Mental health issues including drug abuse and suicide are known to be long-term consequences of child abuse [1A]. Non-Suicidal Self-Injury (NSSI), more commonly known as cutting, is another [1B][4A].
NSSI is defined as the deliberate damaging of the surface of the skin – whether by scratching, cutting, piercing, or burning – but without suicidal intent [1C][2A].
“After I’d seen the blood, it was like a release of anger or some sort of release. I can’t really explain the feeling, but it was just a release.”
According to the Mayo Clinic, this type of self-harm is a maladaptive means of coping with profound emotional pain, anger, or frustration [2B].
Cutting (in whatever form) acts to distract from internal turmoil; restore a sense of control (at least over the body, if not the underlying situation); inflict punishment; and communicate distress to the world [2C].
Though cutting may bring temporary relief, calm is generally followed by guilt and shame [2D][7A]. Soon enough, the troubling emotions return. More-serious (even fatal) harm can follow.
Studies have shown cutting to be extremely common among adolescents. Over 20% of adolescents are now thought to self-harm at some point [7B]. Approximately 18% continue into adulthood [1D]. This does not make the practice benign.
Emotional abuse and neglect seem to play a particularly powerful role in cutting [1E]. Physical and sexual abuse have a more indirect effect, by way of depression and anxiety [1F].
Cutting can happen at any age, but often begins between the ages of 12 and 15 [7C][8A].
Teens may cut themselves to be part of a peer group, which is why their choice of friends is important [7D]. Alcohol and drugs, an eating disorder, poverty, unemployment, and psychiatric illnesses like borderline personality or schizophrenia can, also, be contributing factors [2E][4B].
Signs and Symptoms
NSSI can occur anywhere on the body, but is most common on the hands, wrists, stomach, and thighs [8B]. Cutters are, however, secretive [8C].
The signs and symptoms of cutting include [2F][8D]:
- Fresh cuts, burns, bruises, bite marks, and/or other wounds;
- Scars (frequently in patterns, with linear cuts particularly common);
- Excessive rubbing to create a burn;
- Frequent reports of accidental injury, with implausible explanations.
- Frequent use of wristbands, large bracelets, or oversize watches;
- A preference for long sleeved shirts and/or slacks, despite hot weather;
- Unwillingness to participate in activities such as swimming which reveal the body.
Instruments of Injury
- A habit of keeping razor blades, needles, or other sharp objects readily at hand.
- Frequent use of bandages;
- Blood stains on clothing;
- Presence of bloody tissues in a child, tween, or teen’s room.
- Relationships difficulties, including school bullying victimization;
- Instability, impulsivity, and unpredictability, e.g. risky behavior or sudden outbursts of anger;
- Statements of helplessness, hopelessness, and/or low self-esteem.
Treatment and prevention will be discussed in the conclusion of this series.
[1A through 1F] BMC Psychiatry, “The impact of child maltreatment on non-suicidal self-injury: data from a representative sample of the general population” by Rebecca Brown et al, 6/8/18, https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1754-3.
[2A through 2F] Mayo Clinic, “Self-injury/cutting”, https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950 and https://www.mayoclinic.org/diseases-conditions/self-injury/diagnosis-treatment/drc-20350956.
 Cornell Research Program on Self-Injury and Recovery, Bronfenbrenner Center for Translational Research (BCTR), Cornell University, “The relationship between self-injury and child maltreatment” by Margaret Fleming and Lauren Aronson, http://www.selfinjury.bctr.cornell.edu/perch/resources/the-relationship-between-self-injury-and-child-maltreatmentfinal-1.pdf.
[4A and 4B] National Center for Biotechnical Information, US National Library of Medicine, National Institutes of Health, “Repeat deliberate self-harm: a link with childhood sexual abuse?” by HM Yeo and WW Yeo, September 1993, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285981/.
 Hindawi, “The Association between Deliberate Self-Harm and School Bullying Victimization and the Mediating Effect of Depressive Symptoms and Self-Stigma: A Systematic Review” by Maria Karanikola et al, 2018, https://www.hindawi.com/journals/bmri/2018/4745791/.
 The Conversation, “Cutting to numb the pain of sex abuse: interviews with young women in drug treatment” by Kathryn Daly, https://theconversation.com/cutting-to-numb-the-pain-of-sex-abuse-interviews-with-young-women-in-drug-treatment-62096.
[7A through 7D] Lifespan, Bradley Hospital, “Self-Cutting and Adolescents”, 2020, https://www.bradleyhospital.org/self-cutting-and-adolescents.
[8A through 8D] U Lifeline, “Cutting”, 2020, http://www.ulifeline.org/topics/135-cutting .
 Psychiatric Times, “Treating Self-Harm in Children and Adolescents” by Donald Greydanus MD, 4/28/11, https://www.psychiatrictimes.com/view/treating-self-harm-children-and-adolescents.
 British Journal of Psychiatry, “Childhood sexual abuse and non-suicidal self-injury: meta-analysis” by David Klonsky and Anne Moyer, 1/2/18, https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/childhood-sexual-abuse-and-nonsuicidal-selfinjury-metaanalysis/32656A88888D805C6BC1F96BBEA453F8.
 NSPCC, “Signs of self-harm in children and teenagers”, https://www.nspcc.org.uk/keeping-children-safe/childrens-mental-health/self-harm/.
This series will conclude next week.
Wishing You All a Happy Thanksgiving!
FOR MORE OF MY ARTICLES ON POVERTY, POLITICS, AND MATTERS OF CONSCIENCE CHECK OUT MY BLOG A LAWYER’S PRAYERS AT: https://alawyersprayers.com