"Cutting is for Emos."

[Divine_Nora-inu]

lildawni

Divine_Nora-inu

Personally, I have always wanted to smack people who said that "cutting was for emos". What people who make such narrow-minded comments fail to realize is actually two separate issues, although they also overlap slightly:

1.) they do not realize the depth of cutting as a psychological disorder. Cutting can serve many purposes to each person who suffers from it, though they may be hard for someone not going through the same thing to understand. Part of the ridiculous "emo" statement stems from people not realizing the difference between people who are cutting on a feature or disorder level, and people cutting on one of those two levels who have also progressed to a secondary gain situation. Which is actually rarely seen in cutters (and I'm not using the label in a mean or degrading manner, so please pardon me the usage) although it is also intrinsic to the disorder.
Also, the secondary gain sufferers sometimes seem to make up the majority of the disorder's population as they are the ones most likely to reveal the damage they cause.

2.) they do not realize that some people imitate and emulate this psychological disorder without actually falling into a category that could be diagnosed. These are the people often called "posers" by cutter and non-cutter alike. Although, to want to emulate a psychological disorder could very well be a symptom of mental illness or degredation in and of itself.

I guess I'm rambling now, so I'll cut it short. I've been on the cutting side of the coin, although thankfully it's been almost four and a half months since I have hurt myself. So I certainly understand where many of you are coming from.

~Divine

I'm very confused over what you're saying, Divine, sorry. As far as I know, although self harm can be a symptom of a psychological disorder, it is not itself a disorder.

For many years, it was believed to be only a symptom of a deeper underlying psychological condition. The new evolution of understanding in the medical community is what has made a difference between the feature level and disorder level in the act of self-harm.

The feature level is when a person exhibits the symptoms to fall into a category of clinical diagnosis for self-injury, but the self-injury is obviously secondary to a different psychological problem with which the person is suffering from with a greater severity.

The disorder level is when self-injury has progressed enough that it is seen in a person as the main disorder. This is not to say that the person has no other psychological disorder, but rather that the person is suffering most from self-injury and the subject of self-harm needs to be addressed and resolved before any other steps can be taken in therapy, "recovery", or managing any other mental illnesses. In this case, it is not uncommon for an underlying psychological condition to re-emerge as the primary disorder if the person has undergone successful therapy and ceased to injure themselves. At this point, self-injury, if the person still engages in it now and then, would go back to being classified at the feature level, rather than as a primary disorder.

I hope this helped to explain what I was trying to say.

~Divine

[Aspasia Sariel]

Divine_Nora-inu

For many years, it was believed to be only a symptom of a deeper underlying psychological condition. The new evolution of understanding in the medical community is what has made a difference between the feature level and disorder level in the act of self-harm.

The feature level is when a person exhibits the symptoms to fall into a category of clinical diagnosis for self-injury, but the self-injury is obviously secondary to a different psychological problem with which the person is suffering from with a greater severity.

The disorder level is when self-injury has progressed enough that it is seen in a person as the main disorder. This is not to say that the person has no other psychological disorder, but rather that the person is suffering most from self-injury and the subject of self-harm needs to be addressed and resolved before any other steps can be taken in therapy, "recovery", or managing any other mental illnesses. In this case, it is not uncommon for an underlying psychological condition to re-emerge as the primary disorder if the person has undergone successful therapy and ceased to injure themselves. At this point, self-injury, if the person still engages in it now and then, would go back to being classified at the feature level, rather than as a primary disorder.

I hope this helped to explain what I was trying to say.

~Divine

Could you provide some sources for this information you've provided? Thank you in advance.

[Divine_Nora-inu]

Not a problem. In my following posts, the words within quotations are an exact word by word copy of the source, for which I will provide citation for. Any text in bold is something I add myself that I believe may assist in clarification, though there will be little of that.

[Divine_Nora-inu]

Cutting:
Understanding and Overcoming Self-Mutilation
copyright 1998
Steven Levenkron
Chapter 5: How the Disorder Takes Shape
Pages 77-78



"The therapist will have to monitor the patients self-mutilating
behavior in the same way that someone treating a low-weight anorexic
would consistently weigh her. A familiarity with each cut, burn, or
bruise, and a recommendation as to how to treat it, including
referring the patient to a physician or even a medical hospital,
brings the threapist closer to the patient who has achieved disorder
status (determined when self-mutilation becomes the most prevalent
symptom). Here it should be noted that when the patient's behavior
has amplified beyond a feature to the level of a disorder, the pacing
of the therapy and the therapist's expectations for change must be
extended to include a longer period of treatment.
In Tracy's case, we saw extreme parental abuse lead to the extreme:
self-mutilating disorder. Other less extreme, even subtle family situations
can lead to the development of self-mutilating as a feature, which is
more easily treatable.

