TEARS OF BLOOD – THE SELF-INJURY ADDICTION –CUTTING
By Marla Santos

“Doodle takes Dad’s scissors to her skin
And when she does relief comes setting in
While she hides the scars she’s making underneath her pretty clothes
She sings: ‘Hey, baby, can you bleed like me?
C’mon, baby, can you bleed like me?’
You should see my scars
And try to comprehend that which you’ll never comprehend”
~Shirley Manson - Garbage

In the darkness of the bedroom, the mental pain is unbearable, the razor blade cuts across the skin and you see the red blood…you see and feel that you’re alive after all.  Feelings of worthlessness, inadequacy and a sense of failure have plagued you for one or many reasons.  You have felt stress, agitation, and anger.  Then you sink into a place where you can’t think or feel and the depression makes you go numb.  The only thing that seems to snap you out of it is a form of self-injury, and one of those ways is by cutting.  Self-mutilation is not about wanting to die, or trying to kill yourself;  it’s about trying to feel alive.  It can be described as psychic pain turned inward in a physical way.  Sometimes in a depressed state, it is hard to explain to others how you feel.  That isolation can lead to taking out your pain and anger on yourself.  When the pain or depression is very intense, you might scratch your arms or legs a few times and leave it at that or it can turn into a horrible slippery slope of self-mutilation.  Cutting, burning, scarring (picking at scabs over and over to make a deeper scar) or pulling out your hair are some of the forms of self-harm.  Cutters use razors, utility knives, scissors, needles, and even broken glass to make repetitive slices on their arms, legs or other parts of their body.     

“Enraged, sad, lonely, stupid, worthless, irrational, crazy.  I can't stand what I think because I sound like such a whiner, so self-involved.  During cutting I feel very focused and full of anticipation.  I purposely hold my breath as I cut and let it out when I'm through, so I breathe out as the blood runs out.  I feel so calm…I feel stupid because I feel like I don't have a reason to do it.  That's why I keep it to myself.”

Self-harm is listed as a “borderline personality disorder” in the Diagnostic and Statistical Manual of Mental Disorders.  People who suffer from depression, anxiety disorders, substance abuse, and eating disorders such as anorexia and bulimia are all susceptible to self-harm.  Self-harm is also apparent in high-functioning individuals who have no underlying clinical diagnosis.  It is often associated with abuse either emotional or sexual, or mental traits such as low self-esteem or perfectionism.  Self-punishment may be involved.  When a child is sexually abused, they may blame themselves and feel that somehow they deserved it.  People who are suffering, or who have suffered from significant trauma or emotional upset can sometimes become cutters.

“Mum decided to have an affair with another man behind my Dad’s back.  Her boyfriend thought it would be good to have an affair with me too from the age of 7.  He said if ever I told Mum or anyone he would kill my Mum and family.  I was so frightened and scared but he would be so nice to me in front of Mum.  Mum would drop me off there, even though I would almost beg her not to.  She had no idea and didn’t want to know.”

Cutting and self-injury is nothing new.  Middle school kids have done it for years.  It is most common in adolescence;  with young people who are having trouble coping with anxiety, and usually starts when the hormones kick in at around age 12-14.  Many adolescents from apparently high-risk situations do not participate in behaviors that compromise their health, while many others in apparently low-risk situations participate in high-risk behaviors.  Unstructured leisure time spent with friends who participate in specific risk behaviors like an association with friends’ drinking or drug behavior is a health problem.  The presence of a positive parent/family relationship was identified as a consistent protective factor.  Some young people may feel invisible in their parent’s eyes and therefore feel emotionally disconnected from their parents.  For girls, self-harm may be used as a coping strategy with overly demanding parents, especially in situations where the father is the dominant voice of discipline. 

