Cutting

  I think it’s important to take the time to talk about self-harm and specifically the art of cutting.

  If you’ve never witnessed, have knowledge or experienced the practice it’s easy to feel overwhelmed by the shock of it all. In fact those who are completely unaware of mistake it for a past suicide attempt. And while there is a definite link between suicidality and the act of cutting they are different.

  While cutting can be used by people regardless of gender, race, age and social class it is overwhelming found among female. It is typically seen as begining around 12 -15 years of age and peaks in young adulthood.

The pathology of cutting also see it cuoccuring with other mental health disorders such as borderline personality disorder (BPD),depression,anxiety disorders,post traumatic stress disorder (PTSD)and eating disorders.

  Common treatments include dialectical behavior therapy (DBT), which can help reduce frequency and severity. Cognitive Behavioral therapy (CBT) can help the client identify and challenge the negative thought patterns associated with the act. psychodynamic therapy will explore underlying emotional conflicts and relationships. Mindfulness-based interventions will help enhance emotional regulation and self-awareness. Medications can address more issues like depression and anxiety that are an underlying cause of the behavior.Family therapy can not only improve relationships and communication within the family,but it involves the family to help support the client. Group therapy will provide social support ,skills training and psychoeducation.

  But, the biggest part that needs to be addressed and is rarely talked about is that cutting serves a purpose to those who do it. The act functions primarily as a coping skill and a way for individuals to help emotionally regulate themselves. It can also be seen as a form of self punishment and help with sensory-seeking impulses. Common triggers include stress, conflicts in relationships,being emotionally overwhelmed and processing trauma.

  So far in the field I’ve noticed a direct link between cutting and sexual assault. So many of my young pre-teen and teen clients that engage in cutting share the trauma of some degree of sexual assault. The result for me has been the importance of creating the bond, earning the trust and establishing the rapport.

  Critical to that is more than just a lack of judgement or generating empathy, its understanding that self-harm is a coping skill. Despite how scary and fucking overwhelming it can seem it is something that kept them safe and helped them survive. Which it makes it crucial to reflect that too them. To make them feel seen, validated and understood.

  Because once you can understand what they get from it,  feeling soothed or in control, than you can understand what they need to replacement the behavior and how to accomplish that transition.

…..until next week