“I cut myself.”
It’s a bald statement, which I repeatedly hear in confessions of high school youth, one offered along with more mundane sins, such as disobeying one’s parents or stealing a jacket at school. Sometimes it’s followed by a specification. The young person behind the screen will add, “On my stomach.”
In one face-to-face confession, the young man showed me his arms.
In three decades of hearing confessions, I’d developed the attitude of Qoheleth, the author of Ecclesiastes: “There is nothing new under the sun.” But after twenty years of primarily scholastic ministry, I have returned to parochial ministry. Hearing so many confessions about “cutting” is new for me.
It’s important to know that millennials, like other post-baby boomer generations, have little reticence about confessing sins to a priest. I hear a lot of high school age confessions, but they don’t necessarily represent a resurgence in faith.
When asked to do so, contemporary youth will make confession of sins on a youth retreat, or as part of confirmation preparation, but this isn’t inevitably a personal expression of piety. It’s simply not the onerous, oft-shunted task that it was for their grandparents. They’ve grown up in a culture premised upon self-disclosure, even self-promotion.
I’m hearing of cutting, simply because I’m there to listen.
Hearing confessions is something of an ecclesial triage. Much of what comes in is routine, even trivial. When it’s not, the confessor must make immediate, often consequential decisions. How should one respond to what one has just heard? Which is the greater danger to the soul in front of you? Saying too much or too little?
When in doubt, as I was in hearing of so much self-mutilation, it’s best to opt for the latter, but pastoral responsibility sent me in search of resources, which I want to encapsulate and share.
Cutting oneself is a new, rising phenomenon in Western cultures. It first became a focus of psychiatric interest in the 1960s. In her 1999, A Bright Red Scream, journalist Marilee Strong estimated that perhaps one in five adolescents—of all races, ethnicities, and economic classes—engage in the process. That corresponds to my experience.
First, what cutting is not. It is neither a part of group rituals, nor an adolescent trend of narcissistic attention seeking. It may spread by suggestion, but only to those with an underlying predisposition.
Cutting isn’t failed suicide. It isn’t targeted at arteries, veins, or major tendons. Already in 1938, Karl Menninger suggested that deliberate self-injury wasn’t an instance of self-loathing. Rather, it was a groping towards self-healing and self-preservation, a compromise between aggressive suicidal impulses and the survival instinct itself.
“In this sense it represents a victory, even though sometimes a costly one, of the life instinct over the death instinct,” he wrote.
Dr. Eileen Russell, a clinical psychologist who graciously reviewed this article, and who has just authored a book for psychotherapists on resilience, underscored this point.
“Even our conservation- and survival-oriented self-protective strategies (which may include those that appear to be [and are] self-harming) are manifestations of resilience. I think of the motto of resilience being all things a person does ‘on behalf of the self.’”
Along with burning, head banging, and pulling out body hair, professionals designate cutting as Non-Suicidal Self-Injury (NSSI). None of these activities are about enjoying pain. The young person cutting is under strong emotional duress, typically centered in the family, the result of emotional, physical, or sexual abuse.
The vast majority of cutters are females, who are also most at risk for sexual abuse, the single largest factor contributing to self-mutilation.
Dr. Martina Verba, a clinician whose practice includes many who self-harm, correctly chided me for writing “cutters” in that last sentence. It reduces people to an activity. “Cutting is what they do, not who they are.”
Sometimes the childhood trauma of sexual abuse lies dormant until the onset of puberty, a process that mysteriously seizes control of the young girl’s body, producing abrupt, profound changes. Cutting is often linked with eating disorders, also more frequent among women. Some have suggested that both practices are misguided attempts to retake control of one’s self: thinness is a type of self-sufficiency while bleeding is controlled catharsis.
Cutting may also be a response to depersonalization, a way of combating feelings of unreality and emptiness. Isolation would be a characteristic shared by young women in general and by immigrants in particular. In both cases there is a sense of not being heard, or validated, by the larger group.
Those with inadequate verbal skills, and who are emotionally isolated, are most likely to cut, which explains its high prevalence among the young people with whom I work. Many are first generation immigrants, who, although typically bilingual, don’t feel comfortable in either the English they use at school or the Spanish of their homes.
It’s not a question of proficiency. By most standards, they are considered fluent in both languages, yet neither tongue offers their souls a home. In conversation and confession, I often hear their short sentences punctuated with the English word “Yeah,” used as a question. “My father and I don’t really get along. He’s very disappointed in me. Yeah?”
It is as though the very effort to express what is happening in their lives requires approbation.
The child’s inability to understand and to respond verbally to abuse or neglect leaves the later adolescent a victim of post-traumatic stress disorder. Russell added, “Also, very important for people who have been traumatized, particularly at home, is that often the trauma is on top of a lack of building up of ‘self-regulatory’ skills so that people do not know how to manage strong emotions and may not know how to use (or trust) others appropriately to help them.”
Incidentally, veterans are also significantly at risk of self-inflicted injuries. Both groups share higher levels of hypersensitivity to stress, intense response to frustration, social alienation, and impulsivity.
