Cutting

Due to a recent suggestion, this blog will cover a few key elements about the behavior of cutting. Cutting is not a new topic but an ongoing issue that raises great concern. I’ll be taking two perspectives on this topic because I feel it is helpful to view cutting from the perspective of a person who cuts as well as a person who cares about a person who cuts, often a parent or friend. The language and structure is my attempt to inform people who may not know what cutting is or who have little experience in working with cutting. If it doesn’t seem academic enough but it is extremely informative and helpful, I have done what I hoped.
Though I have an abundance of experience working with many people who cut (notice I stay away from labeling a person a “cutter”), also known as self-mutilation, there are things I learn every time I work with the issue. The most important thing I believe I can say is “make no assumptions”. A person who is cutting is a unique person. They are NOT cutters, they are people who cut. What it takes for them to stop cutting is unique to the individual. In my opinion, anyone who tells you they can make someone stop cutting with a specific technique that “always works” is full of crap.
Definition
Cutting is a form of self mutilation or self injury in which a person typically uses an object that is capable of leaving a scar and/or making themselves bleed. There are physiological concerns as well as psychological, sociological, cultural and even moral concerns with cutting. A teen cutter, for example, often has plenty of reality training from caring adults and friends about the physiological concerns of cutting. However, I suggest we ask what psychological, sociological, cultural and moral(maybe religious) understandings of cutting are? Chances are, there is a lot less understanding of these areas than the physiological. Please know that I have seen people who cut due to moral pressures as much as I have seen people who cut because they lack moral structure.
The Person Behind the Cutting
A person who cuts often does so out of a feeling of need. They get something they deem necessary and positive from the cutting experience. I’ve been told things like, “I have to do it” or “I can’t stop myself”. No matter how difficult this is for a caring person to understand, it is the reality of the individual that they feel a great need to cut themselves. This does not imply a need or desire to die. The reasons for cutting vary and depend on the person. In many cases, there are multiple factors working simultaneously. An analogy I like to think of when working with any client facing a potentially dangerous problem is the analogy of a key. This is how the analogy goes:
Let’s take the key to a house or car as an example. First and foremost, the process of making the key only matters because the key does something in the end that is useful. Without a need, there is no reason to open the door. The house or car might keep a person warm, dry or give a sense of safety. At some point the process down the path of cutting started from a point where the behavior was useful.
The next step in forming a key is by giving it exactly the right shape. Only with the exact right shape will the key be effective and open the door. Emotionally, the behavior has to be reinforced multiple times (the ridges of a key are being formed) in order for the shape to take hold and the behavior to become a pattern. For example, a person who cuts the first time and they feel no relief or comfort will likely stop cutting. There is no need to continue a behavior that doesn’t serve the individual.
The final stage of the key is being able to use it when you want and know that it will work. If a person goes out of town and returns three weeks later, the key still opens the door, starts the ignition or gets you in the house. A person can emotionally have no need for cutting themselves for hours, days, weeks or even years but the ability to access that place still exists. Once a key is made, it is very difficult to unmake the key. In some cases, it isn’t even possible to unmake a key. There is a position of hope though. In situations that don’t allow for destroying the key and starting over, we make a new key that is more effective and less dangerous. Thus, we replace a dangerous behavior with a healthier behavior that fills the same psychological, sociological, cultural and/or moral void that is being filled with cutting.
***What is healthy for one person may not be for another. There are many factors and it’s a good idea to seek wise counsel before making major changes. Wise counsel may or may not be a professional counselor but for the sake of my profession, I hope you would find professional counseling to be a great experience.
Caring other
Anyone who hears about someone cutting or behaving in a manner that doesn’t appear to be healthy and chooses to care is a “caring other”. It seems to be unusual, at least in my experiences, to have a person who cuts come out and say so before I hear it from someone else. Often times, there is a fair amount of shame behind the act of cutting. To make things simple, I am going to highlight what I often teach parents and guide caring people through when dealing with a person who is doing any act that is dangerous like cutting.
- This isn’t a time to run away from or become afraid of the person even if it is a bit scary.
- There is a reason for the behavior but you may never know what that reason is so be prepared to accept that you won’t know. (If you learn why, then that’s just a bonus!)
- The person is what’s important. They are NOT the problem.
- Show the person respect because the feelings are REAL and the behavior is probably only a less typical way of processing something.
- Don’t assume you know how to fix the problem. Chances are, the only one who can truly fix it is them.
- If you don’t know what to do, say or think, then be open to setting the example for them by seeking good counsel yourself. There are good counselors out there who would love to know you.

