Cutting: A Bonafide Addiction?

Every time I speak to a crowd about self-injury, and specifically cutting, I am asked to comment on whether or not I think cutting is an addition. If we look at the online Merriam-Webster dictionary defining of addiction, it states: a strong and harmful need to regularly have something (such as a drug) or do something (such as gamble). Addiction involves both strong psychological and physiological components.

Many young people report to me that once the started self-injuring, they couldn’t stop, or rather, didn’t want to stop. The psychological relief they felt when they cut themselves was a strong reinforcer, causing them to turn to the behavior the next time they were in intense emotional pain. The sight of the blood seems to act as a change agent as it  triggers an emotional change that otherwise couldn’t be achieved by their own will. It serves as a bright red stop sign to the emotional pain. Future cutting episodes are described as planned preoccupations. The how, where and when become as much a part of the behavior as the actual act of cutting. If you ask these young people, cutting IS an addiction. They become as preoccupied with it as an alcoholic is thinking about his/her next drink.

So are there physiological effects that gives cutting similar properties to drug or alcohol addiction? In the limited studies on self-injury, scientists have two major theories. One is that the body released endorphins, such as dopamine and serotonin, which minimize pain and provide a sense of well-being. The act of cutting produces the same “feel good hormones” as a drink or a shot of heroin does. Another hypothesis is that people who self-injure have an opioid (endorphin) deficiency and when a person cuts it increases their natural opioid levels allowing them to feel okay again. In this theory, cutting would bring the person back to a type of homeostasis. Either theory leaves us with the understanding that the act of cutting helps the cutter’s body to regulate it’s chemistry. A powerful force.

Both psychological and physiological factors play a role in addiction. So many of those who self-injure report feeling like self-injury is an addiction for them and that is effective in providing relief. In absence of another coping skill that is equally or more effective, those who engage in cutting are often reluctant to give it up. Considering what we know about addiction to substances and other behaviors, it seems that cutting can be a bonafide addiction.

If you or someone else is struggling with addiction, there is help.