“As a young girl, I was walking home from school when I suddenly got grabbed from behind and dragged into the bush where this evil man hit me and punched me and finally raped me using every orifice I had in my body that he could fit in, leaving me for dead.  I wasn’t found until the next morning.  I don’t remember anything after he had done his awful deeds then tried to kick and punch me to death.  I spent 2 weeks in intensive care and a further 12 weeks in a hospital.  My parents showed such concern to the public and others until we were behind doors, then it must have been my fault, I must have encouraged him, I was a dirty little slut who deserved what I got.”

According to the Mayo Clinic, certain factors may increase the risk of self-injury, including:
Age:  Most people who engage in self-injury are adolescents, starting in the early teen years when emotions are more volatile.  This is when children face more peer pressure, loneliness, and have more conflicts with their parents and other authority figures.
Sex:  Thought to be more common in females, recent research shows the rates to be about the same in males.  Both genders want to “fit in” and sometimes it can be with a particular peer group that encourages and rewards self-harming behavior.
Family history:  Some evidence suggests that self-injury is more common in people who have a family history of suicide, self-injury or self-destructive acts.
Life issues:  Some may have been physically, emotionally, or sexually abused as children, or experienced neglect.  Social isolation, divorce and unemployed parents may also be factors. 
Mental health issues:  At highest risk are people who experience many negative emotions and are highly self-critical.  They are likely to be impulsive and have poor problem-solving skills.  It is also associated with certain mental illnesses, including borderline personality disorder, depression, anxiety, substance abuse, obsessive-compulsive disorders, post-traumatic stress and eating disorders.
Alcohol or substance misuse:  People who engage in self-harm often do so while under the influence of alcohol or illicit drugs.

“I started when I was eleven.  I was abused as a child.  My dad hit me one day with a stick that had nails in it.  He hit me two or three times with it.  Every time someone hurt me emotionally/physically, I would take a knife, and cut myself.  It was a way of revenge—getting back at the people that hurt me, I don’t think I would have ever started this if things at home were better.  My dad hates me.  He’s never told me he loved me.  Nicest thing he says to me on a daily basis is he hates me, and I’m a rotten little bitch.  He’s made me actually want to mutilate my own body just to get back at him.  He can control me, and there isn’t a damn thing I can do about it.  It’s a fucking game to him.  A game he thinks he’s always going to win.  In reality that makes no fucking sense, because I am letting him win.  Every time I let him make me feel like nothing, he’s winning.”

Is self-injury a disease or an addiction?  It is more likely an addictive-like behavior.  The mix of emotions that starts someone on the path to cutting is in general the result of an inability to cope in healthy ways with deep psychological pain.  Self-injury is most often a silent, hidden practice aimed at squelching negative feelings or overcoming emotional numbness.  People who cut regularly when they are experiencing severe emotional pain often have a ritual around their cutting that includes a special place and particular tools.  The physical pain of self-mutilation replaces the emotional pain they are feeling—it becomes a necessary release.  Some people bang their head until they pass out, or break their own bones.  Advanced techniques include fucking oneself with a cactus or taking a knife to one’s penis or labia.  When a person's pain or depression is very intense, they may become disconnected from their real self (known as a dissociative state) in order to protect themselves from their feelings.  They feel so numb and lost that it's as if they are floating above the rest of the world or becoming part of the furniture or drifting away entirely.  The physical pain of self-mutilation can snap them back into the real world.  While self-mutilation can be a real release for the people who do it, it can also be quite scary for them.  Once the act of cutting and the release of blood have revived them, they can be very frightened by what they have done to themselves.

"It wasn't the perfect solution, of course, because after you cut yourself you think:  'I'm totally crazy.  I'm going completely crazy.'  Then you're freaked out, sometimes more than you were in the beginning, but it's continual because, once you get into that place ... you can't talk to people, you can't think, you can hardly move around ...  That's why I thought I had to do it or else I'd die.  There are other things you can do, but all I could see was that I had to cut myself.  Cutting, for me, wasn't something avoidable."

