Wednesday, December 7, 2011

Self Mutilation

Today's advice was requested by a young man from Italy who we'll refer to henceforth as S. S asks:

"We recently found out my 13 yr old niece cuts herself. When her mom asks her where she got the cuts from, my niece says the pets scratched her. But we all know its not from the pets. Her dad was always away because he's in the navy and after affairs and marriage problems, her parents are now separated in the process of divorce.

She likes being by herself and watches tv shows like 1000 Ways to Die and stuff. I just thought she was in the angsty teenage stage of her life. I read online that cutting is due to emotional depression.

I'm not sure what to do but I know our family can probably handle this and make it go back to normal.Should we also seek professional help? We don't want to push her away or anything like that.

 First there is something you should know about cutting: cutting is a coping mechanism. This means one may cut their self for a variety of reasons, not solely due to sadness or depression. Anger, anxiety, sadness, even joy in some cases. Cutters will often feel the compulsion to cut when faced with an outside stimuli they find too emotionally overwhelming to deal with internally. So they externalize their inner pain much in the way an artist or a musician would. Only the method of release they choose is destructive rather then constructive.

Not to trivialize it, but it is also comparable to when a young child who cannot yet understand the appropriate way to deal with anger might break their own toys. Or an exceptionally anxious person might bite their own nails.

Essentially the cutter doesn't know how else to deal with how they are feeling. To them, cutting is the only effective way they know of to improve their mood in times of distress. This makes getting them to see what they're doing as a bad thing difficult, because to them it is helping and helping has to be good, right? That said, they are aware that it isn't normal or acceptable behavior because they will go to great lengths to hide what they're doing from others. Either with concealing clothing or by lying about the origin of their scars. This implies that deep down they know there must be an alternative, they're just ill-prepared to accept it.

Which is why a professional's help is often required.

Try as you might to get her to see the error of her ways, familial advice is often viewed as judgmental. Which will inevitably provoke an adverse reaction. If you can even get her to admit to what she's doing in the first place. Telling a stranger you may never see again that you cut yourself is simple, telling someone who you'll see daily for the rest of your life that you cut yourself is not. You could try talking to her about methods you use for coping, just remember to broach the subject very carefully. You don't want to seem like you're accusing her of anything.

It sounds to me however that the entire immediate family could benefit from therapy given current circumstances. So family therapy may be a keen way to get her help without singling her out. Family therapy usually consists of a group session and several one-on-one sessions with a therapist so that the family can work on issues together and individually in private. In my opinion this would be the ideal approach to her cutting.


  1. This is exceptional advice. Wow.

    1. Thanks. As an update, S and his family did attend Family Therapy and I'm told the circumstances have improved and continue to do so.