[Reprinted from the book My Kind of Sad: What It's Like to Be Young and Depressed by Kate Scowen; Copyright © 2006 Kate Scowen. (Published by Annick Press Ltd, 2006; 1-55037-940-2) Reprint permission granted by Annick Press Ltd. For more information please visit the publisher's website at www.annickpress.com.]
Many people think that self-mutilation is a way of trying to kill yourself. It often isn't. Self-mutilation is a way of expressing the anger, agitation, and pain that many people face when they are depressed or suffering from other mental health issues.
"Just as depression can be described as anguish turned inward, self-mutilation can be described as psychic pain turned inward in the most physical way. Girls who are in pain deal with that by harming themselves." -- Mary Pipher, Reviving Ophelia
Sometimes, if people are depressed, it can be hard for them to explain to others how they feel, and they may not even have the energy to try. That isolation can lead them to take their pain and anger out on themselves. They may use a brief episode of self-mutilation as a way to express how they feel. They may scratch up their arms or legs once or twice and then leave it at that. For others, though, it can turn into a regular thing.
"I had thoughts about suicide, but I wouldn't ever have attempted it. [Cutting] was just a way of doing something a lot less severe and a lot less permanent to express what I was feeling. I guess I didn't have any other way. It really scared me, because I was making myself bleed and it freaked me out. I felt that I just had so much pain inside me and so much I was going through that I felt like nobody could see, so I quantified it. That was what it was about for me, I think. It was like, 'This is how bad it is.'" Marlee, 21
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. Cutting, burning, scarring (picking at scabs repeatedly to make a deeper scar), and pulling out your hair are all types of self-mutilation. Some people bang their head until they pass out, or break their own bones. Self-mutilation is not about wanting to die, it's about trying to feel alive. The description of cutting as "a bright red scream" really illustrates what it's about.
"Cutting was because I needed to get back into my life. You sink into this place where you can't think or feel, you don't know what you're doing. My brain, subconsciously, would tell me that's what I had to do to get out of the horrible hell I would snap into. Cutting yourself is pain and blood and living, and it's taking away the pain of being this empty person." Claire, 17
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.
"When I cut myself, it was almost like blacking out. Something would snap in my mind." Claire, 17
The Impact of Self-Mutilation
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 quite 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." Clare, 17
Many people who self-mutilate do not feel any pain when they are hurting themselves. They can break their own bones, burn themselves with hot irons, or cut up their arms -- with no feeling of pain. Researchers have discovered that, for some people, the stress of traumatic memories or emotional pain causes the brain to release chemicals that act as a kind of pain reliever. These chemicals are powerful opiates that block the physical pain of self-mutilation. Some researchers believe that cutting and other self-harming behaviors can become addictive as a person begins to crave that rush of opiates and the calming effect they have come to rely on. So, once someone starts cutting, it can be hard to stop, even if they know that it's not a healthy thing to do.