Bruised skin, over-plucked eyebrows and lashes, torn fingernails, and scars from self-inflicted cuts can all be results of measures taken by self-injurers. Often, concerned loved ones wonder about the self-injurer in their lives (if they’re even aware of the behavior). The immediate and persistent question is usually, “Why would you purposely hurt yourself?”
Not a Mental Illness: The Cutter is not “Crazy”
The self-injurers I have counseled and have watched the Lord work in their hearts have very clear motives for why they started a pattern self-injury. They use it as a means of dealing with life’s pain. The serious issue of self-harm is a “coping mechanism” for mental anguish, and it has dangerous implications. Physically, the injuries can lead to more serious and prolonged health problems. Mentally, the injury provides temporary relief from the pain, despair, and disappointment of life in a way that makes more sense to the injurer. Spiritually, the injury provides a false mechanism for atoning for one’s own sins through self-affliction. These are some of the flawed yet self-perceived benefits and reasons why a person harms him or herself. Self-injury can become physically and mentally “addictive,” enslaving, and even habit-forming.
For the self-injurer, self-inflicted physical pain is a way to express, control, and transfer the emotional pain of the moment to a physical pain. The cycle of thought is similar to drug addiction: there is an excitement and even an anticipation of what is to come. Then, when the event has been acted out, the physiology of the body responds to cutting and self-harm by producing natural pain killers.
The people that have come to me for help in this regard are not mentally ill. I try to help my counselees grasp that this is not how God intended pain to be dealt with. God designed the body to relieve pain from within – it’s His grace to mankind – and self-injurers have discovered self-affliction as a temporary fix for emotional pain.
The Goal Must Be Different
In biblical counseling, we say that the presentation problem is not the real problem. In other words, the outward behavior of self-harm is not the problem, but the heart motives driving it are the real problem for the counselee. Opportunities to turn to self-injury are always going to present themselves; however, the goal of temporary relief cannot be the driving, primary goal. The goal is the glory of God and that has to become the motivating factor in the heart of the person who struggles with self-injury.
In the Old Testament, people who did not know God would cut themselves at funerals a way of expressing the deep grief and pain associated with losing a loved one. They had no hope for eternal life. They had no promise of redemption in which to trust. They had no message of the Gospel to believe in the forgiveness of sins. Therefore, God loved His children by commanding them in love to live out a better way of responding to pain, death, grief, and suffering: for His glory. God wanted His people to experience the blessing of living for Him and separating themselves from the empty traditions of grieving the dead by the world. Today, the goal for the self-injurer is no different: separate yourself from the practices of this world and make choices to glorify the Lord. It is an eternal choice first. It may produce temporal benefits and blessings, but these are not the motivating reasons to obey.
Gospel Hope and Help
Love of God by living life His way is always a matter of knowing God intimately in a deep, abiding relationship of trust. Obeying the one true living God beyond one’s feelings requires faith. Often a desire for control and self-reliance are at the heart of a self-injurer’s behavior. But a good biblical counselor will help the counselee explore God’s Word and discern his own heart motives from his outward behaviors and to learn how to please God with new, God-honoring responses.
Just like the love God demonstrated to His children in Deuteronomy 14:1-2, the self-injurer needs to be reminded: “You are the sons of the Lord your God. You shall not cut yourselves or make any baldness on your foreheads for the dead. For you are a people holy to the Lord your God, and the Lord has chosen you to be a people for his treasured possession, out of all the peoples who are on the face of the earth.”
As biblical counselors, caring friends, parents, mentors, and pastors, you are given the privilege of pointing people to that eternal hope in Christ. Don’t send them away to secular psychological professionals. Instead, view counseling the self-injurer as an opportunity to reach out by speaking the truth in love to someone struggling with hidden pain by trying to alleviate it with physical habits of self-harm. You have the Word of God, the Holy Spirit, and the Good News of the saving grace of Jesus that gives us access to the power to change and become more like him.
For more information about the topic of helping self-injurers, join us for the ACBC Annual Conference in October, where Mark Shaw will be teaching a breakout session on this topic.
 Shaw, Mark. Hope and Help for Self-Injurers and Cutters, Focus Publishing, Bemidji, MN, 2007, p. 14-15.