The Long Road Back From Bleeding
One Cut Can Calm While Another Can Kill
Tricia McCarter-Joseph - January 25, 2005

After signing a no-cutting contract with her psychologist, Gabrielle (name has been changed for this story to protect her identity) began feeling resentful and eventually began cutting herself again. She was still depressed and missed her blades, which the contract said she couldn’t use. "In the [therapy] sessions…I would not say anything of real significance…,” said Gabrielle. “I was making no progress and I felt too depressed to care about the contract anymore…”

When the tension became unbearable, Gabrielle used a butcher knife on her arm to relieve the stress. Although her parents found out and took her to a psychiatric facility, she never stopped craving hurting herself; strangely it was the one thing that made her life manageable.

Katy was severely depressed for years and didn’t even know it. “This began around the age of five, and… worsened up to the age of 10,” Katy explained of her diagnosis. “At that age, I was clinically depressed. However, my depression was not recognized by my family, my doctor, or myself.”

A medical student who had access to scalpels and needles, she would use these instruments on herself to cope with her depression. Katy also suffered from anorexia nervosa, an eating disorder where the person is obsessed with being thin. Sometimes she cycled up to 50 miles a day. “As I neared the end of my PhD, I was so severely depressed that I self-harmed…several times a day,” she said.

The National Mental Health Association (NMHA) defines self-injurious behavior as the deliberate, repetitive, impulsive, non-lethal harming of one’s self. It is characterized by cutting, scratching, punching, burning and other forms of bodily harm. NMHA maintains that habitual self-injurers make up one percent of the population, affecting females more than.

These women have been self-harmers since they were teenagers, beginning at 14 and 15-years-old respectively. Gabrielle, a twenty-one-year-old college student, likes listening to Pink Floyd and is hooked on Harry Potter books. Katy, 29, comes from a middle class family in Britain where her father worked for IBM and her mother was a teacher. Many may find it unconscionable to physically abuse one’s self. Others mistakenly believe that people who self-injure are seeking attention, but in actuality they are voicing their pain the only way they know how.

“I was bullied very badly at school,” Katy said. “I was unable to voice my pain, and instead cut myself and wore it secretly as a comforting sign that I had expressed my feelings.”

Dr. Wendy Lader, Clinical Director of S.A.F.E. Alternatives (Self Abuse Finally Ends), a nationally recognized program for self-harmers, agrees. “Self-injurers will injure in places on their bodies that others can’t see,” Lader explained. “They will often make excuses…rather than display their injuries in an exhibitionist fashion.”

However, self-injury isn’t a condition unto itself. In fact it isn’t even a disease. Rather it is an indication of something much larger. “Self-harm is a symptom of several different disorders, [for example] Borderline Personality Disorder… but [it] is not classified as a specific disorder itself,” said Matthew K. Nock, Assistant Professor at Harvard University, and a 10-year clinical researcher of self-harm.

“It makes me feel secure that I self-injure…”

Katy first hurt herself with a razor blade, lightly scratching her arm and hand “about 30 times.” She has overdosed on several occasions, and once “had to be resuscitated by a doctor and ambulance staff.” Katy has also cut herself so many times that at least once she has visited an emergency room with cuts that were severely bleeding.

Katy said: “I deposited a pool of blood beneath me on the waiting room floor. Waiting patients were concerned and asked me what I had done. I felt if I told the truth they’d be [horrified]. I lied and said I had accidentally put my hand through a window.”

However, due to her medical background, she later learned how to properly dress and stitch herself without having to go to the hospital, and avoided having to lie to others who asked her about her condition. She claims it is one of the reasons why her scars have healed so well.

Gabrielle’s experience is similar. “When I was 15…I began… pinching myself and digging my nails into my skin,” she said. In 2001 she attempted suicide more than once. At one point she overdosed “and [passed] blood afterwards. It hurt but it didn’t kill me.”

Does the end justify the means?

So how does this kind of self-destructive behavior help the underlying problem? “Control. I like being in control of myself,” Gabrielle answered. “Security. It makes me feel secure that I self-injure, like a blanket a child carries for comfort.” She explained that hurting herself calms her, and helps her to keep stressful situations under control. Sometimes after cutting she is so tranquil that she can go to sleep. When her parents took her to the psychiatric facility, Gabrielle was so distraught, that to compose herself, she went into the bathroom and punched herself in the face. Ironically no one at the hospital noticed her bruised cheek.

Katy herself says that after seeing many psychiatrists, she was finally diagnosed with clinical depression. “I didn’t even know what depression was as a kid,” she said. “I thought it was normal to sleep two hours a night, hate myself, and think about death and suicide all the time.”

Experts say it is important to understand that self-harm is more of a coping strategy and generally not suicide; although some do attempt it when their pain becomes unbearable. For many self-harmers it is a method of relieving emotional stress or tension that they cannot express otherwise. Aside from the fact that many self-injurers may suffer from a mental or psychological disorder, such as depression, an eating disorder, or even substance abuse, self-injury doesn’t cause the underlying disorder. Instead in dealing with whatever condition they may have, self-harm helps them to keep stressful feelings at bay.

In some cases, suppression of feelings may play a role with some self-harmers who may have been taught to stifle emotional or physical pain. Gabrielle had a similar experience with her father. “I remember crying and my grandmother holding me. My father later told me to never do that again. I wasn’t supposed to cry, especially in front of my grandmother.”