Better And Better

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Saturday, August 07, 2010

A strange phenomenon

Look, I understand about depression. I go there, sometimes. I've been there for longer periods than I'd care to admit. Sometimes it's a state of humanity.

What I don't fully understand is cutting.

I run across cutters a fair bit in my job. I don't want to categorize or anything (middleclasswhitekids), but I do see some consistencies.

Cutters usually don't go very deep. Most break the skin to bleed, but don't really do any nerve and/or ligament damage. Often it's not even triple-thickness cuts. I've seen quite a few where there was a long series of parallel cuts down the arm or leg, which cuts barely bled. Occasionally you'll see deeper, but usually not.

Question: Does this really count as harming yourself? As a desire to do further, more significant harm to yourself?*

People give themselves homemade tats, and most people don't blink an eye. I know of a frat that engages in branding, and people don't much notice. Piercings, gaugings, sub-dermal inserts-- all of these are a form of self-mutilation. But say that a person is a cutter, and people freak, and sometimes even declare that the person is an active danger to himself, who must be taken into immediate medical and psychiatric care, whether or not the patient wants it.

As a libertarian, I say, let 'em go, unless someone else's life is threatened.

As a cop, I have a duty to protect them, if they're an active danger, even if only to themselves. So I try to evaluate if this person seems to be such a danger. Unfortunately, my evaluation is only given a grain of salt, so I have to call in the Ambulance Drivers, who sometimes take a different vies of things than I do.

There are more sanitary ways of self-destruction, people.

________________________
*2nd half of the question was edited later after original post.

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20 Comments:

At Saturday, August 07, 2010 6:55:00 AM, Anonymous Anonymous said...

When I did it, I thought I was serious about suicide and I sure was a pretty messed-up kid, but I never made a serious attempt. But that's just anecdote.

And that was 25+ years ago. I'd never heard of people cutting themselves. I came up with it on my own. It wasn't a "thing" that kids did. When they're reading about it on the web, that changes the threshold.

I'm glad I got to be young when I did, however dismal it seemed at the time.

Aren't there any studies on this with hard numbers? It shouldn't be too hard to correlate mild self-harm with suicide, or suicide attempts.

 
At Saturday, August 07, 2010 9:15:00 AM, Blogger Matt G said...

Thanks for the post.
I thought about looking that very issue up, but there are huge shadow variables:
What's the non-report rate?
What's the definition of "suicide attempt?"

Obviously suicides are fairly well reported, but not always. Though I should think that an ME that found a questionable death would take cutter marks into consideration.

The variables are enough to question the validity of any such study.

 
At Saturday, August 07, 2010 10:09:00 AM, Anonymous UnCruel said...

The problem is not the degree of danger that cutting poses in itself. Cutting is a sign of something bigger, deeper. Depression. The link in the mind between self-inflicted pain and the easing of negative emotions. Possibly suicidal tendencies.

The freaking out comes because most people cannot identify with it. Things that don't make sense are scary. I'm not even sure the psychology community can say that they understand it at this point, so no simple explanation has been offered to the masses.

If your kid was doing it, I think you would be more than a little emotionally concerned, even if you couldn't articulate a rational explanation for your concern.

 
At Saturday, August 07, 2010 11:10:00 AM, Blogger Sabra said...

Cutting isn't the same as a suicide attempt. It's an attempt to physically manifest/relieve psychological pain. Not to say some cutters don't advance to suicide attempts, mind, just that shallow cuts are sort of the point--they can hurt a lot more, and hurting is what's supposed to happen. I knew a couple of cutters in high school, and neither of them ever attempted suicide. (They did act out/self-medicate in other ways, though: one was an alcoholic & the other a drug abuser.)

I think the "ZOMG she cut herself she's trying to kill herself" thing is probably from parents more than anything. There's less of a stigma attached to suicide attempts than to cutting, from what I've seen--it wouldn't surprise me that that's the conclusion jumped to a lot.

 
At Saturday, August 07, 2010 12:15:00 PM, Blogger Matt G said...

"If your kid was doing it, I think you would be more than a little emotionally concerned, even if you couldn't articulate a rational explanation for your concern."

I don't disagree, Uncruel. I would be concerned if my kid was doing any self-destructive activity, like heavy drug use, promiscuous sex, drinking and driving, or even just destroying her career and/or relationships.

I agree that cutting is more of a symptom of dissatisfaction with one's life, and acting out on the emotional pain that one feels. I simply wonder about the automatic reaction to it.

I worked for a bit in a jail, and we had more than a few cutters there. The jail foolishly gave them razors to keep with them (I wanted to just check them out and back in at specified times), and they would break the blades out of these very, very cheap safety razors. They would then open up their arms and such, which we then had to move them out of general population for, and for which we would then put 15, 10, or even 5 minute suicide watches on them.

