About 20 years ago, I came to believe that, while there are many similarities in the development of current students and those from previous generations, there are significant differences in the experiences of every generation of students. More primal than cohort-based experiences of any group are the lived experiences of the individual. Adding to this recipe of difference are the historical ingredients that change over time. Lived experiences will differ greatly among people growing up in different times. For example, growing up in a time of war or peace makes a difference in lived experience. Growing up when advanced technology is manifest in a 4-function calculator or current-day laptop computers makes a difference in lived experiences. Growing up when cultural appearance and social mores are transmitted primarily in one’s home or throughout the media makes a difference in lived experience. Growing up when communication among youth is primarily between two friends in close proximity by telephone, or among two people of varying ages who communicate through the computer from locations in different states or even different countries makes a difference in lived experience. Growing up with Americans believed that torture was wholly unacceptable, and a time when the value and support for the use of torture is actually touted by a sizeable number of Americans, makes a difference in lived experience.
Consequently, when one attempts to understand behavior, it must be considered in context. An example of contemporary behaviors that are relatively different than previous generations is the growth in frequency of many forms of self-mutilation. Some examples include cutting, scratching, picking at scabs or cuts, ingesting toxic materials, and pinching that causes bruising. The term mutilation sometimes reflects the intergenerational bias that comes from values perspectives that differ by generation. In other words, the term self-mutilation is sometimes perceived as quite offensive by the younger cohort group. Many who conduct research or provide theory in this area prefer the term self-injury. Some forms of these behaviors, such as cutting or scratching, could be described as physical self-mutilation. Other contemporary behaviors such as branding, piercing, and body sculpting (strategically placing metal pins just below the skin to create images), can be well described by two terms: self-mutilation and self-expression. In this column I will introduce these topics, giving attention to the behaviors generally held to be more hurtful than expressive – cutting and scratching. I first became aware of these behaviors through firsthand experience. As the executive director of a public residential academy for intellectually gifted adolescents, I worked for 9 years with students who engaged in cutting behavior. It was in this context that I first learned of self-injurious behavior.
The foundation of self-injury/self-expressive behavior has a few important elements. Self-expressive behaviors, while sometimes idiosyncratic (obtaining a tattoo with your loved one’s name on it), are more often than not about being a part of a group. For example, some fraternities have a tradition of their membership acquiring brands of the fraternity’s insignia. Some motorcycle riders wear a “one percent” tattoo, revealing their full membership in an exclusive group – the 1% of motorcyclists whose lives are very much about motorcycles (authentic bikers) – but also demonstrating separateness from everyone outside their group. I am a part of this group, but you are not. These forms of self-injury/self-expressive behaviors are at their bases tribal and public. Members are part of a small community or group that is defined by its mores, values, rules, and behaviors. Therefore, the experience of the discomfort or pain that is associated with the brands, tattoos, and so forth is necessary to becoming a part of the group – no pain, no gain. No pain, no group membership. It is important to note that the self-injurious behaviors associated with such membership rituals are not at their core due to any emotional problems or limited coping behaviors.
By contrast, cutting behavior is at its core a private act; one that is not intended as a public indication of membership in a subgroup. Cutting behaviors are intentional acts, often using knives and/or razor blades to slice the skin. Common locations for cutting include the wrists and ankles. Because society holds a taboo against self-injurious behavior, the self-inflicted wounds are typically hidden. There are sometimes exceptions to this rule, however.
Cutting behavior is inherently about the alleviation of pain. Much of the pain is private and often unknown to anyone else. An important myth about those who cut is that they are suicidal. Fox and Hawton (2004) note that, in fact, cutting behavior is an effort to obtain relief from unbearable pain. For many, cutting provides fast relief from distressing thoughts and emotions and helps the individual regain a sense of control. According to Favazza (1996), cutting has three basic purposes: (1) to distract from emotional pain or despair, (2) to dissociate from deep sadness that could lead to emotional numbness, and (3) symbolism. Cutters have reported a sense of relief when they see a flow of blood and describe the experience as regaining a sense of control.
A wide range of estimates of the prevalence rates of cutting behavior in the general population has been offered from less than 5% to approximately 20%, but the broader category of rates of self-injury among American college students revealed a 32% rate (Vanderhoff & Lynn, 2001). Due to these wide variations, I am unwilling to offer a definitive prevalence rate. However, to gain some insight into cutting behavior especially among gifted adolescents, I interviewed Dr. Vickie Barton, Co-Executive Director of a residential academy for academically gifted 11th and 12th graders. As the school’s lead counseling service provider, Barton estimates that for each of the past several years she has seen approximately 5% of the total student body for cutting and scratching behavior. She believes that an additional 1% or 2% of the students elude identification (personal communication, 2007). A prevalence rate of 5% or 6% for cutting as one form of self-injurious behavior among this sample of gifted adolescents gives us a reasonable estimate of what may be occurring in the larger gifted population.
The DSM-IV-TR indicates that cutting behavior/self-injury is associated with a variety of factors including borderline personality disorder, trauma, abuse, eating disorder, low self-esteem, and perfectionism. See Figure 1, Precursors to Self-Injury (LifeSIGNS, 2007), which illustrates the conditions believed to lead to cutting types of self-injurious behavior.
We know that a portion of our young people engage in myriad behaviors that can be described as self-injurious. Some of the behaviors such as tattooing and piercing are artifacts of efforts to become part of a group, or to express an aspect of one’s self. Others are engaging in behaviors that are more worrisome, most likely revealing evidence of distress. These behaviors include cutting. Although prevalence rates for those behaviors among the gifted child population are not readily known, it is clear that gifted students are also engaging in some, if not all, of these same behaviors. The etiology of cutting behavior, unlike tattooing and piercing, is rooted in experiences of emotional pain. Cutting seems to provide temporary solace to the person who engages in this self-injurious act.
It is important to watch for signs of emotional distress among our gifted population and to seek counseling support if there is any evidence of cutting or scratching having taken place. This particular set of behaviors requires the assistance of experts in the psychological arena and fall well outside the realm of typical patterns of social and emotional needs of gifted students. With vigilance in looking for and referring children who show evidence of these self-injurious acts, we can help them through this difficult and complicated period of their lives by providing the emotional safety net they need.
Favazza, A.R. (1996). Bodies under siege: Self-Mutilation and body modification in culture and psychiatry. Baltimore: Johns Hopkins University Press.Fox, C., & Hawton, K. (2004). Deliberate self-harm in adolescence. London: Jessica Kinglsey.LifeSIGNS. (2007). Self-injury guidance and network support. Retrieved April 28. 2007, from http://www.lifesigns.org.uk/.Vanderhoff, H., & Lynn, S. J. (2001). The assessment of self-mutilation: Issues and clinical considerations. Journal of Threat Assessment, 1, 97-109.
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