It takes a lifetime to learn how to handle disappointment, and being a teenager doesn’t help much when things get rough. I was wondering what would cause a beautiful, smart 15 year old like Briana to get a pack of her dad’s razors and some disinfecting lotion from the medicine cabinet and deliberately carve small evenly spaced slices up and down her arms and legs.

It didn’t help when her mom walked into her room and freaked out either. She couldn’t know that her mom would bring her to see me, and that she’d land up having to talk about what happened which was why she was sitting in my office. She couldn’t tuck herself any more tightly into the corner of the sofa without disappearing completely, trying to avoid my eyes and smoothing the long sleeves of her shirt.

And looking at the floor, she whispered that all she wanted was to escape from the bad feelings when her friends at school had turned against her.

In 1921, Freud proposed the pleasure principle is the instinctual pursuit of pleasure and the avoidance of pain. Maturity is learning to endure the pain of frustrated desires when reality requires it.

Self-Cutting

While many people abuse their bodies while indulging in smoking, drinking or recreational drugs, they can shrug it off the next day by remembering the fun and good times that went with their over-indulgence. With self-cutting, the pleasure principle – meaning, the avoidance of one kind of pain as a way of by-passing emotional pain however, results in bodily scarring and disfiguring while offering emotional relief.

Self-cutting is when the injury is intentional, as when as person makes small cuts with a sharp object that draw blood on the wrists, arms, legs, sexual organs or bellies. Unwanted and potentially dangerous side effects are infected wounds, scars, accidentally cutting too deep or uncontrollable urges that get in the way of daily activities.

Research shows that 90 per cent of people who engage in self harm begin during their teen and pre-adolescent years, however onset can occur at any age, including in elderly people.

In a survey by the Canadian Mental Health Association, approximately 13 per cent of adolescents said the engaged in self-harm activities. However, since this habit tends to be secretive, it is difficult to determine the exact percentage.

There is no single pattern or profile for self-injures, however the Canadian Mental Health Association shows that most are from the middle to upper-class, intelligent but suffer from low self-esteem. Almost all say they were discouraged from expressing emotions, especially anger and sadness.

Why do people self-cut?

There are many different reasons that people engage in self-cutting behaviour, but the primary reason is that it provides temporary relief to feelings of frustration, suffering and emotional pain. The flow chart below, shows two common patterns of why people injure themselves.

cuttingchart

Studies show that incidences of self-cutting are increasing. This may be due to cultural trends, where young people are told it is a normal way to express feelings of frustration, numbness or sadness. However, it is not new, in the 19th century some women in Europe became known as “needle girls” because they would cut themselves with sewing needles. Today, for example, there are many websites that give advice on how to go about cutting oneself. In order to fit in to a subculture, teens may try cutting themselves only to find that it is an addictive behaviour that can spiral out of control.

Contrary to the belief of some, self-cutting is not necessarily a ‘cry for help’ nor is it attempts at suicide. Cutting tends to become an impulsive, secret habit where the pain provides an illogical sense of temporary calm. Many self-cutters are ashamed of this habit and try to hide their scars.

Self-cutting is not a mental disorder but is usually a symptom of underlying emotional problems. There is a whole gambit of psychological problems that can be associated with it, anything from depression to borderline personality disorder to bipolar disorder.

If you or someone you know is self-cutting,  speaking to an experienced psychologist could help.


Patients in this story are a fictional composite of people who have sought help for this issue. Any resemblance to real persons, living or dead is purely coincidental.

Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisherFacebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.

Written by Dr. Eva Fisher C Psych
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