment. -D.Whipple
Resources and Additional Links
Websites
Coolnurse.com info about Self Injury
Self-Injury: You are not alone. This page has a wealth of well researched information and additional resources related to self-injury.
WebMD Cutting and Self-Harm: Warning Signs and Treatment
Self-Injury - Why Do I Keep Cutting Myself?
Books for Professionals/Adults
Cutting The Pain Away by: Ann Holmes and Carol C. Nadelson
A Bright Red Scream: Self Mutilation & The Language of Pain by: Marilee Strong
Bodies Under Siege by: A. Favazza, MD
The Plight of Chronic Self-Mutilators by: Armando Favazza, MD and Karen Conterio
Secret Scars: Uncovering and Understanding the Addiction of Self-Injury by: V.J. Truner
Recommended Titles for Teens
It may be difficult to reach teens through non-fiction or books intended for adult users. What follows is a list of fiction titles that are all high-quality books in their own right, and have additional useful information and alternatives for cutters. In some cases, it may be easier or more productive to have teens read these titles before beginning a conversation or confrontation around their behavior.
Thicker than Water Carla Jablonski (2005)
Crosses Shelley Stoehr (2003)
Cut Patricia McCormick (2002) In this short, yet powerful book, McCormick tells the story of Callie, who has turned to cutting herself as a way to deal with her insecurities and guilt. She gets sent to Sea Pines, a group home for students with "troubled minds". At first, she refuses to talk to anyone, not her friends, the nurses, her therapist. However the longer she's there, the more her determination to hold everything inside begins to wane. This story ends in a redemptive tone that suggests Callie will eventually overcome her affliction.
Sleveless Joi Brozek (2002)
Blade Silver: Color Me Scarred Melody Carlson (2005)
Uglies[1], Pretties[2], and Specials[3] by Scott Westerfeld. This is a fantastic series that many students (and teachers) enjoy. In the second book in the series, Pretties the protagonist Tally has a falling out with her best friend Shay. Once friends, the two now find themselves on opposite ends of the social spectrum. While Tally continues to try and free hersefl and her friends from the bonds of Pretty Town, Shay forms a reclusive clique called "The Cutters". Why the Cutters cut and their description of how it makes them feel seems pretty spot on with why students cut. The Cutters maintain their prominent place in the story for the rest of the series, without ever really discussing if the Cutting was bad or needed to be stopped.