Pain sucks… really?

There are many people smarter than I who have written about pain. One of my favorite examples is the author of The Chronicles of Narnia, C.S. Lewis. He wrote an entire book called The Problem of Pain. For your sake and for my own, I’m going to keep this much briefer than a book. There are only three things I am going to address in this particular blog. One is the fact that pain sucks. Another is the fact that pain is awesome (This might be hard to believe). The final part will be about balance. We know pain sucks. On a good day we can usually admit that it has a purpose that is good and healthy. How do we balance the two views? I suggest we look at it as part of our design.

The challenge of pain:
It would be foolish of me not to recognize that each of you have pain that is very real and possibly traumatic in your history. The pains you have felt may have shaped defense mechanisms you still use today. I call this scaffolding and will likely blog separately in the future. In some cases, the mechanisms are unhealthy and can recreate different forms of the pain you felt the very first time you experienced it. For example, sometimes little children are taken from their homes and put in foster care. They may experience the separation as a terrible loss of their primary care giver or they may experience the separation as an extreme relief due to the poor attachment to their primary care giver. Both situations cause real and memorable pain and both situations can cause unhealthy mechanisms that may lead to additional future pain. Boldly put, the suffering part of pain sucks.

Let’s take the same example and fast forward ten years. The little child is now sixteen years old and has their first boyfriend or girlfriend. They begin to feel very close and even express that they are “in love”. The child who, at age six, felt relief from the experience of separation may find themselves wanting to break up because the emotions are too intense. The defense mechanism that helped them survive an early trauma can prevent healthy attachment to others.

The positive side:
We are designed to heal! It may be very difficult and it may take an entire lifetime but our brains are designed to take in new information all the time and the brain is even designed to “trim” unnecessary paths (Badenoch, 2008). In English, this means we can take bad situations and make them unbelievably positive points of change in our life.

I have a bias toward finding positive things even in the most hideous of situations. The reason I feel it’s important to give you this disclaimer at this point is because I am going to take the example from above and show some positive aspects to the difficult situation. There is no intent to minimize how difficult it is to make changes and to heal wounds that run as deep as many of you have. With that said, there exist other perspectives to every situation. Sometimes it’s helpful to learn new ways of viewing old stories. It might create a paradigm shift that will change your life forever in very good ways.

Let’s take the six year old child and say that they felt relief after being removed from their home. Let’s also say the child gets placed in a home with adults that know how to create a healthy attachment to children. The child may feel scared and nervous as they attach to the surrogate parents but with patience and empathy, the child is able to create a healthy attachment. The child has worked through the pain. The key is they didn’t ignore it and they had someone who showed them appropriate empathy. If these things happen, pain can be an awesome thing. Awesome is a powerful word and appropriate because pain can improve resilience. When difficult things arise in the life of a person who is resilient, they can often feel as though it will work out in the end. People who have suffered and worked through the pain often carry more hope. This is one way how the terrible thing of pain can be an amazing and powerful benefit.

A balancing act:
For those of you who are up for a challenge, I’m going to get a little psycheducational now. Pain is felt physically and mentally. If you ask someone who has a bad back problem, they might say the most annoying pain of all is the one you can’t see but still puts you on your knees in pain. Emotional pain can be just as intense as bad back pain for many people. It can make a person curl up in the fetal position and sob uncontrollably or it can make a person completely irrational. The pain is real! I don’t have all the answers as to why this happens. I wish I did. I have learned a few things about the healing process that might be helpful though.

