Saturday, July 15, 2006
By SUE VORENBERG
SCRIPPS HOWARD
DRIAN'S BODY WAS A CANVAS. He painted it by cutting his legs and thighs with a razor, knife or screwdriver bit.
In the mornings, he'd wake up with his pajamas stuck to the clotted wounds. It felt good pulling them off and letting the blood flow again, he said.
"It was a tangible expression of what's going on inside -- like poetry," he said. "It made it concrete."
Adrian's parents, with whom he still lives in Albuquerque, N.M., don't want his last name used because they fear he'll be stigmatized for being a "cutter." He started at 21, and he's now almost 23; he stopped cutting himself six months ago.
Adrian's problem is not uncommon.
Psychologists and counselors say they've noticed an increasing number of patients reporting self-injury.
It's easier in today's culture to admit to cutting than it was in the past, counselors say. And talking about it can spread the problem among impressionable teens, said Nancy Heath, an associate psychology professor at McGill University in Canada and expert on self-injury.
"It's extremely contagious," Heath said.
The prevalence
In her recent study of 728 college students in Canada, which has been submitted to the journal Clinical Psychology: Science and Practice, Heath found about 12 percent had tried self-injury at least once, usually in high school.
"It's out there in huge numbers," she said. "The schools out there don't know what to do."
In Heath's study of undergraduate students, 85 said they intentionally cut themselves at some point in their lives. Of those, 15 were men (9.4 percent of the men in the group of 728) and 70 were women (12.3 percent of the women in the group).
When Heath started studying the issue about five years ago, she found no literature. Now, she's seeing more interest from the academic and scientific communities.
"There's no question it's happening more than it was when [my generation was] younger," said Heath, who is 44.
The idea that more people are reporting cutting now than in the past does not surprise Jane McGrath, a school health officer for the New Mexico Department of Health in Santa Fe, who worked in a hospital about five years ago.
"When I taught [medical] residents, I used to say you can tell [right- or left-] handedness by the arm they cut on," McGrath said. "It's kind of a grim joke, but I was seeing it a lot."
The labels
The problem goes by a number of names: self-injury, self-harm, self-inflicted violence, self-mutilation. Most people who do it refer to themselves as cutters.
People injure themselves various reasons. At its heart is some sort of emotional torment, said Rachelle Dobey, director of Age to Age Counseling, which sponsors a support group for teenage cutters in Albuquerque.
"It's a coping strategy, but they can't regulate their emotions," Dobey said. "It seems to go, 'I get stressed; I cut myself to feel better. I get angry; I cut myself to feel better. I get depressed; I cut myself to feel better.'"
The most common methods of self-mutilation are cutting and burning, but sometimes the self-injury goes further.
"They could break bones. They could amputate digits, chew on body parts, pulling out fingernails, hitting themselves, injection of toxin," she said.
Dobey has run the support group over the past year. Each nine-week session averages six to nine participants, she said.
Cutting might also release endorphins, which some doctors think turns into a chemical addiction.
Long-term cutting is more closely associated with some sort of traumatic childhood abuse or neglect, Heath said. Short-term cutters don't tend to have that, though they still have problems controlling emotions.
"What's dramatically increasing is using self-injury in the same way as experimental drug use, other risky behavior," she said. "They do it for a brief period of time."
For Adrian, cutting was an outgrowth of his depressive and anxiety disorders, which were diagnosed after getting help through a psychiatrist and counselor.
"I can't get over how much I enjoyed it," Adrian said. "In one sense, it did make me feel better. I loved waking up in the morning and seeing that I had done something to myself."
Cutting typically is more frequent among girls and women, but it's not limited to one gender, Dobey said.
Group cutting
A 15-year-old Santa Fe girl, whose parents requested she not be named, said she started cutting herself in eighth grade with safety pins and scissors after a friend in school told her it helped with emotional pain.
The teen ended up cutting with a group of three other friends; they'd cut in private and then show each other the wounds later, she said.
"I tried it and it helped, but it became kind of a habit," the girl said in a phone interview.
Adrian's first memory of trying to injure himself was at the University of New Mexico, where he is a student, about two years ago with a girl he liked but knew he should stay away from.
"I just remember I was rubbing my wrist on something" that scraped off his skin, Adrian said. "It was almost like I was telling myself to stop."
"I actually carved the word whore into my leg," Adrian said. "I think it described my hatred for me."
Sometimes, he'd trace over that word. Sometimes, he'd make cuts around it and on both legs.
Severe injuries
On July 6, 2005, cutting landed him in the hospital.
"That whole day was horrible," Adrian said. "I went home -- it was the most I ever cut myself."
He doesn't recall what set him off other than that it was a bad day.
When he realized the severity of the injury, he held the deep horizontal cuts across his legs together with his hands and limped to his parents' room down the hall to ask for help.
"I cut myself so deep I required staples," Adrian said.
He remembers talking to a social worker in the emergency room shortly after coming in.
"I told her basically that night I did not care what I did to myself," Adrian said.
Cutters usually try to hide the injuries; that's why Adrian cut on his upper legs, where people couldn't see them.
It can be a very personal practice for some people. At the same time, it can be a cry for help, said McGrath of the Health Department.
"I think these kids feel very isolated, alone, shut in and like there's not a lot of help for the emotional conflicts they're dealing with," McGrath said.