For the last ten years we have been studying self-injury: the deliberate, non-suicidal destruction of one's own body tissue, such as self-cutting, burning, branding, scratching, picking at skin (also called acne mutilation, psychogenic or neurotic excoriation, self-inflicted dermatosis or dermatillomania), re-opening wounds, biting, head-banging, hair-pulling (trichotillomania), hitting (with a hammer or other object), swallowing or embedding objects, breaking bones or teeth, tearing or severely biting cuticles or nails, and chewing the inside of the mouth. Before our research, (just published as The Tender Cut), studies of self-injury were conducted almost exclusively by members of the psycho-medical establishment.
Self-injurers have been told that they are (to varying degrees) mentally disordered, suffering from such syndromes as borderline personality disorder (BPD: inappropriate anger and impulsive self-harming behavior), antisocial personality disorder (the tendency to be aggressive, to have reckless disregard for personal safety), histrionic personality disorder (a pervasive pattern of excessive emotionality and attention-seeking behavior often enacted through physical appearance), post-traumatic stress disorder (sometimes due to rape or war), various dissociative disorders (including multiple personality disorder), eating disorders, and a range of other conditions such as kleptomania, Addison's disease, depersonalization, substance abuse, alcohol dependence, and assorted depressive disorders. Moreover, many "experts" considered this practice addictive. Self-injury was regarded as a disorder mostly practiced by teenage, White, girls coming from affluent backgrounds.
These studies are limited because they used people in therapeutic or hospital settings as research subjects, who represent only the tip of the iceberg of the broader self-injuring population. When you look at the rest of the iceberg, at people in their "natural settings" who self-injure, you will see a whole different demographic. And you will see a much broader range of motivations for self-injury and ways that this is defined. We describe the rest of this iceberg in The Tender Cut.
Beginning in the late 1990s and increasing rapidly in the early 2000s, self-injury began to spread to a wider population and take on a whole new meaning. Self-injury emerged from the closet, slowly at first, but with increasing vitality. Disaffected, alternative populations seized on it as a way to rebel and express their rejection of mainstream values. Structurally disadvantaged populations such as homeless youth, minorities, the poor, and people in prisons and juvenile detention centers, turned to it out of frustration. Ordinary teenagers adopted it as a way to relieve the travails of typical adolescent development. Older people started revealing their self-injury to establish themselves as a group and differentiate from the "young and trendy" cutters. Young men channeled their anger and rage into injuring their bodies. One young blogger expressed her feelings about the growth of self-injury into a silent epidemic:
I remember when I had started cutting, I thought I was the only one who did it. The first time I found out others were was in sixth or seventh grade backstage at a play I was doing and four of us talked about how we were depressed and from there found out we were all cutters. I never talked about my cutting. This year (my freshman year) I walked into school second semester and its everywhere. There was this girl that would get pissed off at a teacher and shove saftey pins into her hands. Or other that would compare scars and their recent adventures in the middle of out commons area. Its pathetic. I love how a lot of them are so against "posers." Look at them. This would be the last thing I would ever want to pose about. Because we all know cutting makes you cool. Thats why most of us suffer from depression, or anorexia, or are bi polar.
Once the media discovered self-injury, it spread like wildfire. People who heard about it, and learned that others had gotten relief from their emotional troubles by doing it, tried it themselves. Wannabes and copycatters did it just to fit in. The stigma of mental illness abated, so that people were regarded as being merely unhappy, and possibly too needy. Instead of freaking people out, self-injury became known, especially among youth, as "that thing that people do." As this happened, self-injury left the realm of the purely psychological and became a social phenomenon, spread through social contagion.
Does society judge people negatively for seeking relief from their emotional pain by inflicting harm on their bodies? We still probably do. After all, it violates norms of pain avoidance, self-preservation, and bodily respect. But do we think they're mentally ill? Some do, and certainly some are, but our research suggests that many are not. Is there something tender about cutting yourself? Just maybe there is. Maybe it's a coping mechanism that people who feel down, who struggle with pain and frustration, who feel out of control of their selves, can use to lessen their pain. And in the process, they may empower themselves.