"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.

Ana, Mia, and the Oxymoronic "Christian Emo"

Image courtesy of Katie Halpin

And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. ⁸Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things. - Philippians 4:7-8

It is after much prayer and seeking God that I write this...in response to a growing, disturbing trend I see among young women.

Question: When did developing an identity, based on wallowing in negative emotions and/or self-destructive behavior, become a virtue? Yes, I am talking about the proliferation of "how-to" sites and groups, dedicated to teaching young people how to become "better" anorexics or bulimics; how to cut; and how to develop an "emo" (dark emotional) personality. To make matters worse, more and more professing Christian teens and young adults are getting sucked into this morbid lifestyle.

Following a discussion of the unedifying, "victimization" lyrics of many popular Christian bands today, I found a site entitled "How to Be a Christian Emo" that confirmed what I'd begun to suspect: the attention-seeking "emo" label is now one that not only the world wears with pride; it has invaded the Church. (It even has a name - Urban Dictionary uses the term "chremo"). From the website:

Some may think that Christianity and Emo are incompatible, due to stereotypes in the scene like self-harm and intentional depression. In this article, you will learn to eschew these stereotypes, start an Emo fashion and still glorify God.

Right. So we're going to concentrate on cultivating an image of being dark, brooding, introspective and emotive...without actually being dark, brooding, introspective and emotive. Makes sense to me. (At least they conceded that self-harm does not actually glorify God). Exactly how does any of this - even building an artificial image or facade - glorify God? Does He not command us to "fix our eyes on Jesus, the Author and Perfecter of our faith" (Hebrews 12:2) and "set our minds on things above, not on earthly things"( Colossians 3:2)?

The article continues:

Listen to Christian rock, especially artists signed to Tooth & Nail Records, Credential Recordings and Solid State Records, a metal and division of Tooth & Nail Records. Listen to bands such as Underoath, Norma Jean, POD As I Lay Dying, and Showbread and Flyleaf. and the band Skillet" and Anberlin.

What had gotten me started examining the connection between "emo" music, CCM, and all the teens I've been talking to recently who are cutting and/or purging was the discussion of how often these themes seem to be coming up on the lyrics of today's popular "Christian" bands. I said,

"I am CONVINCED, absolutely, that some of these teens and young adults are getting IDEAS (not necessarily from the artists themselves, but even from each other) and are starting these behaviors, which they see as somehow legitimate and heroic. Even the weepy music itself paints them as “victims”. Don’t get me wrong – abuse is evil and those who are abused are victims. I get that. But glorifying self-abusive behavior, in the name of victimization — even in a song supposedly intended to “raise awareness” of the behavior? NOT cool. Sorry, but these “Christian artists” should know that these songs are neither edifying nor Christ-exalting. You do not need a degree in biblical counseling to know that.

Speaking of the Bible, I cannot seem to get these girls to spend as much time reading it as they do listening to this type of “Christian music”. I am convinced it just makes them slide more deeply into self-pity.

When we take our eyes off of Christ and His finished work on the Cross and put it back on ourselves, (which IS what this genre of music is doing), we’re going to go further away from Him. Believe me, I stand in judgment of no one; I’ve done it myself (and still do). But somehow it feeds the fleshly desire for attention, validation, and vindication. When the Bible tells us to sing and make music in our hearts to God, somehow I don’t think this is what the holy Spirit was talking about. Someone battling emotional problems would do better to sing “How Great Thou Art”, “In Christ Alone”, “Lord of All” or “Blessed Be Your Name” than some of this stuff."

When I was a teen, eating disorders were common (perhaps even more so than now), but cloaked in secrecy and shame. We knew instinctively that starving to excess and purging was damaging to our bodies and nothing to be proud of. Those of us who developed true addictions to this behavior lived in dread of getting caught; fearful of seeking help. We had never even heard of"cutting" or other forms of self-mutilation. Nowadays, however, this behavior is commonplace and almost seems to be a badge of pride among the under-25 set.

Listen to some of the lyrics of Christian "emo" bands, and you can see why.

Do We Raise Awareness, or Raise Up the Cross?

