Articles: The Silent Epidemic
By Lesleigh Owen
(U-WIRE) BOISE, Idaho -- Q: When did you begin self-injuring?
A: I was 15 or 16, in a scary and controlling relationship with this older man, when I began growing out my nails and sinking them into my forearms.
Q: Did it hurt?
A: That's the point.
The tragedy of Heather's story lies not only in the pain she has endured for more than 10 years but in the similarity of her tale to those of the other 2-3 million Americans who self-injure.
Self-injury (SI), as defined by the "Victims of Self-Injury" Web site, is "a term used when someone intentionally (and physically) harms (herself or himself)." The most common form of SI, cutting, involves the use of sharp instruments to cut one's skin. Other behaviors range from biting or burning to self-strangulation. The concept of self-injury isn't so hard to grasp; the real difficulty lies in deciding which behaviors the label excludes. In fact, when I posted messages on self-injury message boards, asking for opinions on how to define and treat the subject, more respondents emphasized what not to include in the definition. "Talk about how self-injury isn't the same as suicide," one person advised, while another urged me to "stress that SI doesn't mean scarification (intentionally carving meaningful designs or words into one's skin), tattoos or body piercings."
Sure it's tragic, but you don't know any of these people, right? Take the 40 percent of teens that Dr. Jennifer Hagman estimates have experimented with SI, mix in those women and men suffering from eating disorders (arguably included in SI's scope), and the chances of not knowing a self-injurer are pretty slim.
Most of them won't walk up and introduce themselves as such, however. Self-injurers are everyday people: our mothers, sisters, brothers, friends and significant others; no one wears a sign, a cape or a scarlet "SI" emblazoned on her or his chest. Most suffer in silence.
Self-harmers have recently begun stepping forward, however, even establishing Internet support groups and communities. Although specifics vary from person to person, a few common themes have emerged from these communities. Not too surprisingly, I learned that women, especially young ones and teenagers, compose the largest chunk (85-90 percent) of self-injurers.
Other than favoring women and teens, SI remains generously egalitarian, not tipping its scale toward any particular race or class. It does seem more common in victims of abuse; nearly half of self-injurers, in fact, report a history of sexual abuse as a child. A friend of mine told me about a woman she knew who cut herself severely.
"She had so much pain inside her the only way to release it was to take razor blades to the underside of her arms," my friend wrote. "It appeared that she tried to kill herself but she had so many scars you know it was much deeper than that." Her friend, she explained, had never experienced an abuse-free stretch of time, starting with her childhood, until the day she fled her violent husband.
Q: How do you feel before, during and after you self-injure?
A1: Truthfully, I don't really feel the pain till the next day. I'm not sure what I feel when I cut, but it makes me feel relieved.
A2: In a way, it makes me feel tougher. Nobody can really hurt me, because what I'm doing to myself is even worse, and I can take it.
A3: Once I do it, I feel better.
Only recently have psychiatrists and therapists begun addressing self-injury; before its "coming out" in the '90s, they often lumped it with other pathologies, treated it as depression, or quietly swept it under the rug. As actors and other pop icons, from Princess Di to Johnny Depp, came forward to discuss their experiences with self-harm, people slowly began emerging from the shadows, sharing within support groups and Internet communities their stories, struggles and methods for coping.
I must admit, I dove into this project in search of some nice, tidy formula to sum up the phenomenon of SI. The more I researched and the more stories I gathered first- and second-hand, the more I came to understand that while common stories and explanations do exist, everyone has her or his unique story to tell.
One of the most common explanations for SI I kept stumbling across theorizes that people self-injure as a means of expressing intense emotions. Steven Levenkron, author of the book "Cutting," says some victims feel they have no alternative means of self-expression. "Cutting," he writes, "is the replacement for absent language." Sara, an otherwise anonymous self-injurer and poet, agrees: "the visible injury cannot express / the pain within, the emotional distress / and yet the feeling of the blade is strong / it helps ease tension, why is it wrong? / it is my body, it is my choice, / it's a chilling scream in a silent voice."
At its most basic level, self-injury gives voice to pain and anger. Is it any wonder its primary victims are women, whom our culture instructs to remain wholesome and proper, always turn the other cheek, and find the greatest joy in placing others before themselves? As a result, some feel uncomfortable expressing anger and pain. SI allows such women to vent their anger and frustration in a manner that harms only themselves.