Often the adolescent wasn’t abused, but experiences an isolation that stems from an inability to connect emotionally with parents. This may be due to stresses that the adults themselves are experiencing, such as substance abuse, divorce, ill health, or simply the exigencies of being an immigrant, struggling to raise the family’s standard of living.
Cutting represents an unhealthy, even dire, turning inward. Intense physical pain is inflicted upon the self in order to mask and to numb emotional pain. Adults for whom the adolescent motivation behind cutting is incomprehensible may find helpful this explanation, offered by psychotherapist Steven Levenkron in Cutting: Understanding and Overcoming Mutilation.
“If a person proceeds despite this pain, that means that he or she is motivated by something stronger than the pain, something that makes him or her capable of ignoring or enduring it.”
What would make intense pain a preferred option? “Fear of abandonment is the greatest fear a child has. It far supersedes the fear of death, which, to a child, is an abstraction at best.”
Consequently, “If a child could designate a parent’s act as ‘wrong,’ then the child would have to accept that he or she has an incompetent parent. This is the emotional equivalent to having no parent at all.”
This explanation corresponds to my confessional experience. A young person is much more likely to confess that she “disappoints and saddens her mother” than she is to say that her parent fails in the role of being a parent. One can’t expect a child to have the perspective that only age and experience bring.
Priests should know that they are not psychotherapists. Confession is a sacramental celebration of our reconciliation, accomplished in Christ. As such, it does not depend upon the therapeutic insights of the confessor.
However, that’s easier to assert than to accomplish, especially with immigrant populations. Those who have no other access to therapy often seek it in the sacrament, regardless whether they realize that they do so.
Specifically Catholic responses to cutting are almost non-existent. My web search revealed only one parish, St. Luke’s in Houston, which addresses the issue with very helpful online information and resource links.
How should a confessor, a youth minister, or a parent respond to a young person who confesses to cutting?
- Do not ignore the revelation. It is not easily offered. Something very important has happened in the life of the cutter. In at least this instance, verbal communication is being used in response to their trauma rather than self-mutilation. That he or she has been heard must be validated. Learning to talk about the trauma experienced is the path they must follow in order to be healed.
- Do not respond with repulsion or fear. The cutter’s candor must be met with calm charity. Nothing separates us from the love of Christ.
- However small the opportunity for response, both the gravity of the problem and the acceptance of the person need to be communicated.
- Always direct the young person towards a resource. This requires great tact. They haven’t acknowledged, and may not even know, that they need professional assistance, which might include behavioral modification, family therapy, and medication. Stridency will likely make them skittish. Initially, you will probably be limited to suggestions that they follow-up with you to explore their options for assistance.
In Bodies under Siege, Armando Favazza writes, “The short answer to the question ‘Why do patients deliberately harm themselves?’ is that it provides temporary relief from a host of painful symptoms such as anxiety, depersonalization, and desperation. The long answer is that it also touches upon the very profound human experiences of salvation, healing and orderliness.”
Favazza would place contemporary assaults on the body in the larger context of cultural history. Shamans, and some Christian ascetics, employed self-injury for purgation and illumination. Cutting one’s self for the dead is prohibited in Leviticus (19:28), but circumcision was a symbol of incorporation into God’s covenantal community.
In many indigenous societies, cutting has been part of highly regulated rites of passage to adulthood, and its subsequent scarring is received as a sign of one’s full communion with the tribe. Some creation myths view the cosmos itself as emerging from the wounds of divine figures. Thus “the individual human body mirrors the collective social body, and each continually creates and sustains the other.”
As profoundly unhealthy as self-injury is, it represents a deep, intuitive search for wholeness. Cutting isn’t self-loathing. It is an inarticulate cry for help.
In Wounded Body Dennis Slattery writes, “Our wounds, scars, and markings may be the loci of a place that put us in the most venerable and vulnerable contact with the world, with divinity, with one another, and with ourselves. As such, the body may invoke an entire cosmology; it is the cosmic in its symbolic nature.”
If Favazza and Slattery are correct, then contemporary cutting represents a unique challenge to Christianity. Can there be a more telling illustration of sin’s effect, or a more trenchant indictment of our inability to prevail against sin, than the self-scarring of young skin, painfully incised, wounded in response to evil and alienation?
One cutter told Strong, “It’s like when you see the blood flowing out, the pain and fear are flowing out with it. Or at least I want them to. I guess they never really do.” How lamentable, that the Christ we preach is still wounded and cries out to us in the blood of our youth.
The Gospels present a God who heals us and calls us into fellowship. St. Mark’s Gospel reports Jesus freeing a demon-possessed man, who would cry out night and day “among the tombs and on the hillside,” cutting himself with stones. He is restored to his family, where he is to “announce to them all what the Lord in his pity has done” (5: 1-20).
Young people need to hear our Gospel. How do we communicate to teens that in Christ we have a voice, that, by his wounds, we are healed, and that forth from his wounded side a new fellowship flows?
First, be there. Second, listen. Then, you may have the opportunity to tell them.
Fr. Terrance Klein is a former seminary administrator and university professor of theology. He now pastors two rural parishes in central Kansas. He’s the author of Vanity Faith: Searching for Spirituality among the Stars.