First, everyone is unique and their situation is also unique. You don’t have to try to be special because you are. It’s amazing to me how many people are trying to be unique rather than being who they are. At the same time, anyone who assumes they have the answers for you probably needs a little more humility in their life. I, by no means, believe that what I suggest to folks is going to heal them. Sometimes I get lucky and look like I work miracles but my suggestions are merely an attempt to empathize with people and present other possible outlooks. The real work and growth comes from the people I have the privilege to know.

Second, empathy is a requirement in healing. We cannot heal ourselves no matter how strong we are and no matter how much we want to. It’s the reason I have chosen the counseling profession. I may not be able to work miracles but I can be present for a person in need and sometimes that’s enough. Many counselors use treatment techniques to promote healing. I’m still learning about the techniques. It seems to me that the techniques being used are generally different ways of showing people empathy. If I’m right, I don’t know for certain if I am, then empathy is the healer more than any given technique. If empathy is the healer then we all have the power to heal by listening to the story of another unique person.

For those of you who want a more scientific explanation, this part is for you. There is a place in the brain called the hippocampus. According to Paul David Nussbaum in his book titled Save Your Brain, the hippocampus is said to be an area of the brain that decides what will get stored in long term memory. An interesting thing happens when we feel pain that is physical and/or emotional. The hippocampus is highly active. Joy has a similar effect on the hippocampus. We can only make a conjecture about the meaning. It seems reasonable to guess that we were designed to remember pain and joy. If this is the case, then I believe we were designed in this manner as a means of staying balanced and protected simultaneously. We’re supposed to experience pain and joy.

To all you logical people out there, feeling pain and joy lead to intelligence. Intelligence leads to improved decision making ability and improved decision making ability leads to hope. Even though hope is an emotion, it is a logical emotion because the logical path comes from preparation just as hope comes from preparation, also known as pain and joy.

Thanks again for taking the time to read a little about my perspectives. I hope you find the content to bring you appropriate joys and struggles. I also hope you have people in your life that support your growth. Remember that there are counselors in almost every community that would love to get to know your personal struggle. They are bound ethically and legally to keep your information confidential in almost every case. Please feel free to read my very first blog if you would like to know more about why I think going to counseling is a good idea.

Badenoch, B. (2008). Being a brain-wise therapist: A practical guide to interpersonal neurobiology. W.W Norton Company.

Unspoken Rules

Every system has rules. In most cases, the rules are verbalized, written or communicated in some clear fashion. However, every system has rules that are more obscure, making them hard to clearly identify. I refer to these as “unspoken rules”.

In most cases, everyone in the system knows there is some kind of a force acting on them but they may struggle to identify the force when they are dealing with unspoken rules.

Example:
Amy and Ben have been married for 20 years. Ben openly verbalizes his disapproval when he doesn’t agree with something. Amy is much more discrete. They have three children in the home. The oldest is a 14 year old boy. There is also a 12 year old boy and an 8 year old girl. Ben has never been abusive to any of the children or to Amy, but all the children are careful not to “make dad mad”. Ben and Amy both know the sentiment of the children and have different views about it. Ben and Amy recently decided to see a counselor because they can’t agree on how to raise the children anymore. Amy struggles to get compliance and Ben gets compliance without difficulty, often without even having to ask for it. Ben feels like Amy should be sterner with the children and Amy feels like Ben is too tough on the children.


There are an infinite number of things going on this family. You may think Ben is emotionally abusive or that Amy is a passive, weak mom. As a counselor, I’m not looking for right and wrong. Instead, I’m looking for incongruence. Where actions don’t match up with desires, there are often “unspoken rules”. Will there be things I agree with and disagree with in family systems like this? Sure. However, I don’t believe it’s my place to point out my beliefs because it would make me part of the system. The only exceptions are areas of legality. In some areas we have legal definitions of wrong, such as physical abuse. I’m always assessing legal situations throughout the counseling relationship.

