Should I stop cutting?

How I managed to get away from the crack

Warning: This text addresses self-harming behavior. This can be terrifying and triggering for some readers.

I'm under water. Can't breathe, threatens to drown. Sunk too low for anyone to help me. I put the blade on. Squeeze and pull. I drift upwards in a flash, the surface of the water rushing towards me. I stick my head out of the water, take a deep breath and stop crying. The psychological pain is over. I'm not drowning, I'm alive I am fine. The whole burden is gone. A thousand stones fall from my heart. The
Warm blood forms small rivers on my skin and flows down. It drips onto the tiles.

People of all genders do it. They cut their arms, burn, scratch, bite, pinch each other. Three percent of the population said they were injured once, 0.3 percent were injured several times in the past year. We're not talking about blunders, clumsiness, or accidents - we're talking about voluntary self-harm.

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Non-suicidal self-harming behavior (NSSV) is a "repetitive (repeated) destruction of body tissue that is self-inflicted, is undertaken without suicidal intent and is socially unacceptable", defines Prof. Dr. Paul Plener, senior physician in charge of the Ulm University Hospital.

Forearms, upper arms and thighs are often injured, according to Prof. Dr. Tina In-Albon, Professor of Clinical Psychology and Psychotherapy for Children and Adolescents at the University of Koblenz-Landau. Why? That is the most pragmatic. In addition, says Plener, those affected are free to show or not show these parts of the body. Injuries to the face or cleavage could not be hidden so easily.

The inability to deal with emotions

Why do people do this? Why did i do this From the outside, self-damaging behavior is difficult to understand. “That hurts,” I was often told.

Yes it hurts. Sometimes. When my soul is suffering so much and I don't know how to help myself, when there is no one to talk to, when the mental pain becomes unbearable and I have to do something on the spot to make it better - then I consciously accepted physical pain to cover up emotional pain. What remains are ugly scars and shocked looks from bystanders.

Self-harm is emotion regulation, explains Plener. In-Albon: “For most of those affected describes, it is the only way to deal with their emotions at this point in time. That means they have no other strategies. "The problem: In the short term, the behavior is effective. The negative state is over for now. People who injure themselves regularly have a reduced feeling of pain. However, this change regresses as soon as you stop hurting yourself.

The emotions are discharged as soon as the first cut is made. Overwhelming. Sometimes I would catch myself with a smile on my face. The physical pain comes later when the fresh wounds start to piss and itch.

The behavior is copied

I often wish I had never started. I injured my skin superficially with paper clips and safety pins. I switched to scissors. In the clinic, the other patients made fun of my wounds. That is not a real scratch at all. They showed me their methods. After that, I mainly injured myself with individual, sterile packaged razor blades. The cuts got deeper from time to time.

In-Albon reports that there is a risk of infection at school or in the clinic. Young people would tend to imitate the self-harming behavior of their peers there. You can also find a lot of inappropriate material on the Internet that could possibly trigger the behavior: To prevent infection, those affected should not show fresh wounds or communicate or that the behavior is a helpful strategy for them to deal with emotions.

Once learned that chinking helps, it feels like an addiction. A vice that is impossible to get rid of - you think. An urge develops which, as In-Albon says, is almost more stressful for many than the self-damaging behavior itself. NSSV is not seen as a dependency disease. In Germany, NSSV is recognized as a symptom - for example in borderline personality disorder (BPD) - but not yet as an independent disease. But not everyone who injures themselves has BPD, explains Plener.

Find harmless substitutes

I was ashamed of my behavior. I bandaged my wounds and found new excuses for the bandages. For years I wore long-sleeved tops in summer and white or skin-colored bandages in physical education classes. At some point I dared to show the scars openly.

I was often assumed to be looking for attention. “From my point of view, that's the big stigma attached to the NSSV. This is very worrying because it forms a barrier for many to seek help, ”says Plener. The primary reason for self-harm is regulation of emotions. Especially since the majority of those affected claim to be hiding their scars and they have been twisted and injured for years. These are clear arguments against seeking attention.

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Many start behaving between the ages of twelve and 14. The majority of adolescents who injure themselves in adolescence stop doing so in adulthood. It does not have to remain a lifelong phenomenon that you can no longer get rid of, explains Plener. However, the NSSV is often replaced by alcohol or drug consumption.

If those affected want to abandon the behavior they have learned, they learn so-called skills in dialectical behavioral therapy (DBT), i.e. substitute actions that are used instead of self-harming behavior in states of tension. They should provide short-term relief instead of causing long-term damage. Skills include putting ice cubes on your skin, smelling ammonia or biting into chili peppers. It is important to take the time to learn the skills, says Plener. "You have to try new strategies and accept that it doesn't work as well as self-harm."

Things that could help you to distract yourself from the urge to self-harm can be collected in a so-called skill box that is always close at hand. In my box there were ammonia smelling sticks, ahoy fizzy drink, chocolate, a rubber band to squeeze and nice letters that friends had written me to cheer me up.

How other people can react

If I told my friends that I had done it again, they usually reacted with anger and incomprehension. Fellow patients hit me for my inability to handle emotions.

In-Albon advises anyone who notices self-harming behavior among friends or siblings shouldn't be shocked, react with rejection or punishment. Accepting the young person doesn't mean accepting the behavior, she explains. It is important to dare to speak to them and to show respectful curiosity, emphasizes Plener. Questions like "How does this help you?" Or "Why are you doing this?" Could be a good way to open the conversation. Conversations with friends or parents, however, never replace a therapy that is urgently recommended at NSSV.

In most cases, people do not self-harm with the intention of suicide, but, according to In-Albon, those affected should be asked about suicidal thoughts, plans or attempts. "Also important here: asking about suicidality does not give anyone the idea."

How I managed to get away from the crack

I injured myself for six years. Once started, it was hard to get out of it. It became a habit, an automatism. Every cut was a release. Shortly after the liberating effect wore off, I regretted my behavior. Again and again. It was like a vicious circle. The motivation to get rid of the behavior should come from within. As soon as you are urged to quit from outside, but you don't want to do so yourself, the successes remain small.

I made a decision a year and a half ago: I want to stop. I want to be able to show my arms in public, I want to be able to do normal sport without presenting fresh wounds or bright red scars and having to reap strange looks. I bought Bi-Oil, a skin oil that was supposed to improve the appearance of fresh scars. The promise: The scars fade faster with the application. I rubbed my arm with this oil every evening and after a short time the first changes were visible.

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At the same time, I downloaded the Quitter app and used it to document how long I had been clean - this is what those affected call the state of being free from self-harm. My friends supported me a lot in my project. When the urge to self-harm arose, I sometimes bought myself razor blades on the move, told my friends about it - and threw the blades in the trash when they were asked. Not only did I do it for my friends, but also for myself.

I lasted a whole year with these methods. Then I discovered ammonia odor sticks, which immediately got me out of extreme tension because of their intense smell. Suddenly I felt completely normal again - as if I had injured myself. The difference: the olfactory sticks are harmless. No blood flows, no scars appear.

Affected people know how difficult it is to stop the behavior from now on. But from my own experience I can say: It is not impossible. As Plener also explained, adolescents mostly abandon self-harming behavior in adulthood. You stop doing it again. It's not hopeless - you can do it too.

to get help

Have you been feeling listless for a long time, maybe even having thoughts of suicide? At the telephone counseling you can find help online or by telephone on the free hotlines 0800-1110111 and 0800-1110222 around the clock. You can get anonymous and confidential advice there on which form of therapy could help you.