Non-suicidal self-injury (NSSI) scares most of us. In the deepest, darkest corners of our primal beings, whether we are consciously aware of it or not, we associate blood with death and dying. This isn’t wimpy or weak; it’s not the mark of a fragile soul nor is it the sign of an overly protective parent. On the contrary, our primitive associations are adaptive. If we see blood and automatically think death, we are more likely to take some kind of life-saving action, like rushing to a person’s aid, calling 911, or grabbing something to use as a bandage. Immediately associating blood with a threat to life makes us alert, focused, and more readily helpful.
As a matter of fact, we as a human race have a long history of associating blood with some kind of life force, and the loss of it with death. In the Bible, Jesus asked his disciples to drink his blood, calling it the “blood of life.” Tribal peoples along the Ivory Coast and in some parts of South America have bloodletting rituals that celebrate the gift of life granted us by a great spirit. As the Twilight books have retaught us, even vampires have to drink blood in order to stay alive.
So it makes sense that people, parents especially, panic when they discover that someone is cutting their own body open: they think they’re trying to kill themselves. In the parents’ defense, the most common form of self-injury is, in fact, cutting. And the most common place for it is, yes, the underside of the arm. Which is very close to the wrist. Which ends up looking a lot like suicide. So, can we really blame them for worrying that their son or daughter is trying to die?
Fortunately, it appears that the media is fighting its share of the good fight and helping us clinicians inform the public that NSSI is not suicidal. On the contrary, NSSI is the opposite of suicide. Self-harm is a form of coping (yes, a graphic one). I often explain to parents, as controversial as this may sound, that as long as we’re cutting, we’re coping. And coping is a statement of life, not death.
So, as hard as this may be, I ask parents (and other loved ones) of self-injurers to step back and try to look at it from a different but familiar perspective: It’s just blood. Think of all the times we’ve fallen off bikes, banged our foreheads on tables, scratched up our arms in the garden, or taken a chunk off our fingers while chopping carrots. We all healed. They’re just cuts. We do a heck of a lot worse to ourselves in boxing matches and motorcycle competitions. Don’t get me started on football and hockey.
Cutters are smart. Their cuts are superficial and rarely go deeper than the top layer of the epidermis. They don’t lose a lot of blood, and they know what’s dangerous and what’s deadly. They’re usually inflicting the equivalent of a cooking injury on their arms, legs, or wherever else, and it’s just blood. It’ll heal. They don’t need immediate hospitalization — they just need therapy, and a little Neosporin.
– Angela Kahn is the Founder and Director of the Kahn Institute for Self-Injury.