Diversity of motivation among self-harming individuals

An estimated one in twelve teenagers has committed self-harm. Of those many will continue self-injuring into young adult hood. Yet older adults are not immune to committing this act. In 2003-2004 adults age 25-44 were responsible for nearly fifty percent of reported/discovered self-harm cases.  There are many reasons that people self-harm. These reasons may include self-harming as a survival mechanism, self-harm as an outer expression of inner emotional turmoil, and self-harm as a means to exercise control over one’s environment.
Contrary to popular thought, only one in ten people who make the decision to self-harm are suicidal. The majority of people who cause injury to themselves willfully have a wish to avoid killing themselves. The act of self-harm is developed as a “technique” to cope and survive the afflictions of life. How can we know that this is the reasoning or thought behind the action of self-harm? “Cutters” typically reason out the least amount of damage that will “remedy” the stress intensive situation that they find themselves in, and exercise an enormous amount of restraint in inflicting only a measured amount of damage. Cutters’ common logic is that through this expression of injury, further damage to their selves may be headed off. --------, a former cutter, attests to the reality of this when he says, “Every time that I touched a blade to my skin, I would resist making a larger cut, a deeper wound. Every time that I hurt myself, I did so only in response to what drove me over the edge; Each time the amount of physical damage that I did was the very least that I could muster. I fought to do the least damage I could, no matter how intense the pain that I felt became.” He sums it up rather nicely.
Secondly, self-harm is used as an outward expression of deeper, more complex emotional and psychological phenomena. It is not a diagnosis; it is a symptom. It is a symptom of a struggle that is inherited by victims of abuse, those who lose a loved one, or experience other traumatic events during their childhood. These groups are far more likely to indulge in self-harm. One study conducted by Boudewyn and Liem found that of those college students that reported a history of self-harm, fifty two percent had been sexually abused as a child. Those that self-harm do not simply cut to cut, burn to burn, or mutilate to mutilate. There is a deeper motivation. This motivation is commonly emotional. These motivational emotions are often the results of tragic or traumatic life experiences. It is seldom that a cutter’s motivation is a want for attention.  In fact, most cutters are chameleons.
Self- harm is used as a tool to exercise control in a chaotic environment over which one would not otherwise have any means to control. Among chaos and turmoil such as the loss of a parent or close friend, relational betrayal, divorce of one’s parents, or consistent, one time, or sporadic physical, emotional, or ****** abuse an individual is radically more likely to engage in self-harm. Outside reasoning on this is only speculative. For this reason it is valuable to look at the action from the perspective of those who commit it. Cody, the same individual mentioned earlier says something else that lines up with this common scholarly opinion. He says “I remember the very first time I cut myself intentionally. I was in the ninth grade, in the school bathroom. I had just experienced what I saw as betrayal by my best friend of about ten years. I felt like I lost him. I felt like things were spinning out of control, and I couldn’t control the way I felt about it all. The only way I could feel that control was with something sharp in my hand.” This is characteristic not only of ----- but also of many other cutters.
Cutters are not (necessarily) crazy. On the surface it may appear that cutting goes against the ingrained survival and self-preservation instincts in human beings. This is actually the opposite of the truth. Many who cut feel that if they don’t inflict smaller harm to themselves that they may indeed fall to suicide. They feel that by letting out their pain in increments, and escaping in fragments, that they can slay the thoughts of suicide and urges to escape that they carry. When at the edges of rational, some instincts may take different forms. What may seem counter intuitive – an act of self-harm – becomes the definition of an instinct that it seems to defy. The desire to survive becomes so strong that it is necessary to inflict pain. This is not uncommon to survival situations. For example, the movie 127 Hours reenacts the experience of a man trapped under a boulder in a beautiful and secluded gorge. He cut off his own arm with a dull multi-tool in order to escape death. That act is the epitome of self-harm as a survival instinct.
Cutting could lead to a series of events that tailspin out of control. Loss of control could take the form of the spiral of therapies and prescriptions that would follow if it were discovered that one were cutting , or it could be the accidental slip of a blade gone too far. It could end in hospitalization. It could even end in death. However, those individuals who choose to cut, as long as sober, take precautions to avoid discovery or more injury than is intended. They are meticulous, careful even. They reason out how, where, and when they can cut “safely”. They are very much in control over the act, when they feel they cannot be in control of anything else.
It may rationally appear that pain is pain. That it would make no difference whether out or inward, because whatever its state, the pain is still owned by the individual. However, emotions are often harder to process than physical events. A burning rage, hate or guilt may well be harder to cope with than a burn to one’s arm, leg, or hand. An emotional cut to the bone may be less painful than a physical one. It may be said that the act does not transform the pain, but multiplies it. This in essence may be true, but one form of pain allows a man to ignore another. A pinch may allow a man to ignore the emotional pain of a nightmare. A small cut may allow ignorance of the bigger cut on one’s spirit or psyche.
There are widely varying and increasingly complex variations of motivation and cause of self-harm. They may include, but are absolutely and in no way limited to: self-harm as a coping or survival mechanism, self-harm as a tool to exercise control over one’s increasingly chaotic environment, and self-harm as an outer expression of inner emotional turmoil. To believe that cutting is simple is to nearly deny it altogether. Its essence is complicated. Stereotyping self-harm or self-harmers may well lead to opinions that will ostracize or further encourage the occurrence of self-harm.  Since the motivation and causes of self-harm are undeniably complex, to attempt to brush this under a rock would be to diminish its importance, and to deny healing to those who need to understand it.

