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Cutting and other forms of self-harm are medical illnesses that occur when patients hurt themselves to help deal with deep-set emotions or distress. The prevalence of intentional self-injury is increasing and understanding the totality of the disease is complex. Proper, swift treatment is the best way to help prevent any dire consequences of cutting.
Why Do People Cut Themselves?
The motives behind cutting are often counterintuitive. For an individual who does the behavior, cutting himself is how he makes himself feel better. Often, cutting is the only way he knows how to deal with negative emotions like depression, rage, guilt, emptiness and self-hatred, according to TeensHealth.
Most people who inflict self-harm do so because they need relief from all the pent-up emotions they are experiencing. Like an addiction, these people are not in full control of their actions, but rather seek the intense relief they experience after cutting themselves.
Cutters perceive that the action provides them with positive benefits. It allows them to express their feeling and feel in control. Cutting may distract them from difficult life events, relieve guilt as it can be used as a form of self-punishment, and for some cutters, make them feel more alive.
It is important to know why people cut themselves because once you know the reasons behind their actions, you can provide other options that provide the same benefits. This allows the cutter to stop cutting and use other, safer methods to deal with their emotions.
Cutting is a seriously dangerous behavior. While each person cuts for different reasons, there are some commonalities seen amongst the group. There are certain risk factors that may put an individual at an increased risk for cutting.
These risk factors help in the diagnosis of a cutting disorder; however, these factors by themselves do not always lead to cutting. A more thorough examination is required to determine if and why a person is cutting.
What are the Risk Factors
Life issues. Many people who cut themselves were abused in some way as a child. Whether the abuse was sexual, physical or emotional, childhood abuse can lead to cutting. Children who were neglected are also more likely to cause self-harm.
Age. Teenagers are most likely to cut themselves. The pattern of self-harm often begins early in the teen years because at this age the child experiences more volatile emotions, peer pressure, loneliness and numerous conflicts with authority figures.
Mental health issues. People who are very self-critical and experience many negative emotions have an increased risk of cutting themselves. In addition, cutters are more impulsive and have poor cognitive skills. Mental disorders – such as borderline personality disorder, depression, anxiety disorder, post-traumatic stress disorder and eating disorders – are associated with a high risk of cutting.
Substance abuse. Cutting often occurs when the individual is under the influence of alcohol or other drugs.
Having friends who cut. Having a friend who self-injures increases the risk of cutting.
Clothing and a calm demeanor can easily disguise cutting and other forms of self-injury. Your loved one may be experiencing inner turmoil but none of the pain is evident on her face. There are, however, some warning signs that may help you identify the disease. If you recognize these signs in your loved one, it’s important to seek help. Without treatment, cutting can lead to other more dangerous activities.
Multiple unexplained cuts or abrasions. These wounds are usually found on the wrists, arms, chest or thighs – places where your loved one can easily reach.
Bloodstains on clothing, bedding or towels. You may also find a lot of blood-soaked tissues. Often, the cutter will try to hide these soiled fabrics. If discovered, they will deny that they own the clothing or that it was an old injury.
Covering up. A person who cuts often wears shirts with long sleeves or long pants even if the weather is hot.
Owning cutting instruments. Cutters will often own razors, knives, glass shards or sharp bottle caps. You may be able to see bloodstains on these instruments.
Frequent accidents. People who cut themselves often say they were in an accident in order to explain their self-inflicted injuries. They may also say they are very clumsy or that they were working with tools.
Isolation and irritability. Individuals who cut themselves often isolate themselves and are irritable in public. They are prickly because they are in extreme emotional distress and unable to cut themselves while in public.
Gauging the Severity of Cutting
Once the diagnosis has been established, physicians attempt to gauge the severity of the cutting disorder. They will set up a series of interviews that identify the extent of the illness and the effectiveness of treatment.
They may ask questions about when the cutting began, how often it occurs, what triggers the cutting episodes, any underlying issues, and whether the patient has thoughts about suicide. Doctors also ask about previous history of mental illness, any forms of treatment the patient received, the patient’s future plans, and about social relationships.
All of these questions help the doctor determine the extent of the illness and what form of treatment is best. In mild cases, the patient will be advised to enroll in a support group that can help them deal with their emotional stresses.
More severe cases require intense behavioral therapy and psychological evaluation. The treatment regimen in these cases may require the use of medications. The goal for this type of treatment is to treat all underlying psychological disorders and to provide the patient with alternative methods of dealing with powerful negative emotions.
In the long run, cutting does not help alleviate emotional turmoil and often leads to a variety of complications. Some complications are relatively minor and can be reversed. Unfortunately, there are other complications that are more permanent or untreatable.
According to the Mayo Clinic, cutting actually aggravates the person’s feelings of shame or low self-esteem. Cutting only temporarily resolves the negative emotions and does nothing to resolve any longstanding emotional issues. This causes the emotions to build over time and they can then overwhelm the patient.
Cutting increases the risk of developing infection, either from the self-inflicted wounds or from sharing cutting tools. Most cutters do not practice proper hygiene and can contract infectious diseases from contaminated cutting implements. There are some reports of cutters dying after contracting an infection due to their cutting habits.
If a major artery or vein is cut, the individual is at risk of bleeding to death. At best the frequent blood letting will lead to anemia, which can damage other organs within the body.
The risk of suicide (whether accidental or deliberate) is increased in people who cause self-harm. In cases of accidental suicide, the patient unintentionally cuts a major blood vessel. To make matters worse, these patients often cut themselves while under the influence of alcohol or other drugs, and these substances increase the chances of suicide.
Permanent scars or horrible disfigurement are also possible complications of cutting. In rare cases, the cutter will destroy a vital tendon or nerve and thus lose the ability to control their hands or legs. In some cases, function can be restored, but in other cases, the paralysis is permanent.
In long-term cases of cutting, the behavior becomes a compulsion. Cutters will seek out times and areas where they can cut themselves. Even if they don’t want to, they have become addicted to the cutting behavior.
The Need for an Intervention
Once you are able to determine that your loved one is cutting, you will obviously want to help him or her. A healthcare professional is always ready to help treat cutting disorders, but it may be difficult to convince your loved one to seek treatment. People who mutilate themselves are very secretive and do not want to share their actions with anyone. If you confront your loved one without preparation, they will usually react with anger and denial.
Staging an intervention is one of the more effective ways to approach someone suffering from a self-harming disorder. The intervention setting allows for a secure, somewhat private place for the cutter and his or her loved ones to hold a compassionate discussion. A proper dialogue can begin between the team members and their loved one. In an intervention, personal feeling and emotions can be expressed without worrying about hurting or damaging a relationship. Everyone in the intervention will know that the main goal is to help the cutter and make sure that they are well cared for.
Using a professional interventionist is also a good idea. Without proper planning, you may drive the cutter deeper into his or her feelings of depression, anger and guilt. A trained interventionist has studied the best ways to approach different patients and make sure they are comfortable within the intervention model.