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Self-injury: A silent epidemic
August 23rd, 2011
12:08 PM ET

Self-injury: A silent epidemic

Editor's note: Ethnographers Patricia and Peter Adler drew on 150 interviews with self-injurers from all over the world, along with 30,000 to 40,000 internet posts in chat rooms and communiqués to write "The Tender Cut: Inside the World of Self-Injury."

For the last 10 years we have been studying self-injury: the deliberate, non-suicidal destruction of one’s own body tissue, such as self-cutting, burning, branding, scratching, picking at skin, re-opening wounds, biting, head-banging, hair-pulling, self-hitting, swallowing or embedding objects, breaking bones or teeth, tearing or severely biting cuticles or nails, and chewing the inside of the mouth.

When teens embed objects in their skin

Our research, just published as "The Tender Cut," offers the widest base of knowledge about this behavior, based on over 135 in-depth life history interviews with self-injurers located all over the world and tens of thousands of Internet messages and e-mails including those posted publicly and those written to and by us.

Self-injury, which has gone by several names including self-harm, deliberate self-harm syndrome, self-mutilation, self-cutting, self-injurious behavior, and self-wounding, emerged from obscurity in the 1990s and spread dramatically as a typical behavior among adolescents.

Long considered a suicidal gesture, is recognized today as offering a short-term release from anxiety, depersonalization, and rapidly fluctuating emotions leading to the lessening of tension, grounding, euphoria, reduced anger, satisfaction of self-punishment urges, and relief from feelings of depression, loneliness, loss, and alienation.

It represents an emotion regulation strategy providing a sense of control, reconfirming the presence of one’s body, dulling feelings, and converting unbearable emotional pain into manageable physical pain.

Before our research, studies of self-injury were conducted almost exclusively by members of the psycho-medical establishment. Many of these “experts” considered this practice addictive. Self-injury was regarded as a disorder mostly practiced, like eating disorders, by teenage, white girls coming from affluent backgrounds.

These studies are limited because they used people in therapeutic or hospital settings as research subjects, who represent only the tip of the iceberg of the broader self-injuring population. When you look at the rest of the iceberg, at people in their “natural settings” who self-injure, you will see a whole different demographic.

And you will see a much broader range of motivations for self-injury and ways that this is defined. We describe the rest of this iceberg in "The Tender Cut."

Beginning in the late 1990s and increasing rapidly in the early 2000s, self-injury began to spread to a wider population and take on a whole new meaning. Self-injury emerged from the closet, slowly at first, but with increasing vitality.

Disaffected, alternative populations seized on it as a way to rebel and express their rejection of mainstream values. Structurally disadvantaged populations such as homeless youth, minorities, the poor, and people in prisons and juvenile detention centers, turned to it out of frustration. Ordinary teenagers adopted it as a way to relieve the travails of typical adolescent development. Older people started revealing their self-injury to establish themselves as a group and differentiate from the “young and trendy” cutters. Young men channeled their anger and rage into injuring their bodies.

Once the media discovered self-injury, it spread like wildfire. People who heard about it, and learned that others had gotten relief from their emotional troubles by doing it, tried it themselves. Wannabes and copy-catters did it just to fit in.

The stigma of mental illness abated, so that people were regarded as being merely unhappy, and possibly too needy. Instead of freaking people out, self-injury became known, especially among youth, as “that thing that people do.” As this happened, self-injury left the realm of the purely psychological and became a social phenomenon, spread through social contagion.

Most people use self-injury to deal with anxiety or emotional pain. This can be rooted in deep-seated past issues such as abuse, family dysfunctionality, or chemical imbalances, but it can also be caused by the difficulty of going through typical adolescent self-discovery and social problems. The temporary relief it provides may help people get through difficult periods in their lives.

Although society was initially shocked to discover that people might harm their bodies intentionally, when compared to other ways that people seek relief from pain it offers several benefits: it’s not illegal, it’s not addictive, it doesn’t hurt others, and the body eventually heals. For those trapped in bad situations, it can be a way to make it through until their lives improve.