It was 98'.
No, it was 99'.
That was the year.
Yeah, that was the year.

I had just landed abroad and knew no one.
Well, I was there with my girlfriend, Page.

I knew her.

We had to get out of the states.
There was nothing for us there.
We were drowning in that nothingness - that lacking future.

Cookie cutters everywhere.

Everything I saw was like an outline of something that had already happened.
I couldn't sleep.
I couldn't ****.
I could barely call my parents to let them know what I was doing.

Nothing really.

Floating downward like a leaf broken from its stem.
I was scared.
I'll admit it.
I was terrified of the next four years.
Twenty-five seemed so far away and so close, all at the same time.

We had a found an apartment to live in while in the U.S.
We were lucky because people we met later on said it was hell trying to find a place after arriving.
I was never too good at that stuff anyway.
I always felt like people were trying to cheat me or something.

It was small.
You would have said you loved it, but secretly hated it.
One could barely stand in the shower.
Want to spread your arms wide?

Forget about it.

There was a balcony though and you could watch the street traffic from above.
People look so small when your high up.
Down the street, there was a large theatre where they filmed movies.
I rarely saw them shooting, but I could tell it was a good place to.
It was beautiful at night when the lampposts would flicker on, orange spilling on the street.
Everything was damp in the Fall when we first arrived.

"What do you want to do today?" I asked her. She was laying face down on the bed.
Whenever she was hungover, she would do that.
All the covers and pillows over her face, blocking out the world and its light.
I did the same thing, so I couldn't really say much.
We were hungover a lot those first couple months.
Then came the jobs and everything changed...mostly.

She moaned something that I couldn't understand.
I was standing by the window, staring at the pigeons and crows perched on the roof across from us.
They had made a little nest under one of the shingles.
Clever little ******'s.

"Look at those things," I said.
The coffee I was drinking was bitter and made from crystals.
It gave me a headache, but it was cheap and we were broke.
I stepped back to get a better look at their nest and knocked an empty beer bottle around.

She moaned again and rose up from bed, kind of like a stretching kitten or a cat.
Her back was arched like a crescent moon and she stunk of ***** and Sprite.
The blankets were twisted and crumpled and she was tangled in them like a fly in a spiders web.
I went into the kitchen and poured out my coffee, thinking of what to do with the day.

"Breakfast?" she asked me from bed.
My back was to her, but I knew she wanted me to make it.
I put the electric stove on and opened the refrigerator.

"No eggs," I said back to her, "I'll be right back."

She moaned and slithered back into bed.
I threw my jacket and slippers on and made my way downstairs.