I do not beleive all this "raising awareness" is having a positive net effect. Talking about these deeds of darkness, offering unconditional sympathy and "support" to those practicing EDs and cutting in place of compassionate, Christ-centered counsel, and glorifying the depressing, "dark nights of the soul" that are common to adolescence is neither edifying nor does it "spur one another on to love and good deeds" (Hebrews 10:24). Folks, the whole point of counseling is to effect change - first heart change (away from sin; re-orienting our hearts and minds towards Christ and His way, laid out in the Bible); and ultimately outward change (in our behavior, as we are re-made into the image of Christ).

I wish that you could see my heart as I type these words. I do not express this with a spirit of judgment, harshness, or "legalism". The burden I feel and frustration I experience as I see girl after girl deceived and entrapped by Satan and his lies is crushing, at times. I know how hard it is to walk out of that prison of self-pity and self-absorption, and it's made all the harder when we surround ourselves with messages and flesh-pleasing music that feeds into our morose attitude.

So many of the people who write to me don't really seem to want to change; they have gotten so used to where they are. Every suggestion I make is shot down; which is fine, but if a counselee refuses to read her Bible, it it truly counsel she wants, or just someone to feel sorry for her? Remember, the two main areas where Satan attacks us is through doubt and discipline. When we doubt, usually it is because we are not in the Word. Bible reading and prayer are spiritual disciplines, which means we must do them whether we feel like it or not. Once that goes out the window, Satan has us where he wants us: at the mercy of our emotions.

Does Jesus Care About our Emotions?

Of course He does! God loves each one of you personally, and cares deeply about everything that happens to or affects you. Recently, I was talking at length with a Christian friend about the role of the believer's emotions, and how God, while He does not exist strictly to meet our emotional needs, is Himself an emotional Being and as such, we are made in His image. (Shout out to Jen: read her great post on the matter here). The Gospels are full of accounts of Jesus responding with tremendous compassion to people....mere sinners like us. When the widow of Nain (Luke 7) wept over her dead son, Jesus' "heart went out to her, and He said, 'Don't cry' " (verse 13). When Mary and Martha, whom He loved, mourned the loss of their brother, He wept right along with them. In the Garden, we see the intensity of sorrow and emotion He was able to experience as a fully human Savior.

Additionally, we see great men of God weeping and, yes; falling into depression over the sin of Israel and rejection of God. Elijah, Jeremiah ("the weeping prophet") and the Apostle Paul anguished greatly over their countrymens' obstinacy and rejection of God. This is one reason I do not believe that depression, per se, is always a sin. There is such a thing as "godly sorrow", and it is right to be burdened for the lost and those stuck in sin. I often am driven to tears by the effects of sin and despair on the eating-disordered women I counsel.

However, the important thing to remember here is that God not only cares about our well-being, He wants to sanctify our emotions. Scripture tells us that the heart (lit. soul; our mind, will and emotions) are the wellspring of life (Proverbs 4:23) and the peace of God is to guard our hearts and minds in Christ Jesus (Phil. 4:7). By no means does God intend for us to stay in a depressive funk, wallowing around in emotions triggered by thoughts that are not from Him, hurting ourselves physically and seeking to draw the attention of others to our plight.

The Westminster Catechism articulates well what the chief end (purpose) of man is: "To glorify God and enjoy Him forever." Ask yourself this: are you glorifying God by cutting/purging/starving/attempting to appear "emo"? Are you able to serve Him while willfully remanining in that state? Are your eyes on Him (even when listening to "Christian" music that explores these themes), or are they fixed inward on self?

A Challenge to a "More Excellent Way'

I challenge you to bring these issues to the Wonderful Counselor for His perspective. I further challenge you to an experiment for one month: turn off your music, just 20 minutes a day. (I almost typed half an hour, but I don't want to scare anybody off). For just 20 minutes per day, for the next month, I want you to read your Bibles - the Gospel of John; the Book of Romans; and finally, the Epistle on Joy - Philippians. At the rate of 20 minutes per day spread out over a month, you should easily be able to digest those three New Testament books.

My purpose in offering you this assignment, should you choose to accept it, is to show you how reading, and believing, the Word of God over what the tapes in your head may be telling you will effect your emotions in a God-honoring way. Much of the reason we may be tempted toward "emo" has to do with a lack of gratitude - we forget how much God, the Creator of the universe, has done for us. The salvation He has freely given us through the death and resurrection of His Son is more than enough reason to rejoice forever - we are free from all bondage - but how easily we forget that. Forgiveness, acceptance in the beloved, eternal love, peace, hope and joy are all ours, but when we take our eyes off of Christ, we carelessly forget this.