SI doesn't limit itself to women, however. Joe, an ex-self-injurer, said he used to conclude his fights with his parents by locking himself in his bedroom and bashing his head against the wall. Better his head than his parents', he noted, and besides, "it relieved the frustration."
Others say injuring themselves makes them feel more in control in allowing them to exercise a little power over their situations and themselves. Some sociologists take a more cultural approach, theorizing that in their effort to assert control over themselves, self-injurers adopt a role commonly associated with power: that of the victimizer. The act, then, becomes less about receiving the injury than about inflicting it. During our discussion, Heather seemed to agree with the theory that she self-injured in an effort to escape her gender role: "I injure because I'm in control. No more being a good girl, no more loving thy neighbor as thyself, no more pretending to care when I don't. It's all about me now. I finally have the right to be selfish."
Still other self-injurers cite SI as a means to temporarily snap them out of their emotional numbness. Many of those who endure or have survived unbearable situations, psychologists say, learn to divorce themselves from their emotions as a means of self-preservation. Some self-injurers, whether locked in abusive relationships or wallowing in the wake of a massive trauma, have clicked off their emotions like flicking a light switch. They injure as nods to themselves that yes, blood still flows through their brains and hearts. "I was married to a monster...Weeks would pass like some dream. Sometimes I would sit on the floor and bang my head against the wall or burn myself with the curling iron to make sure I was still able to feel something," wrote ex-self-injurer Amber.
Q: How do you cope with self-injury? Are you seeking some kind of assistance?
A: The only assistance I want is someone to care about me and not judge me.
Friends and loved ones who suspect someone of SI should approach the person with compassion and lack of judgment. Like everyone else, they seek understanding.
Advice on where to go from there differs according to the source; self-injurers generally told me they don't want loved ones to pressure them into therapy, while many mental health professionals urge injurers to seek immediate medical and psychological attention.
A man from England, whose wife had self-injured for years, told me, "You can never force a Self Harmer into anything -- especially treatment -- frustrating as it is -- you have to wait for them to realize they need help and then nurture them into that idea."
Most important, everyone agreed, is to support self-injurers, who likely already feel isolated and alienated. Help them find their voices by honoring their experiences and cultivating their senses of self. As Sara notes in one of her poignant poems, "tears of blood spill off my arm / and still I do not see the harm / people judge by what they see / so how do you judge what remains of me?"
A: I was 15 or 16, in a scary and controlling relationship with this older man, when I began growing out my nails and sinking them into my forearms.
Q: Did it hurt?
A: That's the point.
The tragedy of Heather's story lies not only in the pain she has endured for more than 10 years but in the similarity of her tale to those of the other 2-3 million Americans who self-injure.
Self-injury (SI), as defined by the "Victims of Self-Injury" Web site, is "a term used when someone intentionally (and physically) harms (herself or himself)." The most common form of SI, cutting, involves the use of sharp instruments to cut one's skin. Other behaviors range from biting or burning to self-strangulation. The concept of self-injury isn't so hard to grasp; the real difficulty lies in deciding which behaviors the label excludes. In fact, when I posted messages on self-injury message boards, asking for opinions on how to define and treat the subject, more respondents emphasized what not to include in the definition. "Talk about how self-injury isn't the same as suicide," one person advised, while another urged me to "stress that SI doesn't mean scarification (intentionally carving meaningful designs or words into one's skin), tattoos or body piercings."
Sure it's tragic, but you don't know any of these people, right? Take the 40 percent of teens that Dr. Jennifer Hagman estimates have experimented with SI, mix in those women and men suffering from eating disorders (arguably included in SI's scope), and the chances of not knowing a self-injurer are pretty slim.
Most of them won't walk up and introduce themselves as such, however. Self-injurers are everyday people: our mothers, sisters, brothers, friends and significant others; no one wears a sign, a cape or a scarlet "SI" emblazoned on her or his chest. Most suffer in silence.
Self-harmers have recently begun stepping forward, however, even establishing Internet support groups and communities. Although specifics vary from person to person, a few common themes have emerged from these communities. Not too surprisingly, I learned that women, especially young ones and teenagers, compose the largest chunk (85-90 percent) of self-injurers.
Other than favoring women and teens, SI remains generously egalitarian, not tipping its scale toward any particular race or class. It does seem more common in victims of abuse; nearly half of self-injurers, in fact, report a history of sexual abuse as a child. A friend of mine told me about a woman she knew who cut herself severely.
