Is ‘Cutting’ a Suicidal Activity?
Self-Injury Makes Tina Feel Better
Tina was 15 years old when a boyfriend broke up with her. On the way home from school, she saw him kissing another girl. When she arrived home, she immediately went upstairs to her bedroom, locked the door, picked up her razor blade and cut herself on the wrist several times. Although she wore long sleeves to dinner that evening, her alarmed mother spotted the wounds and brought her daughter to the emergency room, saying her daughter had tried to kill herself. Tina, however, emphatically denied it. She did not want to die. “I cut myself because it made me feel better,” she said.
A key point in discerning suicidal behavior from non-suicidal self-injurious behavior; suicide is an attempt to end the person’s conscious state permanently, while self-injuring behavior is the attempt to alter conscious behavior in order to live another day.
Behind the Despair of Self-Harm
When it comes to the most difficult situations we face in life, those that trigger raw emotions such as debilitating depression, deep sadness, contempt, shame, frustration, tension, or anger – among others – it’s often quite a challenge for some people to deal with them in healthy ways. Not everyone is wired the same way, and not everyone deals with their pain in the same way.
Many individuals turn to unhealthy, destructive methods of coping. One of them, Self-Injury, is also known as ‘Self-Mutilation’, ‘Self-Harm’ or ‘Cutting’, depending upon the context. Self-injury most commonly includes cutting or burning oneself – without suicidal intent. Other types of self injury include hitting, pinching, breaking bones, ingesting toxic substances, interfering with healing of wounds, and punching walls or other objects to induce pain.
Why would someone want to hurt themselves in order to deal with pain? Well, there are many reasons why those who use self-inflicted violence choose to perform these acts upon themselves. Self-Injury, such as cutting, is a strategy that some survivors use to manage the intense internal pressure, pain, anxiety, or other feelings related to traumatic experiences. Adolescents who self-harm are more likely to report being bullied by peers and experiencing discomfort regarding their sexual identity.
The person who self-harms often desperately wants to regain control over their body after trauma – to have control over their pain, to be able to really “feel” something. The reasons are plentiful for those who choose to take part in self-injury.
Self-injury can sometimes lead to an emergency such as severe infection, passing out, overdose, severe injuries, or suicide. But suicide, in fact, is often not the intent. When someone self-injures, in most cases they’re not actually trying to kill themselves. Rather, they inflict pain in some way so that they “feel” something.
When Does Self-Harm Begin?
Adolescents who injure themselves are often impulsive; engaging in self harm with less than an hour of planning. They commonly report feeling minimal or no pain. Once started, self-injury seems to acquire addictive characteristics and can be quite difficult for a person to discontinue. While some studies indicate that non-suicidal self-injury is more frequent in girls than boys, other studies indicate that there are no consistent gender differences.
So, chances are that if you or someone you know is self-harming, they’ve been doing it for some time, and will need intervention and quite a bit of help to make sure that they stop performing these incredibly destructive and painful acts upon themselves.
What Are Tina’s Alternatives?
The psychiatrist asked Tina what other actions she could take to feel calmer and distract herself from her emotional pain. “I don’t know,” she said, shaking her head. The psychiatrist asked her what she had done before she first discovered the effects of harming herself. “I don’t know,” she said again. “I never hurt then like I do now.”
How to Help a Person Who Self-Injures
When someone discloses self-injury, the first thing we may want to reach for as advocates is a clear commitment from a survivor to stop engaging in self-injury. We know from experience, however, that this is not always helpful or effective. It is important to remember that the decision to stop or reduce self-injury is up to the patient.
So, how can you help someone (or yourself) if self-harm is an issue? If you are ever concerned about the well-being of a person who you believe may be engaging in self-injury, you can ask if she is having suicidal thoughts. Asking about suicidal thoughts does not increase the risk of suicide. In fact, people report feeling relieved when someone asks. If someone tells you that they are having suicidal thoughts, work with them to find appropriate mental health resources.
What About Transcranial Magnetic Stimulation (TMS)?
TMS is currently FDA-cleared for patients with treatment-resistant Major Depressive Disorder (MDD). Transcranial Magnetic Stimulation is a non-invasive, non-drug treatment for major depression that hasn’t adequately responded to antidepressant medication. With TMS, highly focused magnetic pulses stimulate areas of the brain known to be underactive in depression, and restore it to normal function. TMS may also be used in the case of those who are self-injuring or self-harming, if their primary diagnosis is MDD and they have failed multiple previous attempts to treat it with drugs and/or other modalities.
Results of TMS treatment are evident much faster than trying a series of different antidepressant medications, and waiting to find the right one with the right dosage. TMS treatment takes less than an hour, is performed comfortably in your doctor’s office, five days a week, for four to six weeks. You are awake and alert during and after every appointment, so you don’t have to worry about making sure someone can pick you up and drop you off.
Seek Help Immediately For Self-Harm
If you, or someone you know, self-injures, it’s crucial to get help right away so that these behaviors don’t become addictive. Self-injury is clearly not a healthy way to deal with painful issues or traumas, and those who are taking part in these self-harming actions could cause themselves permanent harm, or even death, whether planned or not.
We recommend that advocates seek the help of mental health professionals who are experienced in working with people who injure themselves.
Growing Beyond Survival: A Self-Help Toolkit for Managing Traumatic Stress (Elizabeth Vermilyea, Sidran Press).
Treating Self-Injury: A Practical Guide (Second Edition) By Barent W. Walsh
Healing Self-Injury: http://healingselfinjury.org/
Self Injury (S.A.F.E. Alternatives): http://www.selfinjury.com
- How to Understand and Help My Child Who is Self-Injuring and Self Assessment – A FREE parent educational webinar. Click hereto view.
- A.F.E. Lectures & Webinars Listen to Dr. Wendy Lader, co-author ofBodily Harm: The Breakthrough Healing Program for Self-Injurers, lecture on self-injury
- Click hereto take Self Injury Self Assessment
West, W. (2015). Is ‘Cutting’ a Suicidal Activity?. Psych Central. Retrieved on January 23, 2018, from https://blogs.psychcentral.com/tms/2016/01/is-cutting-a-suicidal-activity/