Cutting distracts you from painful emotions and gives you a sense of control.  It offers an external way to express despair.  The majority of people who engage in self-injury go to great extremes to hide their cuts, scars or burns.  Although not overtly attention-seeking, self-injury is a symptom of an underlying cry for help and the need to be loved.  Some people don’t feel any pain when they cut.  A Cornell University study claims that once the behavior is started, the endorphins released by self-injurious behavior can become quite addictive.  The process can be likened to that of a growing drug addiction, where at first, small amounts (of the drug or self-injury) provide a sense of calm and well being that provide a temporary escape from the pain of life.  As tolerance builds, the user needs increasing amounts (drug or self-injury) to achieve the same effect.  In some cases, a suicide might result as an “overdose” for the habitual self-injurer.  These powerful opiates/endorphins that block the physical pain of self-mutilation are why these behaviors can become so addictive and that the cutting can become very hard to stop.  Self-injurers come from all walks of life and all economic brackets, although most come from a middle-class to upper class background.  They can be male or female, straight, gay, bisexual, rich or poor and from any country in the world.  They can be high school dropouts, college students or even have their Ph.D.’s.  Teachers, medical professionals, lawyers, professors and engineers have all been known to have cutting in their background and some continue to cut their whole lives.

“It is very hard to describe.  I liken it to a heroin addict in desperate need of a hit.  Nothing else matters.  Tunnel vision sets in.  Your heart-rate is bounding, I get the shakes, I cannot focus on anything until I have a razor in my hand and have marked the first cut.  The pain causes me to flinch and gasp, but the more I do it, the calmer I become.”

Many adults worry that adolescents engage in self-injurious behavior because it is somehow a cool thing to do, and that it spreads through peer groups like eating disorders.  Teenagers are less equipped to manage strong emotions and a cult of suicide could have real and horrible consequences.  A well-adjusted adolescent does not self-mutilate, but a vulnerable person might view it as something of a fad.  Sometimes self-injury is an attempt to draw attention or manipulate others.  Self-injury is a disorder and sometimes a cult rolled into one.  In recent years the “Emo” scene, (young teens who are supposed to be ultra-emotional and sensitive), has been linked closely with cutting and self-harm.  They may be “jocks,” “skaters,” “preps,” or “nerds.”  This group can tend to be narcissistic and believe that only they know what pain is.  They are usually suburban Caucasian kids that are lucky enough to be privileged financially, and have their own television and computer in their bedroom.  Yet they think their life is horrible.  “No one understands me!” is their battle cry.  Coupled with the psychological traits of self-pity, self-drama and hormone imbalance, you now have an “Emo”.  The androgynous nature of Emos is appealing because it is sexually unthreatening.  Young teen girls are frightened by manliness and tend to like boys who look like girls.  Attitude is everything.  Emos are expected to be depressed, insecure, sensitive and quiet.  They also are too wrapped up in their own emotions to care about the opinions of others, but can use the Internet to expound on their unhappiness and disillusionment with life.  Much of the music that Emos listen to is on the darker side and self-harming can be ritualistic as they listen to certain music.  Most of the music does not condone negative behavior, but might add to their despair and thoughts of suicide.  Words from Linkin Park’s song  “Given Up” include:  “There’s no escape, I’m my own worst enemy.  I’m sick of feeling, is there nothing you can say.  I’m suffocating, tell me what the fuck is wrong with me.  Put me out of my fucking misery”. 

"I cut myself for two reasons:  to feel something and to commit violence that didn't hurt anyone else.  Like many young people who don't 'fit' in the average American high school, I swung back and forth between a numbness that I still find scary, and an all-consuming rage at the life I had.  At the same time, unlike the Columbine boys, who I had more in common with than I care to think about, I never wanted to hurt anyone else…since I hated myself for not being 'normal', I made an excellent target.”