"She had so much pain inside her the only way to release it was to take razor blades to the underside of her arms," my friend wrote. "It appeared that she tried to kill herself but she had so many scars you know it was much deeper than that." Her friend, she explained, had never experienced an abuse-free stretch of time, starting with her childhood, until the day she fled her violent husband.
Q: How do you feel before, during and after you self-injure?
A1: Truthfully, I don't really feel the pain till the next day. I'm not sure what I feel when I cut, but it makes me feel relieved.
A2: In a way, it makes me feel tougher. Nobody can really hurt me, because what I'm doing to myself is even worse, and I can take it.
A3: Once I do it, I feel better.
Only recently have psychiatrists and therapists begun addressing self-injury; before its "coming out" in the '90s, they often lumped it with other pathologies, treated it as depression, or quietly swept it under the rug. As actors and other pop icons, from Princess Di to Johnny Depp, came forward to discuss their experiences with self-harm, people slowly began emerging from the shadows, sharing within support groups and Internet communities their stories, struggles and methods for coping.
I must admit, I dove into this project in search of some nice, tidy formula to sum up the phenomenon of SI. The more I researched and the more stories I gathered first- and second-hand, the more I came to understand that while common stories and explanations do exist, everyone has her or his unique story to tell.
One of the most common explanations for SI I kept stumbling across theorizes that people self-injure as a means of expressing intense emotions. Steven Levenkron, author of the book "Cutting," says some victims feel they have no alternative means of self-expression. "Cutting," he writes, "is the replacement for absent language." Sara, an otherwise anonymous self-injurer and poet, agrees: "the visible injury cannot express / the pain within, the emotional distress / and yet the feeling of the blade is strong / it helps ease tension, why is it wrong? / it is my body, it is my choice, / it's a chilling scream in a silent voice."
At its most basic level, self-injury gives voice to pain and anger. Is it any wonder its primary victims are women, whom our culture instructs to remain wholesome and proper, always turn the other cheek, and find the greatest joy in placing others before themselves? As a result, some feel uncomfortable expressing anger and pain. SI allows such women to vent their anger and frustration in a manner that harms only themselves.
SI doesn't limit itself to women, however. Joe, an ex-self-injurer, said he used to conclude his fights with his parents by locking himself in his bedroom and bashing his head against the wall. Better his head than his parents', he noted, and besides, "it relieved the frustration."
Others say injuring themselves makes them feel more in control in allowing them to exercise a little power over their situations and themselves. Some sociologists take a more cultural approach, theorizing that in their effort to assert control over themselves, self-injurers adopt a role commonly associated with power: that of the victimizer. The act, then, becomes less about receiving the injury than about inflicting it. During our discussion, Heather seemed to agree with the theory that she self-injured in an effort to escape her gender role: "I injure because I'm in control. No more being a good girl, no more loving thy neighbor as thyself, no more pretending to care when I don't. It's all about me now. I finally have the right to be selfish."
Still other self-injurers cite SI as a means to temporarily snap them out of their emotional numbness. Many of those who endure or have survived unbearable situations, psychologists say, learn to divorce themselves from their emotions as a means of self-preservation. Some self-injurers, whether locked in abusive relationships or wallowing in the wake of a massive trauma, have clicked off their emotions like flicking a light switch. They injure as nods to themselves that yes, blood still flows through their brains and hearts. "I was married to a monster...Weeks would pass like some dream. Sometimes I would sit on the floor and bang my head against the wall or burn myself with the curling iron to make sure I was still able to feel something," wrote ex-self-injurer Amber.
Q: How do you cope with self-injury? Are you seeking some kind of assistance?
A: The only assistance I want is someone to care about me and not judge me.
Friends and loved ones who suspect someone of SI should approach the person with compassion and lack of judgment. Like everyone else, they seek understanding.
Advice on where to go from there differs according to the source; self-injurers generally told me they don't want loved ones to pressure them into therapy, while many mental health professionals urge injurers to seek immediate medical and psychological attention.
A man from England, whose wife had self-injured for years, told me, "You can never force a Self Harmer into anything -- especially treatment -- frustrating as it is -- you have to wait for them to realize they need help and then nurture them into that idea."
Most important, everyone agreed, is to support self-injurers, who likely already feel isolated and alienated. Help them find their voices by honoring their experiences and cultivating their senses of self. As Sara notes in one of her poignant poems, "tears of blood spill off my arm / and still I do not see the harm / people judge by what they see / so how do you judge what remains of me?"