Saturday, February 5, 2011

Why Do People Cut Themselves?

by Tara Deliberto

Celebrities like Megan Fox, Angelina Jolie, and Demi Lavato have all purposely cut themselves. But why?

Well, it isn't all that clear. And the answer "they do it just for attention" doesn't make too much sense.

Sure, getting attention could be part of the answer, but it's not that simple. If you've never cut yourself, consider this: of all the things you could possibly do for attention, is carving your skin with a razor really at the top of the list? Probably not.

After researching self-injury for several years, one thing seems certain - cutting immediately halts emotional pain. It might seem backwards that physical pain stops psychological pain. But we need to take a closer look.

Starting Generally

I would actually say a major contributing factor to self-injury is actually our tendency to make things too simple. Allow me to explain. Although judging what is right and wrong is super complicated - hence the whole legal system - we are quick to slap labels on people like "good" or "bad." But life is more nuanced than that! Of course labeling helps us communicate, but a lot of very important information gets lost when we stamp something as "good" or "bad."

More Specifically

Now getting more directly to the point of this post, the very same language we use to describe our world and communicate ideas to others, is used to communicate to ourselves. We think in words. We label ourselves as good or bad. We tell ourselves we are good or bad.

And what people are telling themselves right before they cut is nearly unbearable to hear. I'd imagine their mind is shouting things at them like "You're a worthless bitch. How could anyone love you? You disgust me."

The thing is, I don't think I've ever met a totally worthless, unlovable, and disgusting human being, whatever that is. It is usually very clear from a third party perspective that the self-talk of a person who cuts, is incredibly harsh and one-sided. Despite this, people go on labeling themselves anyhow.

Not only do people who cut tell themselves abusive things, they believe them too. This is a very important distinction. Once people learn to determine the difference between having a thought and believing it in therapy, we usually see symptoms improving a lot. It is one thing to think "Wow, I am a bad person," acknowledging it as just a thought, and moving on. It is another thing to think "Wow, I am a bad person" and believe it.

With a new understanding of abusive self-talk in the mind, let's shift to discussing the body.

The Body

Let's just say you're strolling along, thinking about how beautiful the sky is, when you walk into a telephone pole. The second after your toe smashes into the pole, are you still thinking about that beautiful sky? Probably not. You're just thinking about how much your damn toe hurts.

Now, what if you were thinking about how you're such a selfish slut? What if you believed it? Would you rather be in the emotional anguish that comes along with berating yourself or would it be easier to have your toe hurt?

Yeah, that's what I thought. You'd rather stub your toe, wouldn't you?

Right after the body sustains an injury, it is kind of hard to be caught up in your thoughts. The physical pain provides a mental break from really horrible self-talk. The pain becomes a vacation.

[It is worth mentioning that even if the emotional pain isn't necessarily tied to what some people might call irrational thought (but is from an actual loss or event), it still be halted by self-injury. Usually though, I'd bet there is some degree of extreme thought causing the pain to be increasingly intense.]

Now back to talking about cutting for attention. Sure, people could also be cutting for attention, but the picture is clearly a lot more complicated. On either side of the spectrum, you may have people who solely for attention, and on the other, people who cut and have never told anyone. Most likely, people cut for several reasons. Now, let's take this discussion a bit further from here.

While it seems that verbal thoughts like "You're a worthless cow" repeating over and over might be an important factor, there are many more pieces of the puzzle.

The Physiology of Self-Injury

There are some non-human primates, especially neglected ones, who tear out bits of fur when they're distressed. They actually harm themselves.

[Side note: The thought of a neglected monkey pulling out tufts of fur can be pretty upsetting, cant it? Unfortunately, while it is easy for some of us to have sympathy for monkeys who hurt themselves, it is more difficult to take a non-judgmental stance towards humans who cut.]

While these neglected monkeys harm themselves like humans, they don't have language capacities like us. Therefore, it's not very likely that abusive self-talk leads to self-harm in non-human primates. Percentage wise, the non-human primate self-injury may be maintained much more by the emotional, rather than a linguistic or symbolic system.

While language is a new development on the evolutionary scene, emotions are not. Emotions have been around for a while, without the complication of human language. As any loving pet owner like myself could tell you, animals have emotions.

What happens on a physiological level after someone cuts is not currently understood; however, my guess is that there is a release of endorphins, which make you feel good. We also know that heart-rate dramatically drops after cutting in people who often self-injure.

In short, on a mental/language level as well as an emotional level, there is likely some serious relief occurring right after cutting.

Wrapping Up

The way I see it at this particular point in time, is that very upsetting abusive self-talk is immediately halted, there a shift of attention to the cut, and endorphins are released, which serves to calm the body further.

Of course, the reasons people cut are diverse and they change over time. This may not be true for everyone. For instance, people may also cut to feel something if they're feeling nothing or numb. An additional reason people report cutting is to punish themselves. Perhaps sometime soon I'll write about these functions as well; however, it seems to me that the main function of cutting is to help reduce negative feelings in the moment.

Thankfully though, wonderful treatments like Dialectical Behavior Therapy (DBT) have been invented to help with cutting. If you or someone you love engages in self-injury, there are wonderful resources available. Go online and find a DBT therapist near you at www.abct.org or join a DBT Skills Group near you. I co-lead one in Manhattan at the American Institute of Cognitive Therapy, if you so happen to be in the area.

Blog Info

For more posts on self-injury, check out The Psychology Easel's Self-Injury Section.

Feel free to follow me on Twitter at @TaraDeliberto and subscribe to this blog in the right sidebar.

Do You Self Harm?

If you engage in self-injury, an excellent resource is S.A.F.E. Alternatives, an absolutely wonderful organization devoted to the treatment of self-injury (you can visit their website at http://www.selfinjury.com/).



Also, a very helpful book on directly treating self-injury is Bodily Harm. Select this book in the icon above to purchase.

The best treatment for cutting is Dialectical Behavior Therapy (DBT).  Go to www.ABCT.org to find a DBT therapist near you.




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