By: Suzanne Maiden, M.A.
I was pleasantly surprised to see the Today Show with Dr. Nancy Snyderman and the Editor in Chief, Ann Shoket, of Seventeen Magazine, discuss cutting behaviors in young women. ‘Cutting’ is the layperson word for Self -Injurious Behaviors (SIB). Why would I be happy to hear this touchy topic be talked about on mainstream T.V? Because cutters and why they cut are grossly misunderstood. I wrote my graduate thesis on SIB. Many medical personnel and mental health professionals find cutters’ behaviors troubling, treatment-resistant, and plain disgusting. As a practicing Family Therapist I have successfully treated many cutters. I appreciate your bringing awareness to this issue. I would like to offer just a bit more insight based on my experience.
Katie Stewart bravely shared her painfully private struggle with the Today Show . In many ways, she represents the various women with whom I have worked – bright, beautiful, and the seemingly a “great kid”. Unless one would see their scars, cutters do not fit an easily identifiable profile. Outwardly, they present as very together. Inwardly, they battle demons. Most want to quit. Many report extreme shame and guilt over their irresistible urge to self-injure and go to great lengths to hide their scars. But why? Why does anyone self-injure? There are multiple hypothesis as to why people self injure to include: 1) non-validating environment, 2) poor attachment in childhood, 3) addicted to their own opiate release system, and 4) history of sexual abuse.
The data strongly support the positive correlation between sexual abuse and future SIB. Not every person who has been sexually abused will end up self-injuring. Conversely, not every person who engages in self-injury has a positive history for sexual abuse. However, in my personal experience, the majority of my clients who self-injure do report a positive history of prior sexual abuse.
What’s sexual abuse have to do with self-injury? The cutters who do have a positive history for sexual abuse frequently report that self-injury is the only way they know to access their pain – or express it. Ironically, many self-injurers do not feel pain while actively self-injuring. Why? Because sexual abuse survivors tend to be very adept at the ability to dissociate. That is, when sexual abuse occurs, the victim often mentally “checks out”. This ability helps the victim endure the abuse when they cannot physically escape. Many cutters report they are in a dissociative state when they self-injure and many do not realize the extent of tissue trauma until they “come back” mentally.
Cutters are often the modern day lepers of emergency rooms and therapists’ office. Nobody wants to deal with them and their self destructive acts. However, their wounds are the physical manifestation of their internal suffering. If they knew how to access their pain in a healthier way – many would. Thank you TODAY Show and Seventeen Magazine for bringing this dark phenomenon into the light.