Remaining at the "Feature" Level

Self-mutilation remains at the feature level, where it is easiest to stop
when it is identified early. Usually, other psychological disorders are
present and have been diagnosed. These disorders commonly include:

Borderline personality disorder
Eating disorders: anorexia nervosa and bulimia nervosa
Episodes of psychotic behavior
Severe rage, especially when it has to be concealed
Depression coupled with anxiety
Trichotillomania
Obsessive-Compulsive Disorder

When a person is being treated for any of these illnesses, her physician
should be examining her regular for signs of self-mutilation."

This source gives a very good example of what I was trying to explain with the difference of self-injury as a feature of another disorder, and as a disorder in and of itself.

[Divine_Nora-inu]

Hosp Community Psychiatry 44:134-140, February 1993
copyright 1993 American Psychiatric Association

Diagnostic Issues in Self-Mutilation

Armando R. Favazza M.D., M.P.H. and Richard J. Rosenthal M.D.

"Objective: Pathological self-mutilation-the deliberate alteration
or destruction of body tissue without conscious suicidal intent-was
examined both as a symptom of mental disorders and as a distinct
syndrom. Methods: Data from more than 250 articles and books were
reviewed, as well as data obtained by the authors from their
extensive clinical experiance in treating self-mutilating patients.
Results and conclusions: The diverse behaviors that constitute pathological
self-mutilation can be catagorized into three basic types:
major-infrequent acts that result in significant tissue damage, usually
associated with psychoses and acute intoxications; stereotypic-fixed,
rhythmic behavior seemingly devoid of symbolism, commonly associated with
mental retardation; and superficial or moderate-behaviors such as
skin cutting, burning, and scratching associated with a variety of mental
disorders. The authors propose that a syndrom of repetitive superficial, or
moderate self-mutilation should be regarded as an axis I impulse disorder*.
In most cases, the syndrom coexists with character pathology."

*Axis I: clinical disorders, most v-codes, and conditions that need
clinical attention
This includes, but is not limited to:
Impulse Control Disorder NOS
Kleptomania
Pyromania
Pathological Gambling
Trichotillomania

Included the information on Axis I classification for clarification.

This source shows the gradual shift between viewing self-injury only as a feature of another disorder, and the proposal that in some cases it may warrent diagnosis as a disorder on the first axis.

[kami two]

hmm does all this theory make sense?? confused

[Divine_Nora-inu]

kami two

hmm does all this theory make sense?? confused

I believe that it does. In my honest opinion, I think the separation of self-injury at the feature level, and self-injury as a disorder is very valuable to the medical community, and very beneficial to people who self-injure who actually end up seeking out help.
If my statement is not at all relevant to your question, I apologize for my misunderstanding.

~Divine

[Col Ironhand Straken]

I think if you need to sut, you should get some help from an adult or a parent. I think the people who cut to get attention are losers. Not only are they ruining their bodies, but it is for a dumb reason. I myself have come close to cutting, but i got help from my parents.

[Aspasia Sariel]

Divine_Nora-inu

Not a problem. In my following posts, the words within quotations are an exact word by word copy of the source, for which I will provide citation for. Any text in bold is something I add myself that I believe may assist in clarification, though there will be little of that.

Thanks for providing those, interesting reads, however, I still don't think Self Injury has yet made it to an Axis I diagnosis - still being debated, and probably at the same tables they're discussing Borderline Personality Disorder. These particular articles have been very interesting, especially as someone who has cut (about a decade ago) and continues to engage in other self-injurious behaviors.

Since 1993, I've seen that Favazza's name here or there but not too much other literature. Of course, being out of school I don't have the same references I used to...still, from what's I've read of his work, it seems to me that his breakdown of self-injury even leads itself to being a symptom, or at best, co morbid to other, established Axis I diagnoses. Even in the case presented with Tracy, I would think we'd see her diagnosed with PTSD, with self injury as a symptom.

Cutting, along with anything in the realm of self injury, happens for so many reasons. Even those who cut may not have a strong sense of what exactly it does for them, or may not be able to effectively articulate it. When individuals have problems with alcoholism, that's a disease, but for cutting, its for attention. Is alcoholism, for example, any more or less a cry for attention, when that cry is for help?

What about tattoos, piercings and other body modifications? They are rarely without some level of pain. Many of these are accepted in society. Is it that we're simply acclimated to these, so we don't consider them injurious in any way?

[Rikki Rottenheart]

As far as the difference between following a trend and possibly having a mental illness goes..

