Sunday, April 02, 2006

Cutting Class

I never wrote about how interesting the Crisis Intervention Team academy was last September. I might write about the team and the training in more detail but the short definition of the Crisis Intervention Team is this:

It’s a group of officers and dispatchers who receive special training and have special interest in helping meet the needs of mental health consumers.

Understanding that officer safety comes first, the “tactical approach” (tasers, hobbles, etc.) to dealing with unreasonable subjects is not always the best method of dealing with mentally ill folks.

Plus a good CIT dispatcher can smooth the way for officers or even eliminate the need for officer response. In my agency we feel lucky to have been given the training but there is no additional pay for being a member of the team. This means that the folks active in the team are dedicated to spending their own extra time with these folks.

It’s just good customer service too. Since most folks will either have a mental crisis in their lives or have a close friend or family member have mental issues, it makes sense that we get training in how to best deal with folks in crisis.

Also, no one particularly wants to shoot and kill a mentally ill subject. It looks bad and it’s a lot of stress for the officer doing the shooting.

Anyway, last week I taught a 5 hour class on the basics of assisting mental health consumers to our new dispatch academy. One of the areas I researched in advance was “self-injury,” “self-harm,” or “cutting.”

The CIT leader happened to see my cutting section (complete with a multimedia presentation) and offered (flattered me into) giving a longer lecture about cutting at the advanced CIT training this summer. Wahoo!

Oh wait, there’s all the work getting ready.

Cutting fascinates me more than ever now that I've done a lot of reading on the subject. This is a huge deal.

While not a diagnosis in itself, cutting can be indicative of lots of mental problems: borderline personality disorder, depression, etc. And all the cool kids are doing it.

Cutting isn’t about suicide; it’s about coping.

Some of us deal with their daily stresses or the stresses of adolescence, grief, abuse, mental illness, etc., by drinking alcohol, smoking cigarettes, taking drugs, over-eating, or (I’ve only heard) exercise.

Others cope by cutting, burning, pulling hair, biting, and otherwise causing themselves harm. It’s like a pressure release. Quotes from cutters include:

“… It gives me a sense of control. I get to be in charge of how much I bleed and how much pain I feel. Sometimes I feel it’s the only thing in my life I have control over…”

Today I looked at, this is not an exaggeration, about 6000 pictures of self-inflicted wounds. It was horrible. I looked at the photos the same way my father watches the Operation Channel: wincing but unable to look away. I paged through these photos for hours looking for ones that show representative injuries.

I have about 50 photos which show “great” injuries, ones that are not decorative or suicide attempts or caused for sexual gratification. There's a lot of crazy bloody ugly stuff out there.

I wonder how the crimes against children detectives do it, looking at abuse victim's pictures all day long. I guess they get the satisfaction of putting the bad guys in jail.

You don't put someone who cuts in jail. You often don't put them in a hospital. If the injuries are not life threatening and they pose no danger to others, cutters have the same rights as you and I. They don't put smokers in jail. They don't put alcoholics in jail. They don't put fat people in jail (thank goodness!).

I'm thankful that for all the little problems I have, including a little "mentally ill lite," cutting is not an obsession/compulsion/addiction I have. I have nothing but sympathy for those who cut.

I wish them the environment and the support where they can stop harming themselves, even if it's a sort of release of tension to them. As a CIT dispatcher I can at least understand and teach my fellow CIT members to not judge the consumers with numerous scars and instead provide them whatever service we are there to provide with as little additional stress as possible.

Anyone out there with cutting stories? Anything you want me to share with my crew this summer?


Steve said...

As I'm still in school, I dont really have any EMT stories to tell, but I used to be a bouncer at a live music venue, and there is an old, I mean OLD punk rock band (1981 or so) around Charlotte called Anti-Seen that still does shows, and the singer still, to this very day, cuts himself up during every single show. Wether it's with a broken beer bottle or by repeatedly smacking himself in the face with the microphone. Once he even used a metal wash board. I always hated working their shows, because theyre so fricking weird. OK, just went on google and found this website about them, so you can see what I mean:
I think there is some deep rooted issues here.

Jas said...

I had a close pal who cut himself.

His quote: "It is the only way I feel anything, otherwise, I'm simply numb, once I see the blood, I feel alive, I feel like I am really something, and not just some coiled up DNA"

I told him that if I ever had him in my presence again, and he had any visible signs of cutting himself, I'd take him to an involuntary intake.

He felt nothing was wrong with his behaviour, and that I was over-reacting.

He won't visit me, but claims that he stopped.

Time will tell.

jen said...

i have a close friend who is a cutter. she says it's like all her pain gets released into a balloon and floats away from her. in doing some research, i found that a lot of cutters use the exact same comparison, which i found really extraordinary.

one day she "misjudged" her cut and she ended up in hospital with a fairly large gash to her arm. it was frightening, to say the least.

she's seeing a therapist and is on medication and she seems to be doing better. it's such a difficult subject to broach with her, though, i can't be sure she's stopped completely.

nylon said...

I am a cutter. I haven't cut in a few months and am on medication and in therapy. I do it when I am feeling depersonalized and numb. I do it to help alleviate stress. and when I am freaking out, which seems to be often. I read a good book about cutting called Bloodletting by Victoria Leatham. it's her memoir. I wrote a piece on my cutting..well I started a piece which I posted in my blog. Today, I try to use dialectical behavioral therapy DBT to prevent cutting episodes. I am also diagnosed bipolar.

Eric said...

Thank you all for your information. It's amazing how many folks practice this act. It's all so hidden, so private, so rooted in shame.

Nylon - I'll email you but I definitely would like to quote some of your piece in my presentation(s).
Thank you for sharing this, I admire your bravery.

queenofHRC said...

Thank you from all of us mental health professional types for doing the education that you are doing for the first responders. Your mother showed me your power point presentation without the pictures and I thought it was great!