"Dobry den," I said to the cashier.
He was a tiny vietnamese man with a extremely high pitched voice.
I struggled to stifle a laugh every time I came in.

"Dobry den," he said back, sounding like air escaping from a balloon.

"Dear God," I thought, "How does his voice box do it?"

I went straight to the eggs, pretending to cough.
All around me were packaged sweets and rotten vegetables and fruit.
There were half loaves of brown, stale bread wrapped lazily in thin plastic.
Canned beans, noodle packets, and cardboard infused orange juice lined the shelves.
Where were the ******* eggs?
We needed milk too.
Trying to drink that crystalized coffee without it was torture.
I don't even know how I did it earlier.
"I must be getting used to the taste..." I thought.

I opened the single refrigerator they had in the place.
It was stocked with loosely packaged cheese, milk, beer, and soda.
There they were, those ******* eggs, right next to the yogurt.
I looked at the expiration date of a small carton of chocolate milk and winced.
"Someone could die here if they weren't careful," I whispered to myself.

"Everyding O.K.?" I heard the cashier squeak behind me.
I turned and nodded and showed him the eggs.
He was suspicious I was stealing something.
It was ironic.
I put the eggs on the counter and handed over what the cash register told me.

"There you go," I said and handed him the 58 crown in exact change.

"Děkuji," he peeped.

His voice sounded like a stuffed animal.
I nodded, smiled, and quickly got the hell out of there.

"You know the guy that works at the shop across the street?" I asked the body still in bed.
Well, she was up now, back up against the wall with her laptop on her lap.
"You mean the guy that has the voice of a little girl?"
"Exactly. I was just in there - getting these eggs - and I nearly laughed in his face."
"That's mean," she frowned, staring at her laptop.
Many of our conversations were with some kind of electronic device in between us.
We needed to work on that.
"I didn't laugh at him directly."
She smiled and nodded and moved down the bed a little more.
Only her head was resting on the pillow.
I cracked two eggs and let them sizzle there in the butter and the salt.

"So, what do you want to do today?" I asked Page, "It's not too cold out. We could go on a walk."
"Where?"
"I don't know. Over the bridge and maybe down by the water."
"It's going to be so cold," she shivered.
"I was just out there in slippers and a t-shirt and I was fine."
"That's because you're so big. I'm tiny. I don't get as much blood flow."

I flipped the two eggs and looked down at them.
Golden and burnt slightly around the edges.
******* perfect.
Now, just gotta wait a little on the other side and make sure to not let the yolk harden.
I hated that more than anything in the world.
Well, that and hearing **** poor excuses like it being too cold.
It was nice out.
She'd be fine.

"Come on," I sighed. I did that a lot. "It'll be fun."
She looked up at me from her computer with a dead look in her eye.
"What?" I asked her.
"You're such a...nerd," she said.
"No I'm not."
"You're so weird. Some of the things you say sometimes..."
"Like what?"
"Let's go on a walk."
She exaggerated the word walk.
I laughed and knew I was being a little too excited about a walk.
"Yeah. So? What are you doing? You're just laying there doing nothing."
"It's my day off," she scoffed, jokingly.

We were unemployed.
Everyday was a day off.
This was not something to bring up.
It was touchy subject.
One had to go about it...delicately.

"We need to find jobs," I stated, "And we can probably ask around or look for signs in windows."

"Oh JESUS," she gagged, coughing and diving back under the covers.

"I'm just thinking ahead so we can stay here. There's got to be something out there we can do."

"Like what?" she asked, her voice muffled by blankets.

"I don't know...something," I mumbled, trailing off as I flipped one of the eggs, "Perfect."

After breakfast, Page finally got out of bed and took a shower.
I tried to sneak in there with her, but, like I said before, one could barely fit themselves in there.
We compromised to have *** on the bed, though I did miss doing it in the shower.
As Page got dressed, I watched her slip those thin black stockings on, half reading a magazine.
I had gotten a subscription to The Review because I was trying to become a writer.
I thought, maybe if I read the stuff getting published - even the bad **** - it'll help.
Later, I realized, this was a terrible idea, but I enjoyed the magazine all the same.
Page finished getting dressed.
I jumped into whatever clothes were on the floor and didn't stink.
Then, we were out the door on Anna Letenske street, looking at the tram, downhill.


