Heath Lambert: On this edition of the podcast, we’re thankful to welcome Dr. Kevin Carson, who is the pastor at Sunrise Baptist Church in Ozark, Missouri, and is a professor of biblical counseling at Baptist Bible College and Theological Seminary in Springfield, Missouri. He’s here to talk to us about the important issue of self-harm. And this, Kevin, is an issue that I think a lot of people are confused about. It’s probably an issue that a lot of people don’t even know of or think about. So when we talk about the issue of self-harm, what are we really talking about?
Dr. Kevin Carson: Well, when you talk about self-harm, you are talking about a number of individuals—they say up to 1% of the United States population consistently harms themselves in one way or another. And self-harm is a broad topic; it could include anything from cutting to hitting to picking—where you would just pick at your skin, you would create a spot, and you just constantly keep it fresh and let it bleed, and it would be a constant thing that produces pain. It could be breaking bones, pulling hair, or pulling eyelashes; there is just a broad sense of what it includes. And so, at that point, people often are struggling with some kind of pain, usually emotional, some kind of guilt or shame. Something is going on in their past. At that point, physical pain seems easier to deal with than what they’re trying to think through emotionally.
Heath Lambert: That’s interesting because I think when people hear the descriptions that you’re providing of the kinds of things that people do—you say that 1% of the population struggles with it, then that leaves a whole big bunch of people, 99%, that don’t struggle with it and are perplexed by that kind of behavior. What is the logic behind it? How can we understand this problem? What is it about the infliction of pain on oneself that helps to deal with whatever these difficulties are?
Dr. Kevin Carson: Well, it’s what I would call the vicious circle of folly if we use David Powlison’s terms from years ago. They have some kind of stressor that could be a current relationship, it could be pressure at work, and that stressor is added to something from the past that they’re dealing with. The combination of those two makes that pain unbearable. That would encourage them to go do some kind of self-harm. Typically, they employ something simple, and it just gets more and more complex. It’s kind of like the law of returns, where it initially helps, and then you have to increasingly do more and more in order to get the same kind of help. So the person doing self-harm gets some kind of momentary relief, and then after the momentary relief, it is replaced with guilt and an unchanged situation. So it’s just this vicious cycle that keeps going over and over again where they have to ultimately do more self-harm and do it more often in order to feel the same sense of relief.
Heath Lambert: If we were going to recognize commonalities here—understanding that when we’re talking about people, we’re always talking about individuals—is there any way we can sketch a commonality in the background or the experience of the kind of people who struggle with this sort of difficulty?
Dr. Kevin Carson: I want to be careful how I word it because, in the various kinds of people that I’ve counseled, there are some things that are similar, but yet as you said, they all have individual stories. So I don’t want to minimize what’s happening in a person’s life. But often, there’s something that has happened in the past that has created an incredible sense of disappointment. And not handling that disappointment in a biblical way has led to this continual, I’m calling it pain for lack of a better word, but just this burden that’s on someone’s soul. Now, I almost think of it as David in Psalms 51 and 32, where he’s talking about God’s hand that was heavy upon him. Just that sense of heaviness, not that it’s simple, but a heavy spirit. And by trying to do something with that in a way that does not honor God, they turn to these self-harm practices. Usually, it’s an individual trigger. Maybe it’s something off of social media, something at work, or something going on in the family that encourages the continual use of the practice.
Heath Lambert: When we talk about a problem like this that is somewhat out of the mainstream, in that a smaller minority of people are struggling with it. Not a lot of folks have experience with it. It seems like it’s the kind of problem that the Bible wouldn’t say very much about. What would you say to people about what the Bible has to say? What can we learn about this problem from the Scriptures?
