How to Help a Cutter -- Why Someone Might Self-Mutilate and How to Help Them
This is in reply to the question asked in the answers section regarding a friend who routinely self-mutilates. Having been a self-mutilator, or “cutter” in the past, I believe I may be able to offer some insight into this practice. Cutting is, especially to the loved ones of those who do it, one of the most confusing and appalling side effects of internal unrest. By understanding a little bit about what drives it, you may be able to not only better understand what your friend or family member is going through that leads them to cutting, but may even have a chance to help them find a better solution to whatever is going on inside of them.
Cutting is definitely a coping mechanism, and it has a very powerful effect. For me, it was the fact that I could handle physical pain much easier than emotional pain. When the body is injured, it releases a lot of chemicals (including dopamine) to numb the person -- first the sharp pain takes your mind away from the inner turmoil, then the release of "feel good" chemicals relaxes and quiets your entire body and mind, driving thoughts and feelings far away. At one point in my life I was cutting every day.
For me, the solution was to find something that had just as powerful of an effect in getting rid of the internal agony. I went through a lot of therapists and inpatient care, learned a lot of coping skills and, while they helped, none of them lasted on their own. I think the thing that works is different for everyone -- for me it was vigorous exercise. If I get to the point that I feel like I just can't handle my emotions, I go for a run until I'm tired and out of breath, then switch to yoga or pilates, which requires complete concentration on controlling the body. Writing sometimes helps too, but usually by the time I get to the point I NEED that kind of fix my hands are shaking too hard to hold a pen.
Sadly, many cutters find different coping mechanisms that are not as healthy...of the people I met while in inpatient care that also cut, all but one aside from myself were on drugs, alcohol, or both. A couple of them are alcoholics to this day. It is not uncommon for cutting to give way to far more destructive and lifelong methods of coping without professional help. It may even initially require medication to level out someone’s emotions enough to allow them to really focus on their therapy, but medication is rarely a permanent solution and should almost never be a first option.
Don't expect miracle answers, it can be a lengthy process. For me, it took several years of therapy and practicing my coping strategies before I was able to stop. However, it is very effective if you can find that solution – to date, I haven’t cut in nearly eight years. If you are in a position of trust with a cutter, you might be in a position to be able to suggest exploring alternate coping mechanisms and he or she may listen to you. The hardest part is that you may have to accept that there’s nothing you can do to help except be there to support them as they seek out qualified help, or even as they resist offers of help. Don’t give up, and make sure they always know how much you care and that you do care about, and are concerned about, the underlying causes of their cutting.
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