There are many ways to hurt yourself.
You can make mistakes, says things you shouldn’t, get into relationships you have no business being in, or accept responsibilities you have no training for. Some of these are indirect and take days or months or even years to manifest themselves to you, even though others may have seen the problems long before you did.
Some hurts are long, slow, and painful. They fester, ooze and seep into all parts of your life as surely as a blood-borne infection travels to the far reaches of your body before it kills you if left unchecked. These hurts can be self imposed, as when one stays in a career entered because of family tradition and not passion. They can be foisted upon you by others, as we see in sexual abuse or neglect that steals away the innocence of childhood and pulls a dark veil down over adulthood like a musty bedroom window shade.
Some hurts are self inflicted, surgical, quick. They serve different purposes.
I see a lot of people who are cutters. Their term, not mine.
They use pocket knives, straight razors, kitchen knives, box cutters to inflict wounds on themselves. Often, these are on the inside of the wrist or arm, neat row after neat row of older-to-newer red lines in various states of healing that read like an archaeological dig of psychological pain and suffering. Sometimes they are on the back of the arms, hiding in plain sight. Sometimes they are on the abdomen, always there but hidden behind this season’s tank top and that one’s bulky sweater. Other times they live on the inside of the thighs, a quiet altar of introspective pain that is shared with no one, visible to no one.
Staff at emergency departments, like other professionals, get very antsy and go into action when they see four inch longitudinal cuts on wrists requiring sutures. The cleaning, anesthetizing, and re-approximation of cleanly sliced skin can be done by any competent health profession with eyes closed and mind on the next trauma coming through the door.
Problem is, every cutter is then summarily stamped suicidal in big red virtual block letters on their chart. Cutting equals bleeding equals exsanguination equals death equals very bad undesired outcome equals emergency psychiatry consult.
All that glitters is not gold, and all that cuts is not seeking death.
Cutters tell me differently, and I believe them.
“It helps me feel something other than the pain in my life.”
“It takes my mind off my mom’s death.”
“It grounds me. It helps me focus better.”
“I like watching the blood trickle down my arm and drip onto the table. It makes me feel real.”
“It makes me feel like I’m in control, even if it’s just for a little while.”
Cutting of the sort I’m describing to you rarely portends death.
On the other hand, it is a sure sign that someone is in pain and wants to live.
It should be viewed as a sign that someone is reaching out.
As surely as clean lacerated edges come together and heal, albeit leaving visible scars, emotional slashes can be healed too.
The scars will be there, unseen, most likely forever.
The difference will be that the person will put down the cutting tools and learn how to stitch themselves up emotionally when life rips something open again.
As it inevitably, inexorably is wont to do.