The hit to our manpower was huge, even though the vast, VAST majority of the cuttings were quite minor. The protocol did not allow us to distinguish between simple self-mutilation and suicide attempts. The same guy could have make pricks in his arm and put ink into them, making a jailhouse tat, and he only would have gotten a minor disciplinary note. In general, his danger was higher from the tat (think MRSA) than from the relatively clean razor cuts.

I realize that jail does not translate into real life, for the most part. But it's a distillation of the stressed human condition. If the prisoner felt that cutting could provide relief for the stress that he felt in a general population tank, so that he could be moved to an administrative segregation tank, and could get more people checking on him, there may be a correlation to the person in the Free World, who feels similarly trapped by their condition.

 
At Saturday, August 07, 2010 12:15:00 PM, Blogger Matt G said...

"If your kid was doing it, I think you would be more than a little emotionally concerned, even if you couldn't articulate a rational explanation for your concern."

I don't disagree, Uncruel. I would be concerned if my kid was doing any self-destructive activity, like heavy drug use, promiscuous sex, drinking and driving, or even just destroying her career and/or relationships.

I agree that cutting is more of a symptom of dissatisfaction with one's life, and acting out on the emotional pain that one feels. I simply wonder about the automatic reaction to it.

I worked for a bit in a jail, and we had more than a few cutters there. The jail foolishly gave them razors to keep with them (I wanted to just check them out and back in at specified times), and they would break the blades out of these very, very cheap safety razors. They would then open up their arms and such, which we then had to move them out of general population for, and for which we would then put 15, 10, or even 5 minute suicide watches on them.

The hit to our manpower was huge, even though the vast, VAST majority of the cuttings were quite minor. The protocol did not allow us to distinguish between simple self-mutilation and suicide attempts. The same guy could have make pricks in his arm and put ink into them, making a jailhouse tat, and he only would have gotten a minor disciplinary note. In general, his danger was higher from the tat (think MRSA) than from the relatively clean razor cuts.

I realize that jail does not translate into real life, for the most part. But it's a distillation of the stressed human condition. If the prisoner felt that cutting could provide relief for the stress that he felt in a general population tank, so that he could be moved to an administrative segregation tank, and could get more people checking on him, there may be a correlation to the person in the Free World, who feels similarly trapped by their condition.

 
At Saturday, August 07, 2010 12:15:00 PM, Blogger Matt G said...

"If your kid was doing it, I think you would be more than a little emotionally concerned, even if you couldn't articulate a rational explanation for your concern."

I don't disagree, Uncruel. I would be concerned if my kid was doing any self-destructive activity, like heavy drug use, promiscuous sex, drinking and driving, or even just destroying her career and/or relationships.

I agree that cutting is more of a symptom of dissatisfaction with one's life, and acting out on the emotional pain that one feels. I simply wonder about the automatic reaction to it.

I worked for a bit in a jail, and we had more than a few cutters there. The jail foolishly gave them razors to keep with them (I wanted to just check them out and back in at specified times), and they would break the blades out of these very, very cheap safety razors. They would then open up their arms and such, which we then had to move them out of general population for, and for which we would then put 15, 10, or even 5 minute suicide watches on them.

The hit to our manpower was huge, even though the vast, VAST majority of the cuttings were quite minor. The protocol did not allow us to distinguish between simple self-mutilation and suicide attempts. The same guy could have make pricks in his arm and put ink into them, making a jailhouse tat, and he only would have gotten a minor disciplinary note. In general, his danger was higher from the tat (think MRSA) than from the relatively clean razor cuts.

I realize that jail does not translate into real life, for the most part. But it's a distillation of the stressed human condition. If the prisoner felt that cutting could provide relief for the stress that he felt in a general population tank, so that he could be moved to an administrative segregation tank, and could get more people checking on him, there may be a correlation to the person in the Free World, who feels similarly trapped by their condition.

 
At Saturday, August 07, 2010 12:28:00 PM, Blogger Groundhog said...

I'm pretty sure that the reason other people don't blink an eye to the other things you mentioned is that the person is likely not doing those things to be self destructive. I do think there is a gray area there though. But a tatoo, branding, even those nuts that hang themselves by hooks usually claim artistic or spiritual benefit to what they are doing rather than "I hate life and want to show it somehow".

I mean heck, if cutters go main stream at some point and it gets called art, it won't be the attention getting device they want it to be anymore.

 
At Saturday, August 07, 2010 6:18:00 PM, Blogger Old NFO said...

You see them in the military too... Usually a 'cry' for help they cannot articulate per se...

Having said that, it IS a traumatic situation when you walk in on a cutter, because they do tend to bleed, not as badly as head injuries, but they DO bleed.

The two first hand incidents I was involved in were both badly depressed; one by a dear john, one who was being boarded (and was being kicked out).

 
At Saturday, August 07, 2010 9:03:00 PM, Blogger Nancy R. said...

I had a roommate when I was in my 30's that was a cutter when she was younger. She'd cut her palm, of all things. I'm guessing it was some sort of control issue because when I asked her why she'd do such a thing, she said it was to prove to herself tha no matter how badly someone else had hurt her, she still had the power to hurt herself more.