"I can see my breath," Page said, "It's cold..."

"Alright," I said as both of us ran across the street, "It's a little cold."

"But it's ok because I'm glad were out of the house."

"If we would have festered there any longer, we would have stayed in there all day."

"And missed this beautiful day," she said mocking me, putting both of her arms in the air.

The sky was gray and overcast and a single black crow flew over us, roof to roof.
No one was out, really.
It was Sunday and no one ever really came out on Sundays.
From the few czech friends I had, they explained to me this was the day to get drunk and cook.

"Far different then what people think in the States to do," I remember telling him.
"What do you do, my friend?" he had asked. He always called me my friend.
It was a nice thing to do since we had only known each other a couple weeks.
"Well," I explained to him, "Some people go to church to pray to God."
He laughed when I said this and said, "HA! God? How many people believe in God there?"
I had heard through the news and some Wikipedia research Prague was mostly atheist.
"A good amount, I'm pretty sure."
"That's silly," he scoffed, "Silly is word, right?"
"Yep. A word as any other."
"I like that word. What else do they do on Sunday?"
"A lot of people watch football. Not like soccer but with..."
"I know what you talk about," he said, cutting me off, "With the ball shaped like egg?"
I nodded, "Yes, the one with the egg shaped ball. It's popular in the Fall on Sundays."
"And what is Fall?" he asked.
You can see our relationship was really based on questions and answers.
He was a good guy, though I could never pronounce his name right.
There was a specific z in there somewhere where one had to dig their tongue under their teeth.
Lots of breath and vibration that Americans were never asked or trained to do.
Every czech I met said our language was a high contradiction.
Extremely complex in grammar and spelling, but spoken with such sloth.
I don't know if they used the word sloth.
I just like the word.

As we waited for the tram, I noticed the burnt orange and red blood leaves on the ground.
"Where had they come from?" I wondered. There were no trees on the street.
Must be from the park down the block, the one with the big church and the square.
There were lines of trees there used as leaning posts for the bums and junkies as they waited.
What they were waiting for, I never knew.
They just looked to be waiting for something.
I kicked a leaf into the street from the small island platform for the tram.
It swept up into the air a couple inches, and then instantly, was swept away by a passing car.
I watched as it wavered in the air, settling down the block in the middle of the road.

"Where's this trammm," Page complained.
Whenever it was cold out, her complaining level multiplied by a million.
"Should be coming soon. Check the schedule."
"Too cold," she said, "Need to keep my hands in my pockets."
I shook my head and looked at the schedule. It said it would be there at 11:35.
"11:35," I told her, still looking at the schedule. There was a strange cross over the day of Sunday.
"You mad?"
"No," I said turning to her, "I just want to have a nice day and its hard when you're upset."
"I'm not upset," she said, her teeth chattering behind her lips.
"Complaining I mean. We can go back home if it's really too cold. It's right there."
"No," she looked down, "Let's go out for a bit. I just don't know how long I'll last."
"Ok," I shrugged.
I looked up the street and saw our tram coming; number 11.
"There it is," I said.
"Thank God," Page exhaled, "I feel like I'm about to die."

Even the tram was sparse with people.
An empty handle of cheap liquor rattled in the back somewhere.
I heard it rock back and forth against the legs of a metal seat.
"Someone had a night last night," I thought, "Hope that's not mine."
We had gone to some dark bar with a lot of stairs going down - all I really recall.
Beer was so **** cheap there and there was always so much of it, one got very drunk easily.
I couldn't even really remember who we met or why we went there.
When everything's a blur in the morning you have two choices:
Feel guilty about how much you drank, lie around, and do nothing or,
Leave it be, try not to think about it, and try and find your passport and cell phone.

