Gillian Woldorf is a 4th-year graduate student in psychology at Case Western Reserve University doing her dissertation on self-injury. As part of her work, she is conducting an Internet-based survey of people who harm themselves. She wants to find out, among other things, if the number of people doing it is actually increasing. Woldorf's interest in the subject is both professional and personal. She is a recovering cutter:
WOLDORF: "I was a year younger than everybody in school to begin with, and short and had glasses and had two braids everyday for six years, so I got made fun of. My outlet in the beginning was music and then later I discovered one night when I was really upset, I bit myself and it felt so much better..."
14-year-old Lynnie is a lot like Woldorf. She's a talented musician, but doesn't like to talk about it, saying it's uncool. She'd rather talk about playing softball. Lynnie says other girls at school make fun of her hair, her weight and call her "The Brain." It isn't a compliment. She admits she has trouble fitting in. Earlier this year, Lynnie grabbed scissors and dug the blades into her left wrist, creating several jagged lines, each a half inch long:
LYNNIE (audio diary): "I was alone in my little corner and if I jumped off the face of the earth...who cares? I just felt so alone that nobody was there...I couldn't go anywhere...when you cut to relieve the pain and stuff, when you cut you don't really feel it. That sounds really weird but when you cut you're kind of not there and you're just, wow, I'm so alone..."
Lynnie says she got the idea to cut herself from some eighth grade girls, girls she considered to be cool, who self-injured. After that first cut, Lynnie began cutting herself three of four times a day, using knives, box cutters, paper clips... or her favorite, the twin blades in her disposable daisy razor. Those she would tuck into her backpack to take to school with her. In April, the headmaster of her school caught Lynnie cutting in the bathroom and called her mother, Colleen, who was shocked by the news:
COLLEEN: "I had prided myself on knowing what my kids did all the time and I didn't know, I just didn't know. So he said she will not be permitted back into school until she has psychological treatment. Luckily this was over spring break so I figured OK, I'll get her to the doctor and it'll be over. It was just the beginning of the nightmare..."
After Colleen found out, she frantically went through the house, removing every sharp object, began checking her daughter's arms for cuts while she slept, asked her to pull up her sleeves when she came down for breakfast each morning. It didn't help:
COLLEEN: "It never failed... she was able to successfully cut without me even knowing it, even with the supervision she had. They were just progressively getting deeper and deeper. Eventually I was able to see the trance... it was a cold stare and she's distant from me, she was in another world. It usually happened around a particular event like somebody at school would say something to her or she'd feel like somebody didn't like her, or if there was something that happened at home where I was trying to reprimand her and she would just distance herself and she was gone..."
Ruta Mazelis, editor of The Cutting Edge, an international newsletter for people who self-injure, and board member of the National Trauma Consortium, says Lynnie's trance is also called disassociation:
MAZELIS: "If somebody is so severely disassociated that they're afraid they're going to lose themselves they'll cut themselves to say, 'That's where I am. I can tell by this blood from these scratches that this is where my body starts and stops...'"
Until she saw the red lines on her daughter's arms, Colleen had never heard of someone cutting themselves, or self-mutilating, as it is clinically known. Other self-injury behaviors include burning, biting, head banging, picking skin and pulling hair, excessive tattooing and body piercing, as well as using alcohol and drugs way past the point where they are attempting to blot out feelings. National statistics suggest that one to four percent in the general population engage in some form of self-injury. The 46-year-old Mazelis cut herself for over 20 years and says although this type of behavior is hurtful, that's not the intention of it:
MAZELIS: "Self-injury tends to help somebody who's suicidal avert a suicide attempt because if they're in such emotional distress, if they had the option of cutting to diminish that, it will keep them from the actual suicide attempt..."
