Cutting and Other Types of Non-Suicidal Self-Injury (NSSI)
You may have noticed cuts or burns on your daughter’s skin, or been shocked when your teenager tells you about a friend who is intentionally injuring themselves. Perhaps you have had the compulsion to harm yourself and felt ashamed of the marks left behind.
Non-suicidal self-injury (NSSI) occurs when a person purposely harms his/her body in a significant way, causing injury but not intending to end life. The most common form of NSSI is “cutting”, often on the wrists, arms, legs, or stomach, using knives, razors, or other sharp objects. Other types of NSSI include: scratching, burning, hitting oneself, breaking bones and inhibiting wound healing.
For anyone who is not a “cutter” or other type of self-mutilator, these behaviors may seem extremely alarming. However, approaching a person who engages in these behaviors without judgment is important in order to open the lines of communication that can help. Understanding the reasons for NSSI and how it can be stopped is, therefore, a vital first step.
Why Do People Cut Themselves?
Adolescence can be a trying time. Pressures to succeed and fit in; interpersonal issues with friends, family members, teachers, and other adults; insecurities and fears are all commonplace in the teen years. This is also a time when mental health issues like depression or eating disorders may surface. Learning coping strategies becomes crucial during this period of every person’s life. For 12-14% of adolescents, NSSI is used to cope with emotional distress, trauma, or mental health issues, despite its inherent dangers, social unacceptability, and ineffectiveness as a long-term strategy.
Many cutters report feeling distress building up like a pressure cooker, with no apparent means of reducing that pressure. They say cutting creates an immediate feeling of relief. Perhaps self-harm has this effect of bringing release of pressure because the pain it induces causes a surge of endorphins. In any case, cutters and others involved in self-injurious behavior are usually attempting to regulate uncomfortable emotions. They may find physical pain a distraction from emotional pain, or they may feel “empty” or “numb” and find the pain of self-injury a welcome reminder that they actually can feel something, that they “exist”. Rather than deal with the underlying causes of disturbing emotions, they soon learn that self-harm provides a quick-fix.
Cutting and self-harm is an epidemic with youth, suggesting the increasing pressures of adolescence and a need to teach more effective coping skills.
-Kathleen Eannone, RN-C Adolescent Unit Director, Carrier Clinic®
The Compulsion to Cut
Because relief, calm and feelings of self-control are soon associated with the act of self-injury, the behavior has an addictive effect on many teens. NSSI becomes a compulsion, a go-to coping mechanism for uncomfortable emotions. As such, it can be very difficult for a self-injuring teen to stop, even if (as is often the case) it leads to feelings of shame or guilt. In fact, most people who harm themselves intentionally go to great lengths to keep it a secret, hiding wounds with clothing or injuring themselves in places that would be covered by clothing, isolating themselves, or pretending to be happy and secure despite internal pain.
Although NSSI usually begins in early adolescence, it can continue into adulthood if not addressed. It often leads to permanent scarring, can interfere with relationships since it is usually kept secret, and it prevents a person from learning essential coping strategies. Sadly, though its purpose is generally to feel better, it may also lead to unintended death since it is difficult to judge the depth of a wound or the blood loss that may ensue. Wounds can also become infected, a potentially serious problem.
How to Stop Hurting Yourself or Help Someone Who Self-Injures
Help for self-injurious behavior requires a non-judgmental, caring approach by both the person engaging in self-harm and the concerned people around him/her. Rather than focus entirely on the self-injury, it is important to deal with the underlying emotional issues being coped with using NSSI.
Although this may well be “normal” adolescent distress, there may also be a traumatic event or psychological issue that needs to be addressed. Learning more positive coping skills will take time, practice, and reinforcement, and might be better achieved with the help of a professional therapist. It is important to be patient with yourself or your loved one as they work through this.
While new coping strategies are being learned, the compulsion to self-harm often continues. Some ways to avoid injuring oneself during this time include talking through the uncomfortable feelings, playing relaxing music, taking a cool shower, writing in a journal, exercising vigorously, holding ice to the skin or snapping a rubber band placed around the wrist.
With time and practice, more effective ways to deal with emotional issues can be learned, and self-injury will no longer seem the easiest way to handle distress and discomfort. Immediate help is available through the SAFE Alternatives Program’s Self-Injury Hotline by calling 1-800-DONT CUT (1-800-366-8288).
If you are the “cutter”, don’t let shame and embarrassment prevent you from seeking professional help. If you are concerned about someone else who is self-injuring, encourage them to get help – not because cutting is “wrong” or “weird”, but because you are worried about the pain or stress that they are coping with through NSSI. Let them know that while you may not understand their compulsion to self-injure, you know that there are coping strategies they can learn over time to deal more effectively with their troubles.
Private, Individualized Education For Your Child
If you think your child has a problem with cutting or another form of self-harm and you think they could benefit from an individualized learning environment that addresses both their educational and mental health needs, Carrier Clinic®’s East Mountain School is a great option to consider.
Please contact us for more information about our school and services.
If you found this topic interesting or helpful, check out this related topic for tips how to handle difficult conversations (like talking to your child about cutting).
Or if print a copy of this resource for a friend to spread awareness about cutting and other types of NSSI.