We made our transfer at the 22 and rode downhill.
Page looked like she was going to be sick.
Her sunglasses were solid black and I couldn't see her eyes, but her face was flushed and green.
"You alright?" I asked her.
"I'm fine," she said, "Just need to get off of this tram. Feel like I'm going to be sick."
"You look it."
"Really?" she asked.
"Yeah, a little bit."
"Let's get off at the park with the fountain. I don't want to puke here."
"Ok," I said, smiling, "We'll get off after this stop."

We sat down on one of the benches that circled around the fountain.
It was empty and Page was confused why.
"Maybe to save money?" I suggested.
"What? It's just water."
"Well, you gotta' pump the water up there and then filter it back out. Costs money."
"Costs crown," she corrected me.
"Same thing," I said, putting my arm around her, "There's no one here today."
"I know why," she stated, flatly.
"Why?"
"Because it's collllllllld and it's Sunday and only foreigner's would go out on a day like this."
I scanned the park and noticed that most of the faces there were probably not Czech.
"****," I muttered, "You may be right."
"I know I am," she said, wiggling her chin down into her jacket, "We're...crzzzy."
"We're what?" I asked. I couldn't hear her through her jacket.
She just shook her head back and forth and looked forward, not wanting to move from the warmth.
Dogs were scattered around the brown green grass with their owners.
Some were playing catch with sticks or *****, but others were just following behind their owner's.
I watched as one took a crap in the center of the walkway near the street.
Its owner was typing something on their phone, ignoring what was happening in front of him.
After the dog finished, the owner looked down at the crap, looked around, then slunk off.

"Did you see that?" I asked Page, pointing to where the owner had left the mess.
"Yeah," she nodded, "So gross. That would never fly in the states."
"You'd get shoulder tackled by some park security guard and thrown in jail."
"And be given a fat ticket," she said, coughing a little, "Let's get out of here."
"Yeah," I agreed, "And watch for any **** on the way out of here."

We made our way out of the park and down the street where the 22 continues on to the center.
"Let's not go into the center. Let's walk along the water's edge and maybe up to the bridge."
"Ok," I said, "That's a good idea." I didn't want to get stuck in that mass of tourists.
I could tell Page didn't either. I think she was afraid she might puke on a huddle of them.
We turned down a side street before the large grocery store and avoided a herd of people.
The cobble stones were wet and slick, glistening from a small sliver of sunlight through the clouds.
Page walked ahead.
Sometimes, when we walked downtown in the older parts of Prague, we would walk alone.
Not because we were fighting or anything like that; it was all very natural.
I would walk ahead because I saw something and she would either come with or not.
She would do the same and we both knew that we wouldn't go too far without the other.
I think we both knew that we would be back after seeing what we had wanted to see.
One could call it trust - one could call it a lot of things - but this was not really spoken about.
We knew we would be back after some time and had seen what we had wanted to.
Thinking about this, I watched her look up at the peeling paint of the old buildings.
Her thick black hair waved back and forth behind her plum colored pea coat.
Page would usually bring a camera and take pictures of these things, but she had forgotten it.
I wished she hadn't.
It was turning out to be such a beautiful day.

We made it to the Vlatva river and leaned over the railing, looking down at the water.
Floating there were empty beer bottles and plastic soda jugs.
The water was brown, murky, and looked like someone had dumped a large bag of dirt in there.
There was nothing very romantic about it, which one would think if you saw it in a picture.
"The water looks disgusting," Page said.
"That it does, but look at the bridge. It looks pretty good right

Go to sleep, and shut your eyes,
Please dream of broken butterflies
That tore their wings against a thorn.
For you know the pain that they have borne.
Silver metal, shines so bright.
Scarlet blood, that feels so right.
Dream of the blood that's trickling down,
And wake up just before you drown.
The moonlight's shining off your tears
Bleed out all your petty fears.
So tonight when you start to cry
You better whisper the cutters lullaby:

Hushabye baby, you're almost dead.
You don't have a pulse and your pillow is red.
Your family hates you, your friends let you bleed.
Sleep tight with a knife, cause it's all you'll need.
Rockabye baby, broken and scarred.
You didn't know life would be this hard.
Time to end the pain that you hid so well,
And down will come baby, straight back to hell.