Cutting is a response to intense feelings, with physical pain taking the place of psychic pain
is a column where experts discuss mental health issues they are seeing in their work
But communication is usually a secondary aim, even if this communication is powerfully felt by others. First and foremost, cutting is an attempt to deal with overwhelming feelings. Physical pain is preferred to psychic pain and, for some, seeing the blood and the scars allows the pain and anger felt inside to appear on the outside. This proved to be the case with my 14-year-old client, Tina*.
These children can find themselves at the mercy of their emotions, consumed by rage, sadness and a raft of difficult feelings that they cannot regulate or manage. They struggle to identify what they feel, or what triggered their distress, and the need to rid themselves of the feelings is paramount, regardless of the consequences for themselves, their body or anyone else.
First I would need to establish a trusting relationship by listening carefully to Tina so that in time she would be prepared to take a chance on my suggestions. I had an approach in mind – dialectical behaviour therapy – but I would need Tina’s buy-in for this to work.
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