“I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”
“It’s a way to have control over my body because I can’t control anything else in my life.”
“It expresses emotional pain or feelings that I’m unable to put into words.”
“I usually feel like I have a black hole in the pit of my stomach. At least if I feel pain it’s better than nothing.”
These are some of the reasons young people have given for why they deliberately and repeatedly injure their own bodies, a disturbing and hard-to-treat phenomenon that experts say is increasing among adolescents, college students and young adults.
Experts urge parents, teachers, friends and doctors to be more alert to signs of this behavior and not accept without question often spurious explanations for injuries, like “I cut myself on the countertop,” “I fell down the stairs” or “My cat scratched me.”
The sooner the behavior is detected and treated, the experts maintain, the more quickly it is likely to end without leaving lasting physical scars.
There are no exact numbers for this largely hidden problem, but anonymous surveys among US college students suggest that 17 percent of them have self-injured, and experts estimate that self-injury is practiced by 15 percent of the general adolescent population in the US.
Experts say self-injury is often an emotional response, not a suicidal one, though suicide among self-injurers is a concern.
The Canadian Mental Health Association describes it this way: “Usually they are not trying to end all feeling; they are trying to feel better. They feel pain on the outside, not the inside.”
The Role of the Internet
The Community Services Center (www.community.com.tw) in Tianmu, Taipei City, provides confidential assistance and Western-style counseling for foreign nationals in distress and can be reached by calling (02) 2836-8134 or sending an e-mail to email@example.com.
Services are available in several languages, including English, Mandarin, Taiwanese and Tagalog. Taiwanese nationals in need of similar services can contact Lifeline Association, Taipei (台北市生命線協會, www.lifeline.org.tw) by calling (02) 2502-4242 or sending an e-mail to firstname.lastname@example.org.
National Taiwan University Hospital, Taipei Veterans General Hospital in Shipai, and Tri-Services General Hospital in Neihu, Taipei City, provide quality psychiatric care and have doctors who speak fluent English.
Janis Whitlock, a psychologist who has interviewed about 40 people with histories of self-injury and is participating in an eight-college study of it, says the Internet is spreading the word about self-injury, prompting many to try it who might not otherwise have known about it.
“There is a rising trend for teens to discuss cutting on the Internet and form cutting clubs at school,” the Canadian association has stated.
Celebrities, too, have contributed to its higher profile. Among those who have confessed to being self-injurers are the late Princess Diana, Johnny Depp, Angelina Jolie, Nicole Richie, Richie Edwards, Courtney Love and the lead singer on the Garbage band album Bleed Like Me.
Self-injury can become addictive. Experts theorize that it may be reinforced by the release in the brain of opioid-like endorphins that result in a natural high and emotional relief.
Whitlock, director of the Cornell Research Program on Self-Injurious Behavior in Adolescents and Young Adults, said in an interview that self-injury mainly seemed to function to “self-regulate feelings and help people cope with overwhelming negative emotions they have no other way to dispel.”
Self-injury makes some people feel part of a group. Teenagers who self-injure often report that there is no adult they could talk to who accepts them for who they are.
“A 13-year-old can go on the Internet and instantly find community and get hitched to this behavior,” Whitlock said. “When they don’t want to self-injure anymore, it means they have to leave a community.”
A Coping mechanism
Self-injury can be manipulative, an effort to make others care or feel guilty or to drive them away. More often, though, it is secretive. Self-injurers may try to hide wounds under long pants and long sleeves even in hot weather, and may avoid activities like swimming.