January 21, 2011. It was a day that started off like any other day, except about noonish I found out that my daughter had skipped school. I rushed home and called around but nobody had seen her. Then, about 4 p.m. or so the doorbell rang. It was her and her friend and they had something to tell me. I was really trying hard not to show how upset I was at that moment from her skipping school, so I patiently waited while her friend gently encouraged my daughter to tell me her big secret.
Then she pulled up her sleeves showed me her arms. Her forearm was all cut up and had the word “HATE” carved into it.
I was first hit with shock, which quickly evolved into intense guilt. How could I not have known she was in such emotional pain that she had resorted to cutting herself? That rapidly turned into confusion — what the heck is wrong with her and why would somebody do this to herself? Then compassion took over and I felt her pain. Deep pain over missing her mother. The pain over being different because of her diabetes. The pain of having an arm that didn’t work fully due to complications at birth. The pain of being a teenager that doesn’t feel she “fits in.”
Then the panic hit. What if she continues to do it? What about infection? What about … well… EVERYTHING??? My thoughts were all jumbled up and I didn’t know what to think! I had a rather traumatic childhood but never once thought about cutting, so what would make my own daughter take such drastic action? She told me it helped her to relieve her stress… Say what?
Once I was able to calm down a bit, I started looking into why children cut.
While not all people who experienced trauma at a young age cut, many cutters did experience trauma to one extent or another. Two things that help people to integrate and overcome trauma (or prevent its aftereffects) are a sense of control (ability to change outcomes) and an ability to make sense of the event(s). Infants and small children really have no way to control their situations. They can’t feed themselves, nor can they change their own diapers. They also don’t have the reasoning capacity to make sense of what is happening to them. They just don’t have the experience or the knowledge. So the brain takes over and goes into survival mode by inducing a dissociative state which “removes” the child from feeling the pain. This state is brought about by the brain flooding itself with opioids such as endorphins and enkephalins which are natural heroin-like substances that kill pain and produce calm. They are an integral part of the brains stress-response system.
Since the brain “learns” from repetition, it learns that the only way to deal with anxiety and stress is to release these opioids (since it has no other way to deal with it). Cutting produces stress on the system through pain, which forces the brain to release these opioids. So when a child cuts, they are typically in a state of anxiety or stress that is so great they are essentially self-medicating the only way they know how.
How does this help? If you know your child is cutting, you can attack the problem by reducing their stress and anxiety for the short term. The long term solution is to re-train their brain to provide them with other, better tools to deal with the stress. Meditation, yoga, and mindfulness are all wonderful tools, as is encouraging writing or expressing themselves through art (and you thought they were just making pretty pictures to hang on your fridge!!). Talk therapy can also be helpful, but keep in mind that therapists can do far more harm than good with RADs. If you can’t find an Attachment therapist, and the therapist you do find isn’t willing to work with you and learn about attachment issues, it may actually be better to go without for the time being (disclaimer: I’m no doctor, I can’t give medical advice, and you need to do what’s right for you and your child. I can only speak from experience).
However you choose to approach it, keep in mind that the cutting is a symptom — the cause is the lack of ability to effectively deal with stress. Treat the cause and you’ll stop the cutting. It hasn’t completely stopped the cutting in our home, but we are able to recognize when she’s in “that mood,” which allows us to frequently stop it before it begins.
Photo by Youth for Truth USA