Dr. Kevin Carson: There are a couple of key passages in the Old Testament in the first couple of books of the Bible. It’s in the Law, and it says don’t cut, but it’s kind of close to don’t tattoo. So that’s not where I typically go to get biblical instruction on this particular issue if we’re just talking about cutting. But in just general self-harm, usually, the person is struggling with a lack of gratitude. Somehow there are parts of their story that they are disappointed about. So there will be a lack of gratitude, a lack of contentment, or a misunderstanding of the goodness of God. Just this sense of a struggle in trying to worship God or a loss of hope. The Bible talks about those kinds of things all over. And so those common issues tend to be behind whatever is going on with the current struggle of self-harm. So as we work with them, we want to look past the behavior and recognize that we have a common person here with common struggles, but that they are responding to it differently than an extra drink, too much coffee, or lack of sleep. There are other ways that we respond sinfully to stuff, and I think [self-harm] is just one way that people respond sinfully.
Heath Lambert: So if we go look in the Bible’s concordance for the specific word, we might feel disappointed, but if we understand the themes behind the actual presentation of the problem, we will find rich resources.
Dr. Kevin Carson: Right. The Bible talks about it in many different ways. And when you look at some of the possible issues of the heart. Sometimes it’s perfectionism, where no matter how hard they try—especially with someone with eating habits—they just can’t look the way they want to look, or it’s an issue of control—something in the past was out of control, and now they can’t control that past pain, but they can control the current pain. So they have a sense of, “I can choose when to do it, when not to do it.” It’s almost a sense of you hire self-harm to work for you, but before long, you are serving it instead of it serving you.
Heath Lambert: What about people listening to this that know somebody who struggles with this, or maybe someone is listening and they do struggle with it? What is some biblical instruction that you could share that would give people some things that they could begin to do to help?
Dr. Kevin Carson: That’s a good question. I think the first thing we want to say is that we have to start with love. The folks that I’ve dealt with over the years that have struggled with self-harm, whenever it gets out—if you can use that term—maybe it’s in a life group or in just a conversation when a Christian hears about your struggle with self-harm they usually start bullet-pointing answers. And most of them would say, “what happened to just saying, ‘I hate that you’re hurting?'” Let’s try to deal with what went on in the past; let’s try to think it through. It burdens me that someone would sin against you if that were the case. It’s so often we jump to the answer before we actually have a sense of compassion and mercy. And a lot of them are just waving their hands and saying, “where’s the mercy?” I think it’s a legitimate question. We believe that we are helping because we are giving the bullet points. If you do these things, God will be honored, life will be better, and the stressors will seem less. That is all help, but sometimes we jump to the help so quickly that we forget to let them know that we love you and we’re concerned about your story. We hate to hear that this has gone on in the past. So that’s the first element. I would just say don’t forget Christ-like love.
The second part is that we don’t want to speak in platitudes. “Let go and let God,” those kinds of sayings that sometimes we share, “That happened in your past, you have to look forward.” You’re going to probably have to help them think through how they actually deal with conflict resolution. How do they deal with disappointments in the past? Steve Viers’ book on how to handle the past is a good resource to think through that. You’re going to have to give them lots of hope. One good friend of ours said that he dealt with three depressed people, and they won. You know, that’s the case a lot of times, right? You go in with someone that has so much pain, and as a merciful person, it does zap your hope. There’s a sense in which you’ve got to put on Christ before you enter that conversation and recognize that sometimes you’re going to give them the very best verse that you know, and they may chew it up and spit it out. At that point, you’ve got to recognize my faith has to be resolute too. Because if I don’t hold on and be patient… and I think of 1 Thessalonians 5. Sometimes they need reproof. My guess is most of the time, they may be weak, and they need someone to hold them tightly. But regardless of where they’re at—in my counseling experience, they are in all three cases, a lot of times—somebody’s just going to have to be patient, kind, methodical, and walk slowly through the journey with them. It’s not a quick counseling case.
One thing is for sure, as we interact and we show them the love of Christ, we want to point them to the glories of the Gospel of Jesus Christ. Because Christ is the one who understands our struggles, He’s the one who’s had the same temptations, He’s walked on Earth, He gave his own life, and in the process of all that, He still glorified God and did what God wanted. So really, it’s pointing them to Christ—initially, maybe for salvation, but for the majority that we talk to, they are people who are just struggling and we just need to point them to the realities of Jesus Christ in the Gospel and help them see the beauty of that.
