Back to Table of Contents

On the Floor: The World of Self-Injury

The writer of the following story wishes to remain anonymous due to the personal nature of the material.

I am sitting on the bathroom floor and I can feel the cold tile under my bare legs. But not for long, because I am crying too hard and then I can only feel the knife in my hands. I don't remember how it got there, only how good it felt to tear it into the thin flesh of my wrists. And now it is too hard to stop. The scars aren't enough to make me stop; nor is the shame that comes with the imploring, subtly critical eyes of those who steal a glance. I am a cutter-a self-injurer-and I am not alone.

It is estimated that self-injurers represent one percent of the population. These acts range from biting, scratching, and cutting, to picking scabs or interfering with wound healing, infecting oneself, burning, punching oneself or objects, bruising or breaking one's bones, hair pulling, or inserting objects into body openings.

While it is a serious issue for many men and women, it is essentially a silent, secret struggle. The stigma, shame and misunderstanding surrounding self-harm lead some to associate it with mental illnesses. But according to statistics from Safe Abuse Finally Ends (S.A.F.E.) Alternatives, an inpatient/ outpatient program founded by Katern Conterio in 1985 for people engaging in self-harming behaviors, those seeking help are "usually from a middle to upper-class background, of average to high intelligence, and have low self-esteem."
"There are a variety of reasons for self-injury," explained Suki Montgomery, Ph.D, who counsels on the Ithaca College campus, "punishment, release of tension, anxiety, sadness. . ."

But what about what society would deem healthy, stable people? I came from a strong and communicative family background, as do many self-injurers. I am left to wonder, as many might, what went so horribly wrong that I have felt that I deserve this? Where did I learn this behavior? Montgomery paints with broad strokes, careful not to oversimplify. However, she does suggest that those who come from stable backgrounds may feel a greater expectation of perfection, to do everything well, to be in control.

But are we sick?

"Some experts would say that all self-injurers have some form of mental illness," Montgomery said. "But this could be anything from mild depression up to borderline personality disorder. I think to make a statement like this is too broad, too simplistic."

The fact remains that self-mutilation runs the gamut of personalities, though there are some patterns. Nearly 50 percent of self-mutilators report physical and or sexual abuse during childhood. And as high as 90 percent report that they were discouraged from expressing emotions, particularly anger and sadness.

Christine Wilkin, an 18-year-old freshman at Manhattanville College in Purchase, NY, has been cutting for two years. At its most intense, she was cutting herself about once a week. In her case, the self-abuse was a seemingly logical expression for someone who never learned healthy communication.

"Growing up," Wilkins said, "my parents were verbally and physically abusive toward eachother, and being the oldest, I remember more."

Her mother, an alcoholic, and her father, involved with drugs, never paid attention to her and her siblings. She learned quickly to repress feelings that would find no audience in such an abusive household. So she turned to her body as a coping mechanism.

"The fist time I did it was junior year in high school," Wilkins said. "I sat in the bathroom at school and my nails were really long at the time. I took my thumb nail and started sliding it back and forth."

And that started it all.

She eventually moved on to knives to ease her pain and depression.

"While I am doing it there is this initial two-second burst of happiness because you feel like you have complete control," she said. "I can feel the pain. But in my case, it only lasts for a short period, and then you realize it isn't worth it. But sometimes, you just can't help it.
Julie*, a senior at St. Joseph's University in Philadelphia, Pennsylvania, has a similar need for control and also experiences the guilt and shame that often plagues self-injurers after the completion of a session.

"Before I cut, I feel so helpless," Julie said. ". . .Completely out of control and that there is nothing I can do to change the situation. It is what it is, and I feel angry about that."

Julie also expresses a feeling that psychologists refer to as disassociation. While pain is experienced, it may feel oddly calming or soothing. It can be related on some levels to having an out of body experience where the self-injurer may feel the pain, but it only serves to lead them to their goal: to feel alive.

"There is a love-hate relationship with the activity," Montgomery said. "They are drawn to the environment that they create for themselves. It is an escape because while they are injuring themselves they can assert a control that removes them from the reality of what they don't want to deal with at the moment."

