May 27, 2020

Intense Reactions Regarding Self-Mutilation Part 3

Trigger Warning:

Before you read the next section, it is important to know that the content is very difficult to read.

If you have a self-mutilation history, this text could be triggering and so please be sure you have good self-care. If you know someone who cuts or burn themselves, it is most likely that their cutting and burning is not nearly as severe as the women in my study.
If your self-harm is severe, then please get help from a qualified professional immediately.

Sadly, like many compulsions, if left untreated the phenomenon of self-mutilation can become worse over time. All of the women in my study had some form of physical damage by either scarring, or cutting into a muscle, or almost cutting an artery or tendon, and via the loss of blood which can cause a drop in electrolytes.

Again, I published my research in 1999 to help identify and reveal, with compassion,
a shame based and often secret phenomenon in order to bring it to light for healing and transformation.

If there is any chance you might be triggered by content associated with intense self-harm, please read the rest of this article in the presence of a competent therapist.

Intense Reactions RegardingSelf-Mutilation: 

How to Identity and Resolve Transference & Counter-Transference via Art 

Part 3

by Ericha Scott, PhD, MEd, LPCC, ATR-BC, REAT


Self-Mutilation: Anonymous Client Art

June 14
Co-Researcher B

I am terrified…
I am terrified in a way that one can only be if one is woken
in the middle of the night
with a slowly growing pool of one’s own blood.
If one has looked down the shredded skin of one’s own arm
To find a razor blade held bloody and dripping in one’s own hand.
If one has looked in the mirror of the dark of the night.
And seen the haunted face of the other.
(Scott, 1999a, p. 136)

CASE STUDY Co-Researcher E
Individual Composite Textural-Structural Description

Self-mutilation happens over periods of time rather than as isolated, encapsulated incidents. These periods of time are often progressive. The paradox: self-mutilation seems to happen over long periods of time and long periods of time seem like moments. Time is not measured in traditional ways. Timeframes are measured by the number of wounds rather than by a clock. Even so, time blends together. Time can be so constricted that it is lost.

At times the individual is disconnected from physical pain. On other occasions she suffers greatly. Even when the burns are third degree, the experience of pain is variable. The same experience of burning may engender a wide range of expressions of physical pain or emotions, including denial. Burning is an outward manifestation of inward pain. Pain is experienced as something that can be moved, not alleviated. Pain or guilt is moved from an internal experience to an external experience.

Moving the pain detracts from the original source of pain and guilt.
Self-mutilation scars are used to prevent sexual intimacy. These marks soothe feelings of vulnerability. The individual is terrified of her sexuality. She feels vulnerable to her own desires. Her body is marked with wounds and scars which she experiences as ugly, thus informing abstinence. The individual uses self-mutilation to set sexual boundaries. She will not let others see her wounded body and so she is less likely to engage in sexual activity.

Her desire to keep her behavior secret creates barriers beyond the sexual boundaries and encourages isolation. She keeps her behavior a guarded secret due to embarrassment and shame. Her methods of secret keeping include hyper-vigilance, pretending to be “normal,” or overt lying even though lying is not part of her value system. She spends a lot of time and energy hiding her wounds. Self-mutilation is an attempt to control the inner world of feelings and thoughts.

There are actions, such as rules, which are created to control the self-mutilation. This is like the lion chasing his tail. The greatest fear is loss of control. Yet, loss of control is common. The individual relates more to her behavior of self-mutilation than to herself. She interacts with her behavior as if it was a live entity, a personification of her behavior. She has rules to control “it”. Her control mechanisms have not worked and she has failed to stop her behavior. She feels hopeless about establishing control. Control seems to be in the hands of this “live entity” which is outside of herself. The behavior has control of her, not the other way around.

Self-mutilation is experienced as a method to burn away all of the filth and impurities. The individual feels punished by herself. Her self-punishment is closely related to her sexual thoughts and feelings. She feels deep shame and guilt. Her guilt is focused on her thinking and behavior while her shame is about her sense of worthlessness. She feels hopeless about breaking the cycle of self-harm and self-punishment. She also perceives her self-mutilation as a way to express her sadness and grief.

She does not try to excuse or defend her behavior. Feelings of hopelessness are heavy and pervasive. There is hopelessness about stopping the behavior and about life in general. The individual perceives her behavior to be about the reenactment of an abusive experience and dynamic. As a child her caretakers were disrespectful to her body. She believes that her self-mutilation is always related to her childhood, just not always in the same way. This reenactment includes self-punishment. Her communications to God include desperate cries for help and relief. She is willing to surrender all for Divine intervention. In this case, the term “sacrifice” may be a correct label for her intense forms of self-harm.

The decision to take personal responsibility is important if significant changes are to be made. It is also important for the individual to know that others care. Telling others of her secrets and knowing they care is an essential component of healing. Conflicts regarding disclosure are based upon the fear of influencing or frightening another. There is also fear of rejection and judgment. Yet, disclosure is a primary factor in healing. There is much to grieve before the self-mutilation starts. Once the actions have become entrenched, the consequences add to the existing grief. Any relief self-mutilation offers is temporary. The long-term negative ramifications of self-mutilation are profound (Scott, 1999a, pp. 243-245).


This case study is regarding a person actively engaging in self-harm at the time of the study and her words are profoundly despairing. It is important to remember people recover from profound self-harm in a manner very similar to those who have chemical addiction(s). People are able to recover no matter how far trauma reenactment has taken them away from the self and wholeness.

Self-portraits – regardless of your artistic medium or skill level – can help identify and rectify intense emotions that have not been adequately or fully processed. Unexpressed intense emotions can be a trigger for relapse. There are times that the visual arts offer a more powerful and immediate resolution than talk therapy. Whether you are experiencing transference, counter-transference and/or you have been engaging in some form of destructive behavior, consider trying the creative arts therapies with a certified art therapist or an expressive arts therapist.

There are a variety of certified therapists in various creative arts disciplines such as the visual arts, music, dance, and theater. If you are looking for a visual art therapist then I recommend the following: or https://

For more information regarding self-harm, including a peer review journal article, a Keynote slide presentation, and a first step – 12-step guide, please visit


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