Can You Catch Cutting and Burning from Your Friends?

There are a whole bunch of self-injurious behaviors that young people pick up from their friends or from the cultural zeitgeist. These include the use of vomiting, laxatives, stimulants and idiosyncratic diets to control weight; self-cutting and burning to deal with intense emotions, numbness or boredom; and binge drinking and drug abuse to facilitate socialization. As with contagious diseases, some people are more resistant to these disorders and some are more susceptible.

In saying that these behaviors can be acquired by seeing other people do them, or even by reading about them or seeing them depicted on the screen, I'm in no way implying that they are trivial or merely willful. Self-harm has many causes and reflects real pain. (Including the absence of pain, such as when cutting or burning is used to pierce emotional numbness.) What I am saying is that, like other bad habits, these maladies begin as voluntary behaviors, and that most of you, had you never seen or heard about them -- from movies, books or your friends -- would probably not have come up with them on your own. In other words, had purging and cutting not been culturally available, you might have "chosen" some other response to psychic pain or numbness. Once having been chosen, however, self-injurious behaviors have a way of becoming self-perpetuating and habitual.

Stopping bad habits is hard. Stopping self-destructive bad habits is especially hard because popular culture has endowed suffering with a perverse glamor. We have made self-inflicted misery chic. Watching your own blood ooze from a cut you made yourself, burning your thigh with a cigarette, vomiting in a restaurant bathroom after a meal, letting yourself look like a derelict -- all the sad and sordid acts associated with "the dark side" -- are in reality little more than pop-culture clichés. They equate misery with creativity, self-inflicted pain with martyrdom, and self-indulgence with nobility. Their sources are the literature of tragedy at its least imaginative -- vampire cults, drug-martyred musicians and actors, mental asylum memoirs, and too-rich for-their-own good celebrities. They borrow from the language of the street but have no meaning beyond the self. Sadly, they are utterly derivative and unoriginal.

But they don't seem that way when you're young. They seem romantic. They feed upon the desire to make your life extraordinary, to be greater than it currently is. You want your life to be filled with passion and creativity. You want your pain to have meaning -- something grander than the run-of-the-mill angst of the typical college student. You want your pain to be cinematic. But by dramatizing your angst and your uniqueness in this conventional way -- by inflicting injury on yourself -- you're not elevating it, you're diminishing it. By hyping it, you're saying that your pain is too trivial to be taken seriously on its own merits. You're saying it can't be spoken about in a reasonable way to a sympathetic listener; it has to be performed on a stark stage for an (imaginary) audience. You're paying a big price for the banality of our films and television.

But regardless of how these self-injurious behaviors began, they quickly take on a life of their own. They cease to become an expression of pain and become a self-perpetuating source of pain. As with drugs, the "cure" for the illness becomes the illness. Cutting and purging break away from their root causes and become very bad habits or even addictions.

Knowing that self-injurious behaviors are culturally determined and can quickly become habitual increases the importance of prevention. Here are some suggestions for preemption: (1) Reduce your exposure to people who are practicing self-damaging behaviors, especially if they -- the people as well as the behaviors -- seem appealing. (2) Improve your choice of movies and books. Be skeptical of "memoirs" that glamorize booze, drugs, self-degradation and risk-taking by turning them into "art." (3) If you've experimented with cutting or purging, stop immediately before those behaviors become habitual. (4) Better yet, think of them as disgusting addictions and avoid starting them in the first place.

Addendum (added October 26,2010)

I apologize to any reader, including the three who made comments on this post, for the tone of my article which seems to trivialize the pain of self-harm and the difficulty in overcoming it. Cutting, burning, and purging are responses to intense psychic pain and may be associated with other very serious psychiatric disorders (such as bipolar disorder, agitated major depression and borderline personality disorder) that require treatment in themselves.

Many, maybe even most, cases of self-harm begin involuntarily and are experienced as shameful rather than "cool." And, regardless of how they began, they rapidly become self-perpetuating and almost addictive -- often because they succeed in relieving the psychic pain.

My article was addressed to the particular part of the college population who is just beginning to use cutting, burning or purging to deal with emotional pain. These are young people whose self-harm didn't develop spontaneously through biting their cheeks, pinching themselves, or digging their fingernails into their skin, etc. It was picked up from their friends or from accounts of these practices they've seen or read about in the media. Some of these young people, unfortunately, do associate self-harm with artistic suffering. For corroboration, see these comments on a related post in "Psychology Today."

In directing my article at this particular subpopulation, I was trying (insensitively it seems) to prevent the progression of their cutting, burning and purging while it was still voluntary -- before it became too "helpful" or addictive to stop. I wanted to make these young people aware that getting professional help to deal with their psychic pain, including medicine as well as psychotherapy, was preferable to treating it on their own by self-harm. It was not my intention to demean either the symptoms or the people suffering from them.

I thank the people who wrote comments bringing these problems to my attention. It's natural to want to make blog posts a little provocative and it's not always possible to hedge every assertion with qualifiers. Nevertheless, I will try to be clearer, more careful and more sensitive in the future.