I do hate those who mimick actual, serious problems because they want attention. A few years back, some girls in my grade started cutting because they thought it was the "in" thing to do. It only happened a few times; they were turned in to the guidance office, questioned, and that was that. It went no further (obviously, they realized they were dabbling in a serious matter and stopped their phony ways). I was so aggravated by what they were doing that I wrote a poem filled with conviction and shared in in front of our English class. It was a called A Message to the Sane Liars. I got a standing ovation, if that tells you anything.

The ironic part about this is that I didn't start harming myself for another two years after that incident. At the time, I did think it was a bit pointless, but those "cutters" had their way of "dealing with things". So I spared them the criticism. It really pissed me off when I discovered that girls in my class were doing it simply for the attention. For the fad. Oooh, I wanted to hurt them myself. I hate posers.

However. And, this is a big however.

Harming yourself simply for acceptance is disturbing, yes. But what happens when that behavior is taken to an extreme? Isn't it possible that those who harm themselves to "fit in" may suffer from their own mental disorder? I bring this up because I know a girl who began cutting to "fit in". Now, I suppose she continues to do it out of habit (for those of you who are experienced, you know how addicting it can get). The thing about this girl is, there's something wrong with her. Like, seriously wrong. She is addicted to seeking acceptance. It's so sickening that I believe it verges on a disorder. When I tell her about bands that I listen to, she obsesses over them. I don't really even know if she likes them, or if she is simply doing it to win my approval. She prints out pictures and lyrics from the band and pastes them in a collage on her bedroom walls. She did this once, literally hours after I told her about my new favorite band. It annoyed me to no end. My best friend has a bladder problem; she's had it for the near-decade that I've known her, and let me tell you, she would do anything to get rid of it. It's a burden for her, and a physical problem. This girl that I speak of (the one who has an extreme longing for acceptance) went so far as to proclaim that she has the same bladder disorder as my friend. "If I laugh too hard, I pee my pants. I can't help it I have a weak bladder." That is exactly what she said to me. I was offended for my friend. That was just ridiculous.

My point: as you can see, there lies a deeper question when it comes to the "posers" who harm themselves for attention. How many of them are truly jumping on the bandwagon, and how many of them could possibly have their own psychological disorder when it comes to acceptance? This girl I speak of needs help. She's obsessive, and her behavior is erratic.

As far as the difference between cutting and piercings/tattoos/etc. goes..

You're right, Aspasia. Society today is highly confusing. How is it that cutters are looked down upon and scorned for their behavior, yet piercings and tattoos are considered stylish and cultural? That is a bit messed up; however, I do believe there's a difference. There are many forms of self-harm, but I'm going to focus on cutting when comparing it to piercing/tattooing. In fact, some may consider piercing and tattooing as other forms of self-injury. My mother freaked when I pierced my lip by myself. She sat me down and asked me, "Is this another form of cutting for you?" Honestly, my answer is yes. Oftentimes, when I'm on the lower point in my emotional cycle, I have a strong urge to pierce something. I obsess over the thought, but I have to restrain myself because piercings are not something I want to hide, like cuts. Therefore, body jewelry is noticable. I'd get caught.

With that said, I truly think there is a difference. Psychologically, not for some people. But cutting presents more of a danger than piercing or tattooing. Tattooing is normally done by a professional (and if you do it yourself and you're not experienced, you're just crazy). On the very rare chance that something lethal goes wrong, sue. Go to the hospital. Piercing is done by a professional, or by an amateur (I pierced my lip twice myself). If you do it yourself, infection can occur. You may hit a vein. This could be a problem, depending on where it is you are piercing. However, piercing your body is still not nearly as dangerous as cutting. Cutting is never done by a professional [with the exception of surgeons (lame joke)]. Often, cuts are deep--they are meant to cause harm. Cutting too deep into the skin, in the wrong direction, etc. can have horrible consequences. Death. Cutting, in extreme cases, is used as a method of suicide: slitting the wrists, the throat. So, although cutting, piercing, and tattooing are all tied together in that they inflict harm/pain on the body, cutting more or less has negative intentions, and much worse consequences.

(Also, a side note to dr_zombie: telling your parents isn't always the solution. What I mean is, one cannot assume that once one tells one's parents about issues with self-harm that everything will go away and all will be just dandy. I thought that telling my parents would save me; it didn't. They cared enough to taxi me to the nearest hospital and get me some help, but that's when they dropped the issue. I've cut many times since then, and they've seen the growing number of scars on my leg. Yet, they never ask. They assume that I'm all happy-go-lucky, and that I don't hurt myself anymore.)

[kari-fae]

ok katey, thank you for the warning that this was going to be lengthy. secondly, (and i'm going to keep this short because i don't have the ability to keep going on and on like you and keep sounding smart without getting off track) i know the girl you were talking about, and yes, she does need help. it could also have something to do with a psychological problem (such as always seeking the approval of her drunken mother) but for the most part i think she's just a two-faced poser with outrageous views of the outside world.

