10 April 2013

How Can I Help a Cutter?

I was asked yesterday if I might share my thoughts about cutting and Anorexia. I am not a cutter nor am I Anorexic, so I can't offer any firsthand insight into what those private hells are like. I do, however, have some experience trying to be there for people I love who have fought them so I can speak a little about that side of things. This time, I'd like to discuss cutting.

One of the things I never understood was that cutting isn't about self-harm at all. It's for a release of internal anxiety and stress. There was a book published last year whose title escapes me, but I caught the author discussing it on NPR one afternoon. She likened cutting to how some anxious animals will groom themselves obsessively to the point of rubbing themselves raw. There's a specific kind of release that physical discomfort can bring, and that's the purpose of cutting.

I never discuss the personal details of anyone else in my blog, so I'm a bit hamstrung about how in-depth I can go about this, but I will offer the following bullet-style advice to those of you whose loved one may be cutting:

  • Be calm about it. Think of your loved one as a Chinese finger trap; the more pressure you put into the situation, the worse it will become.
  • It's okay to ask, "How badly did you cut?" to get a sense of the extent of the damage. Sometimes you can get your loved one to show you the scars, but defer to your loved one about how willing he or she may be about showing you. If you encounter reluctance, let it go. If you're shown the scars, recognize that your loved one is extremely vulnerable at that moment. Be very careful how you react.
  • Don't judge him or her or try to shame him or her out of cutting. Don't encourage cutting, obviously, but accept that sometimes it will happen.
  • Engage him or her about what triggers may have led to the cutting. There's a certain parenting style that believes you tell someone to stop doing something and that they should then stop doing it, and that listening to any explanation for it is just making excuses. That mentality has no place in the dynamics of helping a cutter. A cutter needs release, and dialoging with someone whom they trust can help alleviate some of that pressure.
  • Use positive language. Say things like, "I'm glad you told me about this" and "I'm here for you". (Side note: Actually be there for him or her.)
In my experience, the better my handling of the situation has been received, the more likely he or she has been to confide in me when he or she has cutting urges. We have often managed to discuss things enough that the urge to cut could subside, if only for the night. Recognize that cutting is likely an ongoing issue rather than a limited phase. It's simply part of how your loved one is wired to handle internal stress.

The single most important thing you can do for your loved one is make sure that he or she feels safe confiding in you not just about the cutting, but whatever may be going on that could trigger cutting. A cutter very often feels isolated and ashamed of cutting, which in turn exacerbates the anxiety that triggers the cutting. Remember that it's even more important that you be an available confidante between cutting episodes than it is that you be there for the episodes themselves. You're not a firefighter responding to emergencies. You're a lifeguard watching the pool at all times.

If I were to address those who cut directly for a moment, all I know to say to you is that it breaks my heart that you feel the way you do. If it was in my power to alleviate your triggers, I would do it without hesitation. You're not weak for the times when you cut. You're strong for all the times you don't.

I hope something in all this is helpful to you, Dear Reader. As I've indicated, though, I have not been a cutter myself. For those of you with experience cutting - or others who have cared for someone who has cut - what do you have to say about it? What should the rest of us know or do that maybe we don't know already? What helps you to manage your cutting urges?