The Stories Behind the Scars
Sociologists Peter and Patricia Adler take an unprecedented look at the world of self-injury.
For 23-year-old Rachel, it all started in high school.
After a painful week in which her group of friends turned against her and began starting rumors about her, the angst-filled teen stayed home from school, retreated to her room, and began to slowly drag the ragged tip of a coat hanger across her tender forearm. The sensation surprised her.
“It felt so much better to sit there and scratch myself than to have my heart broke and crying,” she recalls. “It eased me.”
Rachel’s vivid account of her introduction to self-injury — aka “cutting” — is just one of many brutally honest, illuminating interviews contained in The Tender Cut: Inside the Hidden World of Self-Injury (New York University Press, 2011), by University of Denver sociology Professor Peter Adler and his wife, Patricia Adler, a sociology professor at the University of Colorado-Boulder.
The culmination of 11 years of research — including 150 in-person interviews and some 40,000 email and chatroom correspondences — the book offers an unflinching, at times extremely hard-to-read glimpse into the little-understood practice of self-injury. Studies show that as many as 4 percent of the overall population and one in five adolescents have hurt themselves intentionally. Of those, 72 percent cut themselves, 35 percent burn themselves, 10 percent pull their own hair, and 8 percent have broken a bone intentionally.
But while prior research has been able to get at the frequency and methods behind the “cutting” craze, no one has been able to answer the nagging question: Why?
“The lay public knows a lot less about this than other issues, like anorexia or drug use, which have become part of the landscape of middle-America adolescent culture,” Peter Adler says. “People think it is just this bizarre behavior, but no one understood the motivation.”
Unlike previous researchers, who looked to psychiatric patients or emergency room populations for answers, the Adlers took a broader approach, reaching out to everyone from middle-aged housewives to straight-A college students to teenage rape survivors. Their goal was to paint a nonjudgmental picture of self-injury through a sociological lens.
They came away with some controversial conclusions: that self-injury is more coping mechanism than harbinger of serious mental illness or suicidal tendencies; that it is more sociological phenomenon than dangerous addiction; that it is far more widespread than previously believed; and that — while the Adlers stop short of condoning or recommending it — it may even, in certain moments, have its benefits.
“The psycho-medical community had largely defined the behavior as something that white, female adolescents with serious psychological disorders like borderline personality disorder do,” says Patricia Adler, noting that not long ago self-injurers were considered suicidal and often were hospitalized. “We challenge that definition profoundly, with the biggest data set of noninstitutionalized people in existence. Many, many people are out there using this as a mechanism for bridging difficult situations and then moving on. It helps them feel better.”
The husband-and-wife research and writing team met in 1969 at Washington University in St. Louis, where they took a criminology class together and instantly “fell in love” with the subject. They soon made a strange request of their professor: Could they write their final exam together? He obliged, and from that point on they wrote as a team.
“Our early professors used to say, ‘You need to establish an independent voice.’ But we stuck to our guns and tried this very dangerous experiment instead, and it has worked out very well for us,” says Peter, seated in his office beneath a bookshelf crammed with some of the roughly 25 books and hundreds of research papers the two have co-authored over the years.
For one book, Dealing (Columbia University Press, 1985), they spent six years immersed in the lives of high-end drug traffickers in California. For another, Peer Power (Rutgers University Press, 1998), they spent eight years exploring bullying, peer pressure and other harsh realities in the worlds of pre-adolescents. Their central research interest always has been deviance in society, and both teach popular courses with the same name.
In the mid-1990s, the couple began to hear about cutting from their students. “At that time, it was a loner, secretive activity. People rarely talked about it,” Peter says.
One day a 16-year-old family friend came to Peter with a dilemma. She wanted to go to Dartmouth, and she had straight As, but she couldn’t pass gym class. As it turned out, she was ashamed to wear shorts because her legs were riddled with self-inflicted scars.
“A light bulb went on,” Peter says. The Adlers had their next research project.
By the time they launched their study, it was 2000, and the Internet was full of chat rooms where self-injurers shared stories not only on how to quit, but, more often, on how and why they cut.
“It was transformed from a loner, deviant activity into a full-fledged subculture, but unlike in other subcultures we had studied, most of these people would never meet face-to-face,” Peter says.
