Health Care and Cutting

There is a certain population that suffers from a disorder causing individuals to cut themselves, known as �Cutting.� According to info on this website, http://www.ulifeline.org/topics/135-cutting ,  cutting is the act of intentionally inflicting harm on oneself. Cutting isn�t a suicide attempt, though it may look and seem that way. Cutting is a 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 aren�t usually considered self-injury, however, unless they�re meant specifically to cause harm.

Self-injury is an unhealthy way to cope with emotional distress. Some people cut themselves when they feel overwhelming sadness, anxiety, or emotional numbness. Others do it to feel in control or relieve stress. A few see it as a way to �purify� their bodies. Girls tend to cut themselves more than boys do, although cutting can happen with anyone. It often begins between the ages of 12 and 15, but studies suggest 30-40% of college students who cut begin at 17 years or older.

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. An estimated one-half to two-thirds of people who cut also have an eating disorder. And although cutting is rarely meant as a suicide attempt, it is not uncommon for people who cut to think about suicide.

It can be hard to understand why people cut themselves on purpose. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or upsetting relationship problems. They may be dealing with feelings that seem too difficult to bear or bad situations they think can't change, according to this site, http://kidshealth.org/teen/your_mind/mental_health/cutting.html  .

Some people cut because they feel desperate for relief from bad feelings. People who cut may not know better ways to get relief from emotional pain or pressure. Some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness.

There are other ways to cope with difficulties, even big problems and terrible emotional pain. The help of a mental health professional might be needed for major life troubles or overwhelming emotions. For other tough situations or strong emotions, it can help put things in perspective to talk problems over with parents, other adults, or friends. Getting plenty of exercise also can help put problems in perspective and help balance emotions.

But people who cut may not have developed ways to cope. Or their coping skills may be overpowered by emotions that are too intense. When emotions don't get expressed in a healthy way, tension can build up � sometimes to a point where it seems almost unbearable. Cutting may be an attempt to relieve that extreme tension. For some, it seems like a way of feeling in control.

The urge to cut might be triggered by strong feelings the person can't express � such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don't fit in or that no one understands them. A person might cut because of losing someone close or to escape a sense of emptiness. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection.

People who cut or self-injure sometimes have other mental health problems that contribute to their emotional tension. Cutting is sometimes (but not always) associated with depression, bipolar disorder, eating disorders, obsessive thinking, or compulsive behaviors. It can also be a sign of mental health problems that cause people to have trouble controlling their impulses or to take unnecessary risks. Some people who cut themselves have problems with drug or alcohol abuse.

Some people who cut have had a traumatic experience, such as living through abuse, violence, or a disaster. Self-injury may feel like a way of "waking up" from a sense of numbness after a traumatic experience. Or it may be a way of reliving the pain they went through, expressing anger over it, or trying to get control of it, according to KidsHealth.org.

Myths and facts about cutting and self-harm, according to this site  http://www.helpguide.org/mental/self_injury.htm:

Because cutting and other means of self-harm tend to be taboo subjects, the people around you�and possibly even you�may harbor serious misconceptions about your motivations and state of mind. Don�t let these myths get in the way of getting help or helping someone you care about. Much more information about this topic is available at the website.

Myth: People who cut and self-injure are trying to get attention.
Fact: The painful truth is that people who self-harm generally do so in secret. They aren�t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.

Myth: People who self-injure are crazy and/or dangerous.
Fact: It is true that many people who self-harm suffer from anxiety, depression, or a previous trauma�just like millions of others in the general population. Self-injury is how they cope. Slapping them with a �crazy� or �dangerous� label isn�t accurate or helpful.

Myth: People who self-injure want to die.
Fact: Self-injurers usually do not want to die. When they self-harm, they are not trying to kill themselves�they are trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-injure have a much higher risk of suicide, which is why it�s so important to seek help.

Myth: If the wounds aren�t bad, it�s not that serious.
Fact: The severity of a person�s wounds has very little to do with how much he or she may be suffering. Don�t assume that because the wounds or injuries are minor, there�s nothing to worry about.

According to this very important website, http://www.selfinjury.com/resources/faqs,   it is important for family to take the behavior seriously, but anger and hysterics are counter productive. It's important to keep the lines of communication open. Parents and friends should not be the therapist, it is helpful for self-injurers to have someone to talk to who can truly help them to identify the problem and learn healthier ways of responding.

It is difficult to know for sure as researchers have used different populations, measures and definitions of self-injury to collect their data. However, in general studies on adolescents in community samples report a lifetime prevalence of between 15-20%. These numbers are higher in clinical populations. Here are some signs if someone you know may be cutting:

�         Unexplained cuts or bruises

      �         Kids who have trouble modulating emotional states especially sadness, fear and anger are at higher risk for self-injury.
      �         Low self-esteem as evidenced by a tendency to self-denigrate.
      �         Arms and legs are always covered such as wearing cold weather clothes such as long sleeves and pants in warm weather
      �         Presence of an eating disorder and possible substance abuse also seems related to risk for self-injury.

A parent's reaction is very important.

�         Parents should not react with intensity (e.g., fear or anger )

      �         Threats (e.g grounding etc) and rewards (e.g., you can stay up later if...) are rarely effective
      �         They should not ask "Why are you doing this to me?," or even "Why did you do that?".
      �         Speak with your child calmly, and non judgmentally while expressing your love and concern.
      �         Listen, don't try to offer your opinion or "fix" the problem. The goal is to foster open communication
      �         Parents can state that they will educate themselves on self-injury so that they can better understand where their child is coming from
      �         Tell them that you are concerned about them and that they can talk to you about anything, and then follow through with that.

At appropriate times, talk with the person cutting themselves about their life, their friends, their behavior around others, their thoughts, and their beliefs. It is also possible to offer to pray for them, and request they seek spiritual counseling as well as other types of assistance. Be careful not to accuse or make insinuations that they are violating moral codes, even though self-mutilation can be considered in that context. Watch for behavior and attitudes out of normal activity and speech that causes concern, and always seek professional advice with this type of disorder.

Until next time.