Abuse and Cutting, Part 1

Healed scars from prior self-harm, Author James Heilman, MD (CC BY-SA 4.0 International)

Mental health issues including drug abuse and suicide are known to be long-term consequences of child abuse [1A][3].  Non-Suicidal Self-Injury (NSSI), more commonly known as cutting, is another [1B][4A].

Definition

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.”

-Alex [6]

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.

Prevalence

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.

Causes

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][10].

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][9].

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][5][8D][11]:

Cuts/Burns, Etc.

  • 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.

Disguise

  • 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.

Blood Evidence

  • Frequent use of bandages;
  • Blood stains on clothing;
  • Presence of bloody tissues in a child, tween, or teen’s room.

Problems

  • 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.

[3]  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/.

[5]  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/.

[6]  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 .

[9]  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.

[10]  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.

[11]  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

25 Comments

Filed under bullying, Child Abuse, Child Molestation, Emotional Abuse, Neglect, Physical Abuse, Poverty, Sexual Abuse

25 responses to “Abuse and Cutting, Part 1

  1. It’s ao sad to know that people go through this.
    Thank you for sharing this. I look forward to reading the cure for NSSI

  2. This is a hard topic. I did some of that when I was a teenager.

  3. Wishing you a Happy Thanksgiving, back. We are very thankful for the awareness on these issues that you so clearly bring forward.

  4. Great post Anna. Communication has become a huge problems where people often children are not allowed or do not know how to talk or tell others what is upsetting them in their lives so they resort to harming often hidden but really they are wanting to draw attention to themselves. We have become a harmful society even though so many believe we live in good and caring times, if this is so then why so much abuse.

  5. Another very interesting and valuable post Anna. I saw many cases of this back in my police days, out in the streets and even inside. It is a big problem and one that must be tackled carefully and professionally. Take good care and all the best,
    F.

    • Before researching this topic, I had no idea the problem was so widespread. It reflects the pain and isolation in our society. But God remains a steadfast source of comfort and strength. I pray we and our children will once again turn to Him. You take good care, too, Francisco. I wish you all things good, my friend. A.

  6. I can understand that need to release inner pain which can feel unbearable at times. However, it is very sad that so many people feel this is the only, or the most effective, way of dealing with inner torment. It leaves me feeling very sad for those who feel they can’t talk about the struggling with.
    We are failing people (and especially young people) if they don’t feel they can safely open up to their family, friends, teachers, and others in positions of leadership.

  7. Thank you for highlighting the important issues here, Anna.

  8. Thank you for sharing this information with us, Anna. The world needs to know how broken some of our adolescents are. Talking about the problem is always the first step to resolving a pressing issue.🙌

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