Self-injury rarely stops after two or three incidents. Prior to the work that Woldorf is now doing, the only large scale survey ever done on self-mutilators was done back in 1989, and found the average practitioner begins at 13 and continues injuring, often with increasing severity into their late 20's. Self-mutilation is often called, "the anorexia of the new century" and "the rich, white girls' disease." But Woldorf says someone's socioeconomic status, race, or gender makes no difference. Cutting their skin makes the cutter feel better emotionally and physically:
WOLDORF: "...anytime there's intense, immediate acute harm to the body and endogenous opeoids, which are our brain's version of morphine and heroine, they are naturally released and that give you sort of a high. It's the same thing as a runner's high, the same chemicals..."
Woldorf says the behavior is certainly not new. And though it's hard to define the personality traits of the typical cutter, she says there is usually some sort of emotional trauma in their past and depression is almost always there in some form or another. There are other consistent traits as well:
WOLDORF: "...what you see is girls who are perfectionists; they hold very high standards for themselves. They might not perform at those high levels in school but they have these incredibly high standards for themselves and if they don't meet them, they may feel the need to punish themselves...."
Adolescent therapist in private practice, Ingrid Monteith has seen a dramatic increase in the number of cutting teens she sees on a regular basis and says she thinks it's due to the fact that the subject is showing up in teens' music and other media geared toward that age group:
MONTEITH: "I know Princess Diana talked about it in her interview...That TV show, '90210' had a story line about it. There was a movie with Angelina Jolie called 'Girl Interrupted' so there's just a lot more publicity...."
What has changed, according to Montieth, Mazelis and Woldorf, is that kids who are cutting seem to be starting it at a much younger age. But Woldorf says the behavior is so secretive there's no way of knowing for sure:
WOLDORF: "I think that the rates are just about the same as they've been for the past century, but given society's increased openness about disclosing mental health problems and disclosing self-destructive behaviors, I think we're just getting more reports of it. "
The psychiatric community believes cutting is a symptom of other disorders, like borderline personality disorder, anxiety disorder, bipolar or schizophrenia. But Woldorf says they're not sure which comes first - the behavior or the mental disorder.
Current treatment for self-mutilation is a combination of medication and therapy, with an emphasis on trying to make the behavior stop, although Mazelis says some within the psychiatric community say taking away cutting as an option actually increases the chance a cutter may attempt suicide and succeed. Lynnie, now daily taking Paxil and seeing a counselor once a week, has been encouraged to hit a baseball or punch her pillow whenever she feels like cutting:
LYNNIE: "Sometimes I would go out and I've got this hit away thing and I'd hit this softball as many times as I can just to get my anger out... some more alternative ways is like if you play an instrument. You don't have to really like it but you can show your emotions through whatever you're playing. I play the cello and whenever I'm really angry with something, I go over to my cello and I just play constantly...the whole thing is to just get your mind off of it."
Lynnie's mom, Colleen is hopeful her daughter has stopped cutting, though she now knows this behavior is not something that is easily overcome. So every morning, she can't help but check her daughter's arms...
Poem by Lynnie, 14-year-old cutter:
"She cries and she tries to stop herself from adding another scar.
In the dark she sits all alone,
Trying but not succeeding.
Tears fall down her tender pink cheeks,
And blood runs down her red inflamed arms.
She cries and tries to stop herself,
But it's too late.
She cries one last tear and then she leaves her world of pain behind.
The world that will no longer hurt or haunt her.
I don't know what happened
But suddenly I just can't stop
I can't feel anything
The world is numb
As the sun strikes metal
My life somehow
Spins out of control
My heart feels broken
The light is blurry
The door is locked
Silence in my cries
As I pick up the blade
Then, when I see the blood
My world stops turning
My heart stops breaking
My eyes stop crying and
My hands stop shaking
And the blade somehow,
Has made everything normal again
Suddenly, there is more
More silence in my cries
More silence in my tears.
Books on Self Injury:
"A Bright Red Scream. Self Mutilation and the Language of Pain" by Marilee Strong
"Self-Injury. Psychotherapy with People Who Engage in Self-Inflicted Violence" by Robin E. Connors.
"The Scarred Soul. Understanding & Ending Self-Inflicted Violence" by Tracy Alderman, PhD