The largest population of self-injurers still falls within the adolescent years, as most people start when they’re in their early teens. The population gets smaller at each decade of life because of changes that occur over the lifespan, with certain key points that encourage quitting. A lot of young people stop during the transition from high school to college. Some give it up when they get a professional job or if their significant other is bothered by it. Others desist when they have children because they don’t want to role model this behavior for them.

The psycho-medical community offers many solutions to people looking for help in dealing with their self-injury. Outpatient therapy, drugs of all sorts, and specialized clinics that offer inpatient treatment are all available.

But in addition to these, and as a free alternative, a host of support groups have sprung up on the Internet where self-injurers can find others like themselves who offer understanding, advice, social and personal acceptance, and community. Available in a range of philosophies and stages along the self-injury career from early onset through recovery, they provide an outlet from the pain of inner isolation, social rejection, and struggle with the practical issues of daily living with this coping mechanism until better ways of resolving life’s struggles can be forged.

These sites offer not only help but an alternate to the psycho-medical community’s model of self-injury as pathological. They aid people in realizing that this behavior does not mean that they are crazy, weak-willed, sick, or bad.

In fact, our longitudinal data show that many people who struggle with self-injury during their formative years, like those who try drugs, eating disorders, or delinquency, grow out of it to live fully functioning productive lives as professionals, parents, spouses, without further problems.

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soundoff (279 Responses)
  1. trish

    I used to cut as a way to ease pain when I was feeling depressed or if someone humiliated me or made me feel stupid. Then as I became more depressed and started to consider suicide I think I did it because I was hoping someone would see the scars and ask me what was wrong. But people are too polite for that, and I did a good job of hiding them most of the time.
    I don't cut anymore because it doesn't give me a release like it did when I was younger.

    August 23, 2011 at 23:28 | Report abuse | Reply
  2. pj

    I am heartened by all the displays of compassion and caring here. I appreciate all the positive responses that so many are willing to leave.

    August 24, 2011 at 00:30 | Report abuse | Reply
  3. Naomi

    Kids should be taught Biblical morality instead of self-fulfillment. This worship of self in the West would make any normal human being downright sick. Racist Americans were a lot more normal than present Americans. The colored must be treated fair, but something is very wrong with the mentality of present Americans. It must be from the rampant immorality and blasphemy and the unnatural selfishness. Democracy only works well with godly educated people, not with perverts.

    August 24, 2011 at 01:00 | Report abuse | Reply
    • Kleentx

      The WHO must be treated fairly? Did you actually type the word "colored"???? What "color" are you, Naomi? Were your ancestors actually British royalty or something? I'll bet if you look into your own heritage, there might be a "color" or two in there you didn't even know about.

      August 24, 2011 at 18:16 | Report abuse |
    • Kleentx

      I think you need to take another look at your Bible. It actually says that God created Man in His own image. It doesn't say God created WHITE man in his own image. It means ALL people – unfortunately that includes you.

      August 24, 2011 at 18:19 | Report abuse |
    • Jenesy

      Self harming isn't a choice it's pure pain to know that you want to cut yourself I was raised in a Christian family I've read about 6 bibles but that doesn't mean god changed my mind about cutting it sucks doing what I do it sickens my mind but there's nothing I can do about it what's done is done I can't change the fact that I started to cut now it's an addiction I can't control it not god or anyone will change what I do or what happens to me every night the craving to put a blade in your skin

      November 26, 2012 at 01:29 | Report abuse |
  4. Naomi

    American comedy shows make kids sick. It's not funny. It's bad to human brains.

    August 24, 2011 at 01:03 | Report abuse | Reply
  5. 20 Year Veggie

    News flash: It ain't just teens. Not by a long shot.