Well, that, and she likes drama.

 
At Sunday, August 08, 2010 12:58:00 AM, Blogger On a Wing and a Whim said...

Having lived with cutters, been friends with cutters, and currently being friends with people who grew out of being cutters, I have to say that it's very simple from the "living three feet away from this person" range: it's nothing more than an extremely effective, though dysfunctional, coping mechanism.

They're kids who, for the most part, either have a.) a very high-stress environment, b.) a lack of available effective coping mechanisms, c.) a strong pressure to not engage in healthy coping mechanisms, d.) a lack of self-control or maturity to take the harder road with the less immediate coping mechanism, e.) some or all of the above.

Cutting not only is a physical expression of emotional pain, it's also an endorphin rush and a distraction from the emotion pain, and a ritual that allows them to dissipate stress. It solves nothing, changes nothing about their situation to prevent further stress or pain, and being such a quick n' dirty solution, does not encourage formation of healthier, harder solutions that don't provide as immediate a relief.

On the other hand, if one is motivated to maintain a facade of "being the good kid" or "being perfect" (or "not get effin' committed again"), it's easily hidden (note most cutters mark places hidden under clothes, until they get really off the deep end) to make it appear that things are going fine, and not make waves about the situation they're in.

Doesn't mean I like it, or approve of it (I don't), but it does mean I understand it.

 
At Sunday, August 08, 2010 10:07:00 AM, Anonymous Anonymous said...

Groundhog, I'd disagree that cutting is (always) an attention seeking behaviour. In my experience cutting tends to be secretive and shameful, you don't roll your sleeves up and show people the scars. This can set it apart from other self-destructive behaviours (e.g. deliberately getting drunk routinely). Even extreme cutting is far easier to hide than extreme drug/alchohol abuse.
I think, because it tends to be secretive, it spooks people more. Also, most people seem to be a bit squeamish about blood. It isn't necessarily related to suicide; rather, as others have commented, it functions as a release valve of sorts.

 
At Monday, August 09, 2010 10:28:00 AM, Blogger Jay G said...

I never understood cutting mainly because I was always *unintentionally* slicing myself open on one blade or another...

 
At Monday, August 09, 2010 10:28:00 PM, Anonymous LabRat said...

I'm with Wing and the second anon, having been in a position of closeness with cutters or ex-cutters as well. It's usually not an attention-getting thing, though of course attention-getters will use what gets attention, and it's an immediate coping mechanism that works even if it's highly unhealthy, not any sort of actual attempt to destroy themselves. Speaking as a person that actually sees the pain of a tattoo session as a side bonus instead of something to dread when highly stressed (not that that's ever anything but coincidence as I schedule them at least a month in advance), I understand how the endorphin release and immediate focused coping of physical pain can be a relief from anxiety or anger.

I'd classify it entirely differently than suicidal ideation.

 
At Tuesday, August 10, 2010 12:22:00 AM, Blogger Matt G said...

I completely agree, 'Rat.

I have absolutely seen a cutter that was using it for attention, but I don't think that's the norm. Lots and LOTS of coping mechanisms are self-destructive. Light-running self-mutililation can actually fall rather low on the priority list of Most Self-Destructive Ways To Cope.

 
At Tuesday, August 10, 2010 8:07:00 AM, Blogger Tam said...

And this is one reason why I'm not in your line of work, Matt, or AD's. The temptation to say "Remember, little emo: Across is for show, down is for go!" would be entirely too great.

 
At Tuesday, August 10, 2010 8:46:00 AM, Anonymous Anonymous said...

There's another reason for cutting: when you can't feel anything, even feeling pain is good.

 
At Tuesday, August 17, 2010 9:58:00 PM, Blogger J.R.Shirley said...

I put it in the same category as dermatillomania.

 
At Wednesday, August 25, 2010 11:27:00 AM, Anonymous Anonymous said...

I used to self-harm. Not cutting - although had I been able to think of a way to pull it off without my parents noticing, I suspect I would have - but hacking the nails on my fingers and toes down to the quick, until they bled, was just as effective.

At the time, had someone cottoned on to what was going on and asked me about it, I wouldn't have said it was a cry for help (although I had seriously considered suicide around the same time, but never tried it). But I was depressed; emotionally, I was numb...and I was desperate to feel something, anything, just to try and reassure myself that I could still feel.

After all, if I could feel pain, then I could still feel happy too. Not feeling happy didn't mean I couldn't; it just meant that I didn't have anything to be happy about.

 
At Wednesday, August 25, 2010 1:15:00 PM, Blogger Matt G said...

Thanks for that, Anonymous 11:27. Hell, come to that, thanks for all your input.

I'll say that it's not always a cry for help, directly. Some are very good at hiding cutting. But then I think there's sometimes a thought of "perhaps they'll find this message in a bottle..."

 

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