Part of the problem is that the youth of today often have relatives who are not available for the day-to-day support of being an active part of their lives.  This means that in times of difficulty there are fewer adult confidants and the young turn to clueless peers for guidance.  They go home from school to microwave meals for one, computer games and the Internet, because both parents are working.  Texting rather than talking is the norm and the isolation deepens.  We live in a body-focused culture where the television bombards them with the latest fashion and makeup, and when they feel they can’t measure up, they emulate the look of the ghetto.  Kleptomania, compulsive shopping, gambling and self-injury are all on the rise.  It’s a time when it’s chic to be dysfunctional…their favorite stars are always in the news with some problem…think Lindsay Lohan and Britney Spears.  Many of today’s entertainers have admitted to self-injury or been photographed where the scars appear.  Rumored cutters are Johnny Depp, Colin Farrell, Courtney Love, Marilyn Manson, Sid Vicious, Christina Ricci and even Princess Diana, who in 1996 revealed she had struggled with it.  Fiona Apple was raped and that sent her spiraling.  Angelina Jolie thought about blood in a romantic way and we all saw the pictures of the out of control Amy Winehouse.  Shirley Manson, lead singer of the band Garbage, has gone public with her own past experiences of cutting, in hopes of helping others.  She said, “I'm speaking out because I feel this problem is getting worse for some kids.  I'm not an expert on this, but you have to talk to someone.  I've seen kids with cigarette burns on their arms or gashes on their legs.  It kills me, but hopefully my coming forward can help a little.”

WARNING SIGNS
Wearing pants and long sleeves in warm weather
Lighters, razors or sharp objects (items you might not expect) among a person’s belongings
Low self-esteem
Difficulty handling feelings
Relationship problems
Poor functioning at work, school, or home

symptoms of self-injury
Frequent cuts and burns that cannot be explained
Self-punching or scratching
Needle sticking
Head banging
Eye pressing
Finger or arm biting
Pulling out one's hair
Picking at one's skin

What you can do to help yourself

Acknowledge this is a problem
You probably need professional help to stop
Realize this is not about being a bad person
It’s a behavior that has become a big problem
Find one person you trust and get professional help
A relative, friend, teacher, minister or rabbi
Reach Out to Others:  Phone a friend, go out and be around people, call 1-800-DON’T CUT. 
Express Yourself:  Write down your feelings in a diary, cry—it’s a healthy and normal way to express your sadness and frustration.

Alternatives to avoid self-harm

If you have Anger:  Run, jump rope, dance, ride your bike, swim, punch a pillow, scream, flatten aluminum cans for recycling—anything that helps you move the anger out of your body.
If you’re Sad or Depressed:  Calm yourself by taking a bubble bath, hug a stuffed animal, play with a pet, curl up under a comforter with hot cocoa and a good book, smooth a favorite lotion into the parts of yourself you want to hurt, draw, listen to soothing music, watch a feel-good movie.
If you are Feeling Numb:  Hold ice cubes in one hand and try to crush them, hold a package of frozen food, take a very cold shower, chew something with a strong taste (chili peppers or raw ginger root), wear an elastic rubber band around your wrist and snap it (in moderation to avoid bruising).
If you crave the Sight of Blood:  Try drawing a red ink line where you usually cut yourself, in combination with some of the other suggestions above.

There is no sure way to prevent self-injury.  Prevention strategies may need to involve both individuals and communities, including parents, schools, medical professionals and coaches.

“I made a mix of 10 happy songs I would listen to sometimes when I was rollerblading to put myself in a good mood... It was uplifting music.  It was good.  It was like ‘Walking on Sunshine’ and ‘It’s Raining Men’ and stuff like that.  Maybe I shouldn’t listen to depressing, abusive music when I’m feeling like this.  Maybe I should try to get in a better mood.”

Websites for help:
SelfInjuryHelp.com (aka S.A.F.E. Self Abuse Finally Ends) 1-800-DONTCUT
TWLOHA.com (aka To Write Love On Her Arms)
Psyke.org

Issue 49 featuring: Jordan Daniele, Darenzia & Georgia Jones