I am 18 and i constantly feel the need to cut myself to release all my emotions….when i do, i feel so much better. i started cutting my wrists and arms about four to five years ago.I don’t do any drugs anymore, and im taking zoloft for depression. i started at five milligrams and now im taking 100 milligrams. i take it every night and i still feel depressed, down, and dumb. i recently cut my wrist pretty deep…i dont think of killing myself, i just think about feeling better….and it works. i know thats not a healthy way to express my feelings but its the only way that feels good. what should i do?

hi i cut my wrist when i get really mad or upset and its just bothering me so bad and i cant tell someone do you have any suggestions on how i could stop cutting?

I’m combining two reader questions into one answer as they are so similar.

People who self-injure often find that cutting on themselves provides them with a means of managing very difficult and otherwise overwhelming emotions. They may feel numb, and cutting becomes a way to feel again. They may feel overwhelmed with emotion, and cutting becomes a way to focus the pain they are feeling and transform it from something amorphous into something concrete that they can control. There can be a self-punishing aspect to self-harm as well.

Once established as a habit, cutting is hard to stop, simply because it works to transform those emotions from something unmanageable into something manageable. The behavior can take on a compulsive quality, just like masturbation to pornography for some people; you may feel bad about doing it part of the time, but you end up cycling back into wanting to do it and you go back to choosing it every time. In order to get a handle on stopping cutting, once it has this compulsive flavor to it, it is helpful for people to learn alternative means of dealing with their emotions, or to work on the issues that have led them to have problematic emotions in the first place. This is very hard to do on your own, which should be obvious from the fact that the people who cut aren’t stupid and the best they’ve come up with is to cut. It is easier to heal from trauma in the context of a healing relationship – either with caring peers, or with a therapist of some sort. This is key – you can’t easily do this yourself. You need to get yourself into therapy for this. Therapeutic settings can provide a relationship to witness your pain, can be a support you can trust, and can provide you with new ideas for how to cope. You do the work yourself every time, but it is much easier when you accept help.

Many (but not all) people who cut do so because they have experienced some life trauma in their day. This could be abuse, or rape or abandonment or anything in that spectrum. Something that made them feel vulnerable and bad; something that was overwhelmingly horrible which convinced them at a deep level that they were no good (e.g., evil, sinful, slutty), or that they are undeserving or that they are not in control of their lives. There are therapies which are designed to help dissolve the emotional impact of being traumatized. Eye movement desensitization and reprocessing (EMDR) is one prominent one widely available today. Another is called Dialectical Behavior Therapy (DBT). Still another variations relies on the power of peer relationships in a group therapy or the therapist-client relationship in individual therapy context to help people open up and talk about what they have stuffed down. EMDR uses a sort of attention trick to make trauma memories less intense. DBT teaches mindfulness techniques to help create a detached ‘witness’ perspective from which it is easier to tolerate emotions. The other therapies basically rely on the formation of a trusting relationship in which people eventually become able to feel safe enough to talk about what they are ashamed of and, through the process of sharing that load and being accepted still, the load lightens.

The power of sharing in a trusting environment happens because normally, trauma memories are avoided. Since people are unwilling and unable to tolerate those feelings associated with the memories, they are pushed away, and can’t be unlearned. By learning to tolerate the feelings, people can talk about them which brings up the feelings and allows them to air out. By experiencing them and having a new experience of not being rejected because of them, new learning occurs which lessens the impact of the fear and dissolves the trauma some.

As your ability to tolerate whatever it is that you’re needing to avoid; whatever it is that is so distressing and disturbing grows, your need to cut will lessen. There isn’t any magic pill or wand to wave; you have to do the work and be brave and grow new ways of coping before you’ll be in a position to be okay with giving up cutting. Cutting serves a function for you now, and you need to replace it with something safe before you can easily give it up.

There are many therapists who can offer assistance with self-injury today. You might try looking for one in your area using our therapists directory. If you are in need of intensive inpatient assistance because your self-injury is really severe, you might contact Andrew Levander who runs a residential treatment inpatient facility for severe self-injurers in the Los Angeles area. If you are interested in learning more about DBT, you can listen to this podcast with DBT founder Marsha Linehan, Ph.D. If you are interested in learning more about EMDR, you can listen to this podcast with Francine Shapiro, Ph.D. the founder of EMDR. Both podcast pages have links to websites where therapists who specialize in these respective treatments can be looked up.

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