[Divine_Nora-inu]

Aspasia Sariel

Divine_Nora-inu

Not a problem. In my following posts, the words within quotations are an exact word by word copy of the source, for which I will provide citation for. Any text in bold is something I add myself that I believe may assist in clarification, though there will be little of that.

Thanks for providing those, interesting reads, however, I still don't think Self Injury has yet made it to an Axis I diagnosis - still being debated, and probably at the same tables they're discussing Borderline Personality Disorder. These particular articles have been very interesting, especially as someone who has cut (about a decade ago) and continues to engage in other self-injurious behaviors.

Since 1993, I've seen that Favazza's name here or there but not too much other literature. Of course, being out of school I don't have the same references I used to...still, from what's I've read of his work, it seems to me that his breakdown of self-injury even leads itself to being a symptom, or at best, co morbid to other, established Axis I diagnoses. Even in the case presented with Tracy, I would think we'd see her diagnosed with PTSD, with self injury as a symptom.

Cutting, along with anything in the realm of self injury, happens for so many reasons. Even those who cut may not have a strong sense of what exactly it does for them, or may not be able to effectively articulate it. When individuals have problems with alcoholism, that's a disease, but for cutting, its for attention. Is alcoholism, for example, any more or less a cry for attention, when that cry is for help?

What about tattoos, piercings and other body modifications? They are rarely without some level of pain. Many of these are accepted in society. Is it that we're simply acclimated to these, so we don't consider them injurious in any way?

In Dr. Levenkron's book, "Cutting: Understanding and Overcoming Self-Mutilation", he actually approaches that topic. If you'd like, I could look up the exact wording. His approach to it is that while piercings, tattoos and other body modifications fall into a category of "adolescent trendiness". He goes on to explain that while this behavior may be repugnant to some people, it has a level of acceptance by society. The main differentiation between piercings, tattoos, and body modifications and self-injury, is that the majority of people aren't getting said modifications to solve any problem or to help cope with any situation. Many of them even hate the pain of said modifications, but it comes as a package deal: if you want the piercing or anything else, you have to put up with the pain. Whereas many self-injurers are actively seeking the pain; whether it be to simply feel alive, or to calm themselves and bring some sense of control back into their lives.

[lildawni]

Thanks for the clarification, Divine. smile I think I understand better what you were getting at, now, though I'm very curious where exactly the "line" is between symptom of a greater problem, or disorder in and of itself. Is it the level, the extent of harm? Does the type of harm matter? The regularity?

[lildawni]

dr_zombie22

I think if you need to sut, you should get some help from an adult or a parent. I think the people who cut to get attention are losers. Not only are they ruining their bodies, but it is for a dumb reason. I myself have come close to cutting, but i got help from my parents.

I'm really glad you were able to go to your parents and get help before you turned to self harm. I think that's wonderful! But I do have to say that this doesn't always work out so well. I definitely agree that if you're struggling in whatever way you should seek help -- whether that be from a parent, professional or other adult - but sometimes it's not that easy, and I want to acknowledge that for the people who have to fight an uphill battle against these things.

[Divine_Nora-inu]

lildawni

Thanks for the clarification, Divine. smile I think I understand better what you were getting at, now, though I'm very curious where exactly the "line" is between symptom of a greater problem, or disorder in and of itself. Is it the level, the extent of harm? Does the type of harm matter? The regularity?

From all that I've read, the type of harm doesn't matter. The regularity and level or extent does have bearing on the separation. The generally draw the line like this:

a.) if the most prominent disorder, as in the one causing the patient most difficulty in their day to day lives, is not cutting but cutting is present, it is a feature of a different disorder.
ex. A patient with an eating disorder who spends most of his/her days wrapped
up in all the rituals of the disorder, but who cuts occasionally will have the
cutting classified as a symptom of the greater more pressing problem of
the eating disorder and the imminent harm of doing lasting bodily damage

b.) if cutting appears alone and no other mental illness can be diagnosed, or if the cutting progresses and gets bad enough that it overshadows the other disorder, it becomes a disorder in itself. To stay with the earlier example....
ex. Say that this eating disordered patient suffered a hospitalization or other
event caused the individual to lose control over nutritional intake (i.e.
intravaneous nutrition, eating under duress, or hyperalimination) who had
suffered also from self-injury may take the to the next level. They may
self-harm more frequently and with greater damage to self. If weight gain
begins to occur and the patient continually moves into a healthier weight
range, and maintains that, then the self-injury that has increased becomes
far more detrimental to the patient and the need for the behavior to be
addressed and hopefully resolved becomes the most pressing issue and has
then advanced to a stage where it can be classified as a disorder itself.