Determine today to live a Christ-centered life - free from the trappings of self-harm and self-hatred. Check your motives and screen your music....is it truly Christ-exalting, or is it man-exalting?

Open Letter to a Christian Cutter

The phenomenon of self-mutilation, or "cutting" as it is colloquially known today, is a frighteningly common problem - especially among teens. Much like eating disorders, it is hard for an outsider to understand what would make a person harm herself physically; what is driving this compulsion?

Recently, I have started getting more and more e-mails from young ladies who, while they believe in God and profess to know Him, have turned to this addictive form of self-abuse. While I have no personal experience with "cutting", I've come to believe it's demonic. Human beings were made in the image of God, and in revenge towards Him, Satan tempts (or compels) individuals to deface themselves.

Another common denominator between bulimics and "cutters" is the prevalence of sexual abuse in their childhoods, one of the most satanically-inspired forms of torment there is. Shame, rage, and a denial of God's poeima ("workmanship") combine in the heart and manifest in such symptoms of self-abuse.

Recently, I wrote to a teenaged cutter:

"The cutting is definitely acting out of rage and anger. This is actually demonic (NOT saying you have a demon in you -- but all sin and sinful temptation comes from the devil). The devil cannot control you or force you to do anything, but he can tempt you and put ideas in your mind. One of those "ideas" is to hurt yourself and mutilate your body. Remember the story in Mark 5 of Jesus healing the man at Gerasenes (he was tormented by demons)? Read verse 5 - "he cut himself with stones". Why do you think he did that? The demons literally made him do it -- they wanted to hurt and deface him, as they do all people, because we were made in the image of God. That's why self-destructive behavior is a sin - it defaces God's greatest creation and work of beauty - humans.

Remind yourself of that the next time you feel compelled -- where is this compulsion coming from? To deface the body Christ died to redeem? Straight from the pit of hell, Theresa. Please turn to God in these moments and pray -- tell Him how you feel, and ask Him for His supernatural comfort and strength to get through it. Do not be afraid to let yourself feel emotions and cry; tears are often the beginning of healing. But do not resort to cutting yourself and making the devil smile.

The Bible tells us to be anxious for nothing but in everything, by prayer and petition, with thanksgiving, present your requests to God. (Philippians 4:6). This definitely includes your peace of mind - He can renew your mind, as you stay in the Word, too. This is one reason why it's so important to be reading your Bible, and digesting it bit by bit. As you think on what God's saying in His Word, gradually His thoughts will beome your own and you will have much less fear and anxiety. It is never His will for you to be fearful or anxious - repeatedly, throughout Scripture, God tells us "fear not" and not to be anxious about anything (easier said than done, I know. But we can overcome unhealthy thought patterns with prayer and developing the habit of asking ourselves "What does the Bible say about this?")

Forgiveness is very important in order to let go of bitterness and anger. Sexual abuse is probably one of the worst things a human being can inflict upon another, but you cannot let ANOTHER'S sin destroy YOUR life. When you're having a horrible flashback or memory, I want you to calmly remind yourself that Christ is there; He is with you and HE is sovereign. This means that although the abuse was evil, He allowed it, for reasons we can't see this side of eternity. If you allow Him to, God can bring good out of this; I promise. You can be a display of the amazing grace of God. He is stronger than that flashback or any ugly memory. Turn to Him in the midst of it and remember that He is REAL, powerful, and true. He is the Protector of the powerless and the Defender of the innocent. I would say for now, stay in the Word and set time aside daily to talk to the Lord and ask Him for help in this area. Definitely see if it would be appropriate or an option for you to get pastoral counseling at your home church.

You need to fight this starting by turning to God and resolving to think His way. The cutting is just a symptom of the problem; it is not the problem itself. The anger and hurt and fear can only be healed by bringing it to Christ and letting Him shine His light of Truth on it -- and no one can do that except for you. Promise me you'll talk to Him about this this week, and at least read something from His Word. Let me know what stands out to you in your reading. Even if you're not sure you can or really want to stop this behavior, tell Him that, too. Be honest. He already knows, anyway. The devil is definitely trying to torment you, but he can have no more power over you than you give him because of Christ's shed blood on your behalf.

Don't go to sleep tonight without at least spending some time with God. Please write soon and let me know how you're doing, so I can continue and we can talk about this further.

Praying for you!"