"Cutting" and Bulimia: Striking Similarities

It is with interest that I just read Mark Shaw's booklet, "Hope and Help for Self-Injurers and Cutters" (Focus Publishing), as very little has been written about this growing phenomenon from a truly biblical perspective. Shaw, who is the author of "The Heart of Addiction", condenses extensive research into the physiological and emotional drives behind this maladaptive behavior into 29 pages of scriptural exhortation. This booklet is extremely helpful both to "cutters" who want to understand and break this dangerous habit, and to Christian counselors who are perplexed by "cutting".

While many young people involved in the stereotypical "emo" lifestyle may experiment with self-harm either for attention or to deal with very real pain, the fact is that "cutting" does become a very real addiction...very much like eating disorders. In fact,  the reason for my research stems from the high correlation between "cutting" and bulimia. Many bulimics who have written me for counsel (especially from the under-30 generation) are also "cutting". In the 1980's, when I was a teenaged anorexic/bulimic, "cutting" was unheard of. Now, partly due to the media and perhaps the sub-culture, it has become a self-destructive addiction for increasing numbers of young people.

Shaw explains the physiology of "cutting", and why it becomes so difficult to stop:

"The pain signal sent to the brain causes a pain relief response in the body. Natural pain relievers produce pleasure in the brain and body. An unpleasant action produces a pleasant feeling in a short amount of time. "Cutting" can be addictive because the endorphins, dopamine, and serotonin that are released by the body can feel similar to a drug rush, although to a lesser degree. Chemically, these neurotransmitters are very similar to many prescription pain killers."

Similar to the "endorphin rush" that follows a purge and generates an artificial sense of calmness, the chemistry behind the behavior produces a certain response.

After citing specific Old Testament passages that forbid cutting and other forms of self-mutilation (see Leviticus 19:20; 21:5 and Deuteronomy 14:1-2); I previously blogged about cutting in the New Testament here), Shaw illustrates seven ways in which modern-day "cutters" are imitating the idolatrous pagans who "cut" themselves ritualistically:

1. “Cutters” of today are responsible for their actions just as the pagans were for their actions.


2. “Cutters” are grieving that they are not getting what they want. God’s people have the hope of eternal life and must not allow their focus to be upon receiving satisfaction in this world alone.

3. The severe, strong emotions experienced by the “cutter” of today are very similar to those felt by grieving pagans as they experienced terrible, final, and traumatic loss of a loved one. Remember that those strong emotions are preceded by negative thoughts about God or about the person who offends and hurts the “cutter.” (MY NOTE: Or both – often Christians with addictions, like cutting, are angry at God because He “allowed” the abuse to happen).

4. “Cutting” is often planned in advance of the actual cut. The “cutter” places a knife or sharp object in a drawer in her bedroom with the intention of using it later if the desire to cut arises.

5. The “cutter” and the grieving pagan have lost control and cried until there are no more tears left. All of this occurs with no real resolution: the pagan’s deceased loved one did not return to life as a result of the idolatrous ritual the pagan performed nor does the “cutter” resolve the hurt in a biblical manner (Luke 17:3-10) with the person who hurt her.

6. Some “cutters” want to be discovered because they desire attention or are crying out for help.

7. “Cutting” oneself produces blood for both the ancient, grieving pagan and the modern “cutter”.
 
Reading this list (and the elaborations under each point) really clarified the connection between bulimia and "cutting" to me. The rage, pain, and shame felt are "transferred" to the cut - and then "released" physically. This is very much analogous to what the bulimic does when she vomits - she is attempting to "purge" herself of both the self-indulgence (the food consumed) and the negative emotions.
 
The cycle a "cutter" follows and the self-reliant reasoning behind it is similar to the bulimic's. The answer to the problem, of course remains the same. Rather than taking refuge in the temporary "rush" of self-injury, the "buzz" of drunkenness or the "high" of a binge, God wants the person enslaved by addictive sin to turn to Him for comfort and encouragement. This is a key factor in resisting the temptation of an eating disorder, and the importance of accountability is just as real to the "cutter" as to the bulimic.
 
Describing a counseling scenario of an adult "cutter", Shaw writes:

At first, Pam did not want to think of it as "grief" but she took the wrong that she perceived to have experienced at the hand of her parents as a serious oppression that caused deep distress and mental anguish to her 'teenage world'. Just as the 'cutters' who grieved over the death of a loved one in biblical days, Pam felt a type of grief: intense emotional pain that caused her to mourn the deep injustice she felt inside.

 The pain is real, and just as is the case with eating disordered women, there is a high correlation of abuse among "cutters". The answer to dealing with this pain, however, must be firmly rooted in Scripture in order for the "cutter", like the bulimic, find true and lasting freedom. Internalizing anger (justified or not) leads to bitterness, which only further fuels the addiction. Just as is the case in overcoming eating disorders, biblical confrontation and forgiveness of abusers plays an important part in the restoration of a "cutter".
 
As I do in my own book, "Redeemed from the Pit",  Mr. Shaw makes the case that "cutting" is a sin because it offends a holy God (and violates 1 Corinthians 6:19-20): "Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body." As I did recently, Shaw countered the oft-thrown criticism that calling these attitudes and behaviors 'sin' is harsh, or that it is preferable to think of "cutting" as being a 'mental illness'. Citing 1 John 1:9-10, he reminds the reader that in Christ, the sinner is forgiven (including the sin of self-injury). This should give the addict great hope, because A) the guilt associated with the life-dominating sin is also resolved; and B) by acknowledging her sin, the "cutter" is now free to experience the forgiveness and encouragement of a loving God.

As is the case with eating disorders, repentance from "cutting" must follow certain steps:

- "Putting off" the sinful behavior and habitual, idolatrous thoughts (Ephesians 4:22; Colossians 2:11);
- Renewal of the mind (Romans 12:2; see also my posts on the importance of renewing the mind here);
- "Putting on" new, God-honoring behaviors and thoughts (Romans 13:12). Often, addicts will inadvertently replace one self-destructive habit with another one. For this reason and in order to have the mind of Christ about her situation, the "cutter" must rely on consistent, deliberate Scripture reading in order to become more like Christ. Sanctification, which is the goal of all biblical counseling, does not happen automatically or passively.

Much like her eating-disordered counterpart, a "cutter" is stuck in a deadly, seductive cycle of trying to solve her problems and ease her inner torment by means apart from God. The addiction, whether purging or "cutting", will ultimately only bring more misery and alienation from God and others. By recognizing the futility in self-harm and seeing the compassion of the Father, both bulimics and "cutters" can find true hope, genuine renewal in heart and mind, and a permanently changed life.