In the example above, it’s pretty likely that Ben views his response from his children as a mutual understanding. Amy’s view might be that Ben uses fear based leadership to get the children to do things that make him comfortable. Somewhere in the gap is a rule that may or may not be fully understood by Ben and Amy. For the purpose of changing the focus of what may be viewed as the blame game, I would like to suggest that the 14 year old boy may have figured out the Mom and Dad don’t talk to each other about the children enough. This might suggest the possibility that Ben and Amy can be manipulated if they are pitted against each other. This isn’t to say the 14 year old is a bad kid. The system allows for him to get what he wants in this way. The unspoken rule may be “blame someone else”, or “don’t make Ben mad”. It could also be “Amy is a softy when Ben is pointed to as a mean man”, or “it’s us against the parents”. The list of unspoken rules could go on and on.

You may be wondering how to identify which rule it is. The truth is, it doesn’t really matter at the beginning. I take a guess and ask if it sounds like something that is going on in the home. The clients will assess whether it is one of their rules or not. An interesting thing happens when an unspoken rule is identified. Usually, one or more members of the family have a feeling that it makes sense and they hold on to the rule for a while and, possibly, test it out. Over time, they are usually able to verbalize the, previously, unspoken rule. Once the rule is verbalized, the family can decide how much power the rule holds in the home. Essentially, my goal is still the same as you may have seen on my web page. I am here to help create insightful opportunities. You can look at the blog about Johari’s Window for a clear perspective on what I’m trying to achieve as a counselor.

This blog, however, is intended to help us remember that we have unspoken rules in our systems and that those rules impact everyone in the system, whether it’s in a good way or a way that complicates things. What are the unspoken rules in your family? What about your family of origin (where you were raised)? What are the unspoken rules between you and your spouse or girlfriend? Ask yourself some of theses questions. They won’t be easy to answer. You’ll have to think about them and possibly talk to others about them. You may reflect on old journal entries and notice that there was a rule you always followed but never knew. Whatever the case might be, identifying the rules we conform to is a valuable piece to taking control of our lives. Once we know the rules our systems adhere to, we can decide to use them purposefully rather than having them “happen to us”.

Frequency, Intensity & Duration

For those of you keeping up with me each week, you'll notice I didn't post last week. I was doing some self care by doing some camping. My supervisor at Fairview Clinical Services recently drew my attention to a process this week described by Ray S. Anderson in his book “Self Care”. The process was described like this:


Beginning at the bottom with any event that comes to mind, it is explained that we experience a trigger which gives us an internal sensation that becomes a feeling. From the feeling state, we have the option of going down the thinking path or the emotion path to the application phase. For the purpose of this blog, I’m not going to go into much more detail than that. Instead, I would like to take a moment to focus a little bit on the part in the middle that is bold and in red. I added this piece based on what I learned in Research Methods and Statistics a couple years ago. I’ve found it very helpful.

Frequency-Intensity-Duration

As part of our design, we are intended to measure subtleties. It helps us survive and thrive in our world. When we encounter a trigger that leads us to “thinking” or “emotion” it is sometimes helpful to slow the process down. Slowing down the process gives us the opportunity to more clearly identify the trigger before we get too far away from the trigger. Ultimately, growth or healing is easiest when we can identify what causes us to respond in certain and sometimes unhealthy ways. Could we wait for the behavior (Application Phase)? Sure we could. What I’m suggesting is that when we find ourselves moving from the observation phase to the application phase, we consider three things.

1) Frequency
2) Intensity
3) Duration

These three things provide us great insight. With insightfulness, we can be more purposeful in our decisions and actions. The truth is, people are often hurting others or helping others without even knowing it. Through insight, I believe people can maximize how much good they do for themselves and others.