Self-Injury

Notes taken from "Self-Injury:  Ministering Christ to cutters" by Elizabeth Kirkland

"Just as a reminder, the typical cutter really struggles with verbalizing her emotions, and it's not that she can't speak or she can't communicate intelligibly, it's just that usually it's all bound up and she doesn't really know where to begin.  So helping her to begin the process of unraveling these emotions and holding them to the light of Scripture can be a wonderful place to start for her.

A great homework assignment is to have her keep an emotion log.  An emotion log.  It's basically a running log where she can record each instance through out her day that she finds herself wrestling with intense emotions.  So it's not every single emotion through out the day, but whenever she's wrestling with intense high levels of emotions, you'll want her to jot these things down and encourage her to be as specific as possible and you can ask her to lay it out in like a grid type format if that's easier for you or paragraph form, whatever’s easiest, but you want her to record a few things.  Ask her to record the date, the time, the location, the people or persons involved or that may be around her at that given time, and the events leading up to, during, and after her struggle.  And finally, her emotional response.  Over time, this will be an incredibly rich source of information for her to draw from in discerning potential pit falls and stumbling blocks and patterns in her emotional response to things, and as Proverbs informs us, "The one who is wise is cautious and turns away from evil, but a fool is reckless and careless."  This log will show her when and where she is most vulnerable to fall into sin so that she can be cautious and discerning whenever she may find herself in those kinds of situations in the future.  Something to note here though is that due to the intense emotions that the cutter typically experiences, she may struggle to objectify her or to be objective at first, so you might need to help her sift through her emotions to get to the essential data.  It can actually be a really helpful exercise as you sit with her and go through this log together and kind of walk her through ways she can kind of pull her emotions away from experiences and just look at things objectively.  It may be actually completely new to her.  The next thing that you can encourage her to do is to keep a cutting log.  And this log will actually be a great resource of accountability for her as well as help her to grow in her ability to Biblically discern her own heart.  Similar to the emotion log, this should be a continuous exercise.  It's focusing on the objective data.  But the only difference is that she completes it only when she is struggling with the temptation to cut.  And in this exercise, she should be encouraged to record the following information:  the date, time, and location, just like before, the events leading up to, during, and after her point of temptation, just like before, and then she should also record her thoughts during the events leading up to, during and after her point of temptation.  When she presents this log to you as you meet together with her, take the time to work through it with her, and hold each thought up to the grid of Scripture and help her begin to discern which thoughts were honoring to God and which ones started to lead her down the course of being lured away by this temptation to want to cut again.  And typically, it'll reveal what verses will be helpful to her to spend time meditating on and memorizing too so that can also produce another homework assignment as you're going through this with her.  And help her begin to connect the dots between her thoughts and her course of action that follows.  The next assignment would be journaling and this can be another great exercise to help the cutter begin to release some of her emotions and to help her objectify them as she sees them written out in front of her on black and white, on paper.  This should be a means by which the cutter can disclose her thoughts, her feelings, perceptions, and whatever else SHE finds helpful.  There shouldn't be any real directions or limitations or restrictions put on this assignment, unless the cutter finds herself actually getting more worked up as she's journaling.  Sometimes it can have that effect.  So that would be the only prohibition is if she is to stop journaling if she gets worked up, otherwise encourage her to journal as much as she wants to.  And prayer; it's not uncommon for the cutter to struggle with prayer.  After all, she's really not had much practice in being transparent.  So being open and vulnerable, soul to soul, as it were, as she's seeking to commune with God can be a real struggle for her.  So if she's struggling with getting things started, then you can encourage her to share one of her journal entries with God by praying it to Him as a form of self disclosure or if she's not even sure to begin to know how to pray, then encourage her to spend time in the Psalms and pray those back to God, and assign to her increasing increments as you meet with her weekly to spend time in prayer where she is adoring the LORD, confessing to Him, expressing thanksgiving, and even supplication as well.  ...so we see how prayer can just really be, well we know that it's vital in the believer's life already, but for cutters it can be a particular struggle, so helping her to get that going can be a blessing.  Also, you want to have her record down an emergency list and this should be a list of very practical and relaxing activities that the cutter can do in her moment of temptation and you can let her come up with the list of activities that she finds particularly relaxing, things like taking a bubble bath, or walking the dog, or listening to worship music, or praying for five minutes, whatever it is, and encourage her to whip that out during her greatest moments of temptation to cut.  And it's not intended to be a solution to her problem, but rather give her a buffer of time so that her emotions can subside and she can readdress her problems more objectively and then attempt to deal with them more Biblically.  We already mentioned Bible memorization, so you'll want to have her memorize some passages that are particularly meaningful to her and it's also a key ingredient to renewing her mind like we talked about earlier.  And the last component is service.  You'll really want to encourage the cutter when she's past her crisis point to get involved in the lives of others.  It's the best method humanly speaking for her to get her eyes off of herself and her problems and seek to serve others.  Help her to discern her spiritual giftedness and encourage her to pursue opportunities to exercise them in her local church. ..."