by Gregg Johns

Created on: January 09, 2008

As a psychologist for 20 years, I have seen several different manifestations of self-mutilation in clients. My personal clinical experiences have paralleled those described in the writings of Steven Levenkron, Marsha Linehan, Armando Favazza, and Merilee Strong in that self-mutilation is a language of pain. I have had multiple clients state, "This may sound crazy to you, but I cut myself to avoid killing myself." These statements are a testament to the function of self-mutilation as an emotional management tool, although maladaptive, as opposed to suicidal gestures.

Self-mutilation can be viewed as an emotional diary transcribed on the body of the individual. This behavior can serve different functions for different individuals. For some, cutting, scratching or burning may be a way to channel or express intense emotional pain or anger, to "feel alive" after feeling emotionally numb or detached, maintaining control or emotionally averting the control assumed by a perpetrator, or a means of self-punishment associated with abuse. This behavior is further complicated by the body's release of endorphins, which are the brain's natural chemicals similar in composition to opiates. These neurochemicals are associated with the "runner's high" or the body's calming effect associated with serious injury. I have often had to draw the analogy for my clients that self-mutilation is their drug of choice or another choice in their chemical repertoire.Just like with ingested opiates, the self-mutilator can build up a tolerance and must cut deeper or more severely resulting in serious physical damage and/or medical emergencies. This poses a great risk both for physical health and social ostracizing due to noticeable scarring and wounds.

Persons with borderline personality disorder suffer on emotional, social and psychological levels. This disorder is a continuum rather than a distinct entity with individuals experiencing different clusters of symptoms. The disorder develops into a way of life, maladaptive coping, and character traits. It involves intense emotions and mood swings, feelings of distrust and ambivalence of feelings, impulsivity, fear of loneliness and managing boredom, and feelings of depersonalization. Individuals experiencing the disorder tend to be more sensitive, emotional and higher strung. They have been reared by a parent with borderline traits who showed much inconsistencies in nurturing, discipline and limit-setting. They have often been victims of physical,

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