    August 24, 2011 at 01:12 | Report abuse | Reply
  6. baileya82

    I am 29 and have been self-injuring for 14 years. I disagree that it is not an addiction. I have new coping mechanisms, am stable on medications and see a therapist regularly. I can't stop. Its become an addiction for me. A pattern formed that is insanely hard to break. If it was just a coping mechanism I could of stopped a long time ago. I want to stop but sometimes urges come out of no where and I have to cut. I want to stop. I just don't know how.

    August 24, 2011 at 01:18 | Report abuse | Reply
  7. Jasmyn

    I have two friends that did this; luckily i got both of them to stop, glad i was there to help them so they wouldn't go further

    August 24, 2011 at 01:44 | Report abuse | Reply
  8. Zed Powers

    Not sure about the difference between a problem and a decoration. Probably if you care compelled to keep doing it. Does this mean that people who tattoo their entire bodies are crying for help?

    August 24, 2011 at 09:33 | Report abuse | Reply
  9. showard76

    I have self-harm issues due to my borderline personality disorder, sometimes its like an 'urge' other times a need to punish myself for real or imagined wrongs, you can read more about my experiences here – http://showard76.wordpress.com/wp-admin/post.php?post=928&action=edit

    August 25, 2011 at 10:51 | Report abuse | Reply
    • showard76

      that link should be – http://showard76.wordpress.com/2011/07/06/trigger-thinking-about-self-harm/

      August 25, 2011 at 11:04 | Report abuse |
  10. Karen

    Excuse me, i'm 16 years old and have had problems with cutting since I was 12. If you think that its something people can just stop doing, or even that its something to shun/make fun/ etc for you have more issues than people like me! Its an addiction, its an escape, and more importantly, its a challenge. You don't have to come from some low standing in life to have problems with self-esteem or self-harm. In fact, a lot of people that self-harm come from good families, homes, and enviroments even...it has to do with the person, their experiences, and a lot with the expectations and pressures put on them during life. Don't talk about things you don't know about. Thanks.

    September 5, 2011 at 21:59 | Report abuse | Reply
  11. SarahRose

    I beg to differ. The first time I cut I was barely 13. Now, I'm almost 17 and I'm still doing it. I've been able to give it up for almost a year before, but without fail it comes back. It *is* addictive. If I can't cut I get stressed, upset, freaked out, etc. Finally when I give in and cut all the tension is released. I need more and more to get my "fix".
    I have cycled through cutting, bruising, scraping, starving, and many other self-destructive behaviors. They are all addictive ways to cope with my depression and home life. They are not harmless at all.

    October 23, 2011 at 23:53 | Report abuse | Reply
  12. California Wing Tsun

    It's actually a cool and helpful piece of info. I am happy that you shared this helpful info with us. Please stay us up to date like this. Thank you for sharing.

    April 23, 2012 at 21:43 | Report abuse | Reply
  13. Amber

    I struggled with self- injury from age 13 to 19 and it makes me angry reading things that say its not an addiction or they are making fun of self-injurers. Yes I have stoped cutting but i still struggle with it every day of my life and I am now 23. Its just like a person with a drug problem. I did not come from a bad family and I was not allowed to watch alot of tv as a child so to naomi who thinks people like me are "sick" you better check youself before you judge others because if you actually read the bible it says your not supposed to judge. It aggrivates me everytime i read something about self injury being a "fad" or "sick" its not and people that think that need to do their research!! The people that do this need help they dont need people making fun of them. I am sorry if i offend anyone by my post! I just needed to make my feeling known

    June 22, 2012 at 22:29 | Report abuse | Reply
  14. Ella

    Oh, so it's not addictive? Right. Really good research, if that's what they're saying. They clearly have no clue what they're talking about there.

    September 13, 2012 at 20:44 | Report abuse | Reply
  15. cuttingdepression

    Great article that covers the "during" and "after" what happens when one self injures.

    Michael Silver
    Cutting Depression
    Self-Injury

    September 2, 2013 at 21:02 | Report abuse | Reply
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