Posters freely discussed the grisly details of what “tools” to use, how deep to go, and where on the body was least likely to scar or be discovered. Some shared their techniques for fending off infection.
“I’d have my Band-Aids and my paper towels and my Neosporin, and I’d put a new blade on my X-Acto knife. It was like preparing for surgery,” explained one subject quoted in The Tender Cut.
The news was filled with stories about celebrity cutters, including singer Marilyn Manson (who reportedly self-injured on stage), British comedian Russell Brand (who allegedly lacerated his chest and arms with glass), and actors Johnny Depp and Angelina Jolie, who reportedly had marked pivotal life experiences with the sharp blade of a knife. In a famous BBC television interview, Princess Diana revealed that she, too, self-injured.
“When no one listens to you, or you feel no one is listening to you, all sorts of things start to happen,” Diana said. “You have so much pain inside yourself that you try and hurt yourself on the outside because you want help.”
While some celebrity cutters also suffered from serious mental health problems, drug addictions or eating disorders, the Adlers discovered less pathological motivations among many of their subjects.
Mike, a “scruffy-looking college student who always wore a stocking cap,” started cutting at age 14 after a girlfriend broke up with him. “I just need something where I could vent and rage without having any outward signs so that nobody could tell,” he told the Adlers.
Amy, 19, started burning herself with a heated-up screw, largely out of rebellion, at age 14. “I was into the honors classes and I was a goody two-shoes, so I determined to be all-out bad.”
Jane, a high school cheerleader, said she did it for the physical release: “I would have this intense emotion of anxiety and panic and pressure and frustration, and when I did it, it was a release. I was reorganized and I could breathe again.”
Other interviewees said they did it for the physical endorphin rush. (Research has shown that repeated self-injury results in a rush of opiate-like substances in the body, which helps deaden the pain and ignites a high.)
Some who had shut down emotionally due to tragic life events said cutting made them at least “feel something.” For others, self-injury was an act of control at a time of life when they felt they had none.
“Often, they are not going through anything that you and I didn’t go through,” Peter says. “They are just choosing a different method for coping with it.”
Wendy Lader, clinical director of the St. Louis-based self-injury treatment program S.A.F.E. Alternatives, agrees that self-injury affects a far broader demographic than once believed, and that it is in fact a coping mechanism. But she says certain subsets are more prone to start cutting than others.
“It’s often about emotional disregulation,” she says. “Kids who self-injure seem to — for whatever reason — feel things more intensely, and they don’t know how to modulate that intense emotion. These are desperate, unhappy kids.”
She stresses that “there is no safe or healthy amount of self-injury” and fears that characterizing it as faddish, or normalizing it, paints the wrong picture.
“Yes it helps them feel better, just like heroin, but it is not solving the underlying problem,” she says. “And, like with an addiction, they often need more and more for the same effect, so it can get dangerous. If I were the parent of a child who was self-injuring, I would intervene immediately and get help from a therapist.”
Daniel Cress, a professor of sociology at Western State College of Colorado, says he sees the book as neither condoning nor condemning self-injury, but rather offering a much-needed, nonjudgmental perspective.
“It is a courageous book,” Cress says. “Instead of playing it safe, taking the party line and condemning it whole cloth, they have taken something that seems super abnormal and tried to make sense of it. That’s what great sociological research is all about.”
Cress liked the book so much it is now required reading for students in his introduction to sociology class. Some students “completely freaked out” about what they read. Others felt that, at last, they could understand why some of their friends engaged in self-injury. The students with the strongest reactions to the book were those who came up to Cress after class to confess that they, too, had self-injured. “They loved it,” Cress says. “They felt like, ‘finally, somebody gets it.’”
Peter says he and Patricia have been overwhelmed by the thank-yous they have received from current and former self-injurers.
“These people can offer this up to their loved ones and say, ‘This is me. This is how I feel.’ A lot of them just can’t articulate it themselves.”
Their advice to someone who finds a loved one cutting?
“Do not freak out or overreact,” Patricia says. Instead, sit down and have a talk with him or her about what’s going on in his or er life. Check out some Internet chat rooms to get a better sense of why people do it. And offer the support of a counselor who specializes in self-injury.
Above all, says Peter, “keep in mind that this is just the symptom. This is not the problem. For a long time it has been treated as the problem.”