question about "cutters"

[sarasmith805]

I am a nursing student, and I was in my clinical rotation recently and a floor nurse says to me, "that girl over there is a cutter ( she was pointing to a patient)" with a disgusted look on her face. I wanted to say "SO?"

Well, I have about 5 scars on my arms from cutting years ago that I hide with a long sleeve shirt.

A few months ago I went to the school health clinic for a check up and the nurse gave me a nasty look when she saw my arms and said, "Are you done with all that???" She made me feel absolutely horrible and I just started crying.

Here's my question.... why are these nurses so disgusted? Obviously someone has to be in some major turmoil to self inflict harm. I'm already ashamed and I live with it everyday when I look in the mirror.

I had a classmate ask me about them as well when I was wearing a t-shirt, before I could respond she said "oh, you're one of those"

I honestly don't like lying so when people ask me about my scars I usually just shrug and change the subject. Are colleagues going to think I'm mentally unstable?

[kjkkm]

So sorry you had that experience - those nurses are probably burnt to a crisp. When I have someone that is a cutter my first is to question why & usually my next words are "Child, we need to find a better way to express those bad feelings - this isn't doing you any favors & it's not addressing the problem". I am not a cutter, so I really do not understand what motivates someone to harm like that, over & over again. YOU as a nurse can bring an insight to the table & an understanding that these people desperately need. The best thing I have found being a Psych nurse is that Everyone - no matter what side of the nurse station you are at - has problems, dysfunctions & struggle with anxiety, pressure, anger & depression. Those that deny it are lying to themselves. Everyone is just 1 or 2 events away from being a patient & we are not above any of those patients. Alcohol & addictions are a response to anxiety, anger & attempt to self medicate. Those with true mental health issues usually go off their meds, self medicate & then are back in the hospital. Ineffective coping skills is the norm & stay by stay, it is up to us to try to teach, help, nurse regardless if we can get thru to them or not. I leave the "will it stick" to faith & keep throwing positive guides & navigations at them. All the while, I learn how to guide & navigate my own rocky road (what's good for the goose & all that". Please do not let burned out nurses jade your choice to be a nurse. No matter what specialty you find, you have insights from your own experiences to help your patients on their road to recovery. Let yourself shine in nursing - you will never regret it![/quote']

You rock!

What a blessing your compassion & lack of judgement has surely been to many.

[Kooky Korky, BSN, RN]

I don't want to minimize your concern or what difficulties you had, OP, that caused you to cut yourself. I'm so very glad that you have been able to overcome them, too.

The easiest thing to do would be to just keep the scars covered. Maybe one of these days you can consult a surgeon for scar revision.

You also really need to start calling people on it when they say these rude and ridiculous, ignorant things that you have stated here. Don't get angry at them, just educate them.

[Psychopath, MSN, RN, CNS]

Good points there rncash89 re: nurses coping mechanisms. A macabre sense of humour is a fine thing to have! Helps us regulate and balance our own mental health when we're dealing with potential stressful situations eg cutting.

[DermottMcSorley]

Thanks to the OP. Also it is a reminder to all of us to be careful what we say.I include myself in this. Our judgmental talk can Hurt.

[liketheairport]

Deliberate self harm, particularly via superficial cutting, is a manipulative action. Not all self harm is the product of emotional distress. It can be a form of revenge, and certainly as a method of eliciting attention. It forces an emotional response from people (psych nurses included) that they would not necessarily wish to impart under more normalised circumstances.

When I did cut, it wasn't manipulative. It literally was an outward expression THAT I DIDN'T WANT ANYONE TO KNOW ABOUT expression of inward pain that I DIDN'T WANT ANYONE TO KNOW ABOUT. Luckily, I've found better ways of coping with my emotions/stress/anger/depression.

Maybe some people do it to get a reaction or some sort of sympathy. I didn't. I think saying it's "manipulative" isn't necessarily true.

[DermottMcSorley]

Been thinking about this a lot. The OP displayed courage in her post. There are many reasons for cutting and I am sure that I don't know all of them.

Cutting/scarification is used for decoration,both in the west and in several 'native' cultures .

It is done in some SM play.

It can happen in some Autistic people as a stimming activity.

Lots of reasons and to treat it as a unitary act is useless, look for the reasons,then treat if appropriate.

[SageFemmeReveur]

Agreed with Airport. Not sure why everyone is patting RnCashy89 on the back when the first line of his/her comment blatantly reinforces the stigma behind self harm. I get that it did become a fad and there are people who do it for attention but to default to that assumption is detrimental. It reinforces the isolation and fear of seeking help. I injured because I never learned coping skills. Injuring was a way to focus and dull the emotional pain. It provided a release. It is ritualistic even for those of us who use it in a negative manner. I became addicted to it. You'd be surprised how many people self injure without realizing that is what they doing. The resource that really helped me that I refer people to is the book Bodily Harm by Karen Conterio. If you know someone who needs help or wish to have a clearer understanding there is no better book.

[asil5274]

In my 5 years as a Psych RN, most of my cutters/swallowers have been frequent fliers on 1:1 observation because of their danger to self behavior-swallowing non food objects and cutting themselves. Most of these patients have Borderline Personality Disorder, love to manipulate and be disruptive. I have had as many as three of these patients on the unit at once and they are exausting to care for. The last one body slammed a door and broke it in half.

[RNcashy89]

By definition, the context you have addressed was form of manipulation. You were manipulating your own pain - please don't see the word "manipulate" as having any particular connotation (negative or otherwise). Furthermore, I clearly stated that "not all self harm is the product of emotional distress" - ie; self harm CAN be the product of extreme emotional distress - as it has been in your historical experience.

I am convinced that you understand that self-harm is a complex phenomena. So certainly, self-harm is not necessarily a behaviour utilised to manipulate others, however, it most certainly CAN be a behaviour utilised to manipulate others. Similarly, self harm is not always utilised to "get a reaction or some sort of sympathy", but sometimes it is (or as revenge, or to generate chaos/drama, or to elicit the 'rescue' response). I hope this clarifies my previous comments somewhat.

[albymangel]

It's certainly behaviour that has a purpose and for them is somewhat a way to adapt and deal with the intense psychic pain that they often experience. Majority of those with BPD Dx have experienced childhood trauma which could Include sexual abuse, neglect, emotion deprivation and so on. As a clinician one needs to consider how one responds part from the obvious safety and duty of care. Good evidence to support the clinician to think dialectically.