An unhealthy coping skill

“When I see the blood, I start to feel better,” she said when I asked her to tell me about her cutting behavior. “She” is one of the many teenage and college-age girls I see in my practice as a licensed marriage family therapist.

In my 10 years of providing mental-health counseling, I have seen an increase in this type of behavior. Mental Health Month—May—is a perfect time to explore it.

According to the girls and women I have counseled, there are two reasons why they cut. The first is that cutting allows them to feel because they are so numb otherwise. The second reason, and the most common I hear from clients, is cutting provides a release. They experience a “build-up” of feelings that they believe they have no control over, and once they cut that tension is released, keeping their attention on the physical pain rather than dealing with any emotional anguish or stress.

This type of coping skill then becomes addictive. It starts to become a pattern that one has difficulty changing.

So, what is the problem that makes cutting into the coping skill of choice?

Teens and young women who self-injure have difficulty understanding and expressing intense feelings, feel powerless over their lives and have low self-esteem. They might also feel isolated and alone, believing they deserve to be punished. I have also had clients share that they would rather take their anger out on themselves than hurt someone else.

The other characteristic one needs to know about cutting behavior is that it gets worse over time. Superficial cuts become deep wounds. The “addiction” starts to take full control, and the person becomes more powerless.

It is important to note that, in most cases, one is not necessarily suicidal. The goal has nothing to do with “ending it all.” Rather, it is used a stress reliever or coping skill.

What can you do to change the behavior or support someone you know is cutting?

If you are someone who engages in cutting, you may need to ask yourself some questions: “What is the stressor that has me thinking I need to cut myself?” “What purpose does self-injury serve?” “What are my thoughts right before I feel the need to cut?”

If you are a parent or loved one, encourage the cutter to express her feelings, provide support without judgment or criticism, and let her know that you care.

If you suspect that someone you love is engaging in self-injury, please take it seriously. Cutting is a serious issue and requires professional assistance. But there is hope, and one can find other ways to manage stress and cope with feelings.