PREFACE TO THE REVISED EDITION

When I began to write the original edition of Cutting, I had no idea that the prevalence of self-mutilation, according to most estimates today, would be one out of fifty adolescents. At the time, a survey done by the Canadian Broadcasting Company in 1999 suggested one out of one hundred and fifty adolescents was a self-injurer. Currently, while lecturing in areas throughout New England and the Mid-Atlantic states, the feedback from school counselors and faculty as well as community mental health professionals indicates a remarkably higher prevalence.

That such a high rate of young people feel compelled to assault their skin to relieve negative feelings indicates to us how many suffer from emotional pain and have inadequate verbal skills to work through this pain with thought and talk. It also speaks to the issues of bonding, trust, and intimacy, all of which would create emotional safety in relationships. The language for these issues is learned from others or it doesn’t develop at all, leaving the person to resort to a “solution”that requires no language and is applied in isolation.

Cutting addresses this prevalent problem, and since its initial publication it has been translated into languages representing such diverse cultures as Japanese, German, and Chinese. The book’s reception suggests that this disordered behavior is cross-cultural. The behavior is also seen across class lines, income levels, and all habitation settings, from urban to rural. It seems that under a given set of circumstances, self-injury represents an aspect of human nature.

This set of circumstances encompasses a spectrum of backgrounds ranging from seemingly benign life experiences, such as insufficient verbal communication between parents and children, to malevolent, cruel, and sexually assaultive experiences causing trauma. These experiences typically include an additional trauma to the victim: the perpetrator forbids communication about these assaults and/or rapes. He often threatens injury or death to the victim or her loved ones if she tells of the abuse.

In the pages that follow, we will see examples of all of the above in the form of anecdotes drawn from therapy sessions. The reasons for these anecdotes are twofold: first to illustrate the range of the spectrum of cases and backgrounds, allowing the reader to find elements of his/her experiences; and second, to demystify behavior that is viewed by many, including professionals, to be madness. Cutting interprets this behavior and its development as an adaptive coping mechanism arising out of desperation.

In order to eradicate these behaviors, societies throughout the world will have to focus on child raising, better protection of children, and practices that promote healthy parental role-modeling. Permission for these kinds of exchanges between members of the family will have to be present both implicitly and explicitly in the family environment. Without the presence of these elements, children are left to their own meager resources to invent solutions to reduce their emotional pain. These behavioral disorders are not limited to self-injury but include obsessive-compulsive disorders, anorexia nervosa, bulimia nervosa, and substance abuse.

New York

January 2006