Julie described the first time she cut herself: "It was the summer after I returned from my freshman year of college. I had been fighting with my parents. It was the whole independence issue; readjusting to rules when I had just lived on my own for a year. I finally broke. On the floor of my bedroom I was crying-feeling these fits of rage and uncontrollably shaking. I couldn't take it anymore. I saw a pair of scissors on my desk. I had been sewing earlier. I don't know how the scissors got in my hands, but I remember clenching them-feeling them in my hands. And then I scraped it across the flesh of my left wrist. I saw a few marks and I made them deeper. I felt the pain, but it felt good. I looked at the scissors and dropped them; curled up and cried. I couldn't believe what I had just done. What the hell did I just do?"

Jeff Petrosky, Julie's boyfriend and a senior at St. Joseph's University, remembers when she told him.

"I was surprised, and I started asking her a lot of questions," he explained. "I tried to figure out what was going on with her, but it was so foreign to me. I looked online to try to find information, but it was frustrating because I couldn't find anything concrete. She promised me she wouldn't do it again," he said.

"I promised him I wouldn't do it again," Julie said.

"But she did," said Petrosky.

"But I did."

"There is a belief in self-injurers that they cannot cope without it," Montgomery said. Self-injury is not addictive in the framework of the disease model (under which alcoholism falls). However, often during the act, opiates in the brain are released that supply an adrenaline rush that can make it psychologically addictive.

"I am an absolutist," Julie affirmed. "I feel like the first time you do something, you are more willing to do it again. Your resistance is low and it takes a strong person to go back to that place and fix it. I hate the idea that I might do it again, because it just makes me feel fucked-up and crazy."

If shame is not enough to make someone stop, what is?

For Wilkin, medication and therapy were a step in the right direction.

"I told my dad, because, subconsciously, I wanted to get help," she said. "He put me into therapy and it helped me realize the reason behind the cutting was so I could take care of myself because I was always taking care of others."

She was also put on Paxil, a common drug used to treat depression, for eight months. She is now off the drug and has not cut herself for a few months. By her own admission she is doing much better, but she is quick to dispel the idea of recovery.

"I don't know if you can ever fully recover from something like this," Wilkin said. "But I have worked out the things I didn't want to realize or deal with."

Montgomery stressed that for self-injurers to stop their destructive behaviors they must be fully ready.

"The barrier to recovery is often the person's own resistance to giving it up. This is something that works for them. There are moments when they see no other option and this has worked in the past, so they revert to injury. It is really hard to get people to believe that they can cope without this."

Julie hasn't cut herself since September, although she has been tempted. But she, like Wilkin, is reluctant to commit to any sort of recovery process.

"I don't want anyone to be too concerned for me because I am fine," she said.

Does she really believe she is fine?

"Yes. I really believe I am fine."

But she does not associate being fine with ending her sessions.

"I don't want to stop yet. I don't want to think of myself as a person with problems. And what if I get upset? What if I can't stop? I need something to help me get through it. Well," she wavered, "it doesn't help me get through it, it helps me to deal with it."

Julie is confident that one day she will come to a healthy point in her life when she will not want to self-injure. Until then, she has a supportive boyfriend.

"I can't push her into anything," Petrosky said. "It concerns me, but all I can do is try to make myself available to her if she needs to talk."

Indeed, most treatment does not support an ultimatum approach.

"Letting a person know you care and that you will listen is important. You can't make them change, but you can give them resources and let them know that when they are ready, you are willing to help them get help," Montgomery said.

"It may be sound silly or naive, but I have a lot of hope that Julie will stop," Petrosky said. "No, it is more about trust. Whenever it has happened, I believe it won't happen again. I believe that. From what I know, I think it has stopped," he said.

About two weeks ago, I felt weak and out of control. The reason now seems a bit ridiculous, and I feel foolish for being so dramatic. But I craved it, and I did it-and I felt a little better. I will probably go another few weeks, perhaps months, without cutting myself again. But I know I will be tempted, because every time I am upset, I am always drawn back to this, my simple, if not temporary, salvation.

I don't know that I am ready to seek help yet, but it strengthens my resolve to know there are other people out there like me, and to realize I don't have to put things back together again all the time-neither do you.

If you or someone you know is ready for help now, call S.A.F.E. Alternatives' hotline at 1800-Don't CUT, or seek resources on the web at www.self-injury.com.