I Am a Cutter Series insights 
by Allison Kress PsyD.


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The work that you are viewing represents the unlocking of a passageway into the sacred and private world of twelve women who purposely cut themselves. Each woman in this series has found the courage and strength to expose the hidden parts of her body that betray her secret to the world — a world that often misunderstands, and misinterprets, the meaning of her concealed life. With pictures and prose, the women in this series are granting entrance into the darkest corners of their souls. Most of what you will see in this work has only been seen through the eyes of the women themselves. Most of what you will read in this series has been heard only in silent inner dialogue or poured onto diary pages in an effort to somehow express the inexpressible emotional pain speaking through the cuts on the skin.  The women in this project never intended for any other eyes or ears to know their silent truths. Then William Cox, a man with a unique and different perspective entered their lives, and revelation of the tender and violent realities of their life stories began.  

  William Cox is an artist with a calling to shed light on societal issues that deserve a voice and require advocacy in order to be heard.With this work, he has taken a risk to bring the controversial issue of self-injury into public view. William’s ability to gain the complete trust of twelve women who cut themselves as a means of coping, is extraordinarily admirable. The women found healing in the environment of dignity that William provided. His belief in the poignant resiliency of the human spirit inspired a relationship of deep honoring and safety, allowing the women to reveal their nude and scared bodies to him, and perhaps begin healing the deepest wounding of their souls.   

  This unique and powerful series breaks new ground by raising awareness about the realities of self-injury through the honesty and bravery of these women.  As frightening as this may be, it may also be healing and liberating. As a Clinical Psychologist who specializes in treating teenagers and adults who are cutting themselves, much of my work involves breaking through the culture of secrecy that holds great power in containing and perpetuating the ritual of self injury. However, once the secret is exposed, secrecy is stripped of its protective dominance. Once the behavior is revealed, the deep soul/body wounding can become the seeding ground for the resilient and authentic self to emerge.    This work is important in that it has the potential to de-stigmatize cutting and foster more compassionate understanding for people who self-injure.  Cutting does not define or describe the totality of a person’s identity. It is behavior that expresses aspects of a person’s mental health. The people who I treat for self injury are among the most kind, amazing, and dynamic people I have ever met, and, they cut themselves.In terms of pathology, the organizational language used by the mental health community, cutting is often conceptualized under the same umbrella as eating disorders, addictive use of drugs and alcohol,compulsive gambling, compulsive sex, and other behaviors that serve as self-destructive coping mechanisms. Many of these coping mechanisms have been studied and discussed over time, leading to greater understanding and treatment strategies. Research and dialogue about cutting are at the beginning stages in this larger mental health discourse, and information is very slowly being disseminated to the public. Those in the mental health field know that cutting is linked to difficulties in regulating strong emotions, difficulties with self-soothing, and coping with stress.  Whereas cutting is not physically addictive,it often becomes a compulsive behavior in that the more one cuts the more one will crave the specific relief that cutting provides.  Mental health conditions often associated with cutting are Mood Disorders (Depression, Bipolar), Eating Disorders,Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, Dissociative Disorders, Anxiety Disorders, and Borderline Personality Disorder.  Suicidality and a history of sexual abuse areal so not uncommon in people who cut.  It is estimated that there may be 3 million self-harmers in the U.S. today.  Studies suggest that 13% to 25% of adolescents and young adults surveyed in schools have a history of self-injury(Rodham & Hawton, 2009).  A study conducted by Cornell University (Whitlock, Muehlenkamp, et al., 2011) stated that 15.3% of the study participants reported a history of self-injury and 6.8 had self-injured within the previous year. The average age for starting self-injury was 15.2 years old (Whitlock, Muehlenkamp, et al., 2011).  In my work with clients, I have come to understand that cutting serves many functions depending on the unique circumstances and life story of each person.  

Contrary to popular perception, people who cut themselves come from all cross-sections of society. They are not always dressed in black, using drugs, or living and working in places that are socio-economically under privileged. People who cut are your neighbors, daughters, co-workers, friends, and relatives. They can be the valedictorians, star athletes, and prom queens – often the people who portray a picture perfect life from the outside while concealing their deep suffering on the inside.  Cutting typically affects teenage girls, although cutting does not discriminate by race, age, gender or socio-economic status. Often, the behavior can continue into adulthood, especially in the absence of professional treatment with someone who is knowledgeable about treating self-injurious behaviors.

A common myth is that cutting is an attempt to commit suicide. Often, it is just the opposite.  Cutting is commonly a paradoxical attempt to evoke feelings of aliveness, to pierce numbness with sensation, to relieve pain with pleasure. Cutting is a mechanism to release energy in order to keep going on, not end it all.  However, this does not mean that people who cut never become suicidal and people who are suicidal never cut.  A person can fluctuate back and forth depending on their state of mind at the time. Self-injury is a complex issue, a multi-layered expression that requires sensitivity to each person’s unique struggle and process.    Cutting can be a deliberate and desperate strategy to focus on physical pain in order to drown out emotional pain that feels beyond control. People cut their bodies in order to relieve the unbearable pressure of emotions that are primal in intensity,that defy verbal expression. Often times, people describe feeling like they are going to explode if they don’t give themselves the physical release of cutting.It is an instinctive act of self-preservation in the de-escalation of tension.It is a way to redirect unbearable and confusing internal pain outward toward visible, definable pain. Cutting can be a cry for help and a way to wake up and feel alive. For a person who feels emotionally dead, the sight of her own blood is the tangible proof that she is in fact alive. Blood communicates what words cannot capture, and flows where tears cannot break free. Drawing blood brings the essential life force into undeniable view.     In other circumstances,cutting is a way of exerting control because a person can be autonomously powerful with their own body. A person can choose when to cut, where to cut,how deep to cut, how many cuts to inflict. In the aftermath of cutting, there is power in the demand for giving self-care and nurturing – qualities often profoundly absent from daily living.   Cutting is a form of self-medication. It is believed that cutting works to relieve pain because the body releases endorphins when a physical injury occurs. As a safety measure, the human body is programmed to pump feel good hormones into a traumatized nervous system. Cutting stimulates such a release of endorphins that do in fact provide comfort and relief.  The trap is that cutting is a symptom of an underlying problem.  It does not solve anything beyond providing momentary relief.  In the wake of the hormonal high, the shame and secrecy of the cutting behavior perpetuates the cycle of isolation and negative self-perceptions. People who cut describe feeling like they are living double lives; one for public view that is a facade, and one that is private,secret, and real.  They often describe feeling that no one really knows them because they are harboring a deep secret that must be kept hidden at all costs.  The young people who come to see me often do not fit the familiar profile of troubled teens and young adults who express their angst by acting out against conformity and authority.  My clients are generally bright, energetic, talented people between the ages of 12 and 24 who are seeking to live up to their parents and/or the achievement benchmarks of our society. They take honors classes, lead school clubs, play team sports, and volunteer in community service.  These young people are driving themselves hard to succeed through middle school, high school, and college, in order to keep building toward a successful adult future – acceptance into a good college, candidacy for the best jobs. They are weighted down by a giant scorecard that constantly measures their worth via grades in advanced courses,hours spent volunteering, goals scored, leadership positions held, and awards won. In addition, there is constant social pressure to maintain appearances through tweets and texts, coupled with the absence of empathic and bonded connections with family and friends. These young people are going full speed ahead at all times, never feeling like they are doing enough and always feeling behind.  They are selfless people who are doing the best they know how to give themselves relief and save themselves.  Cutting is a strategy for self-sufficiency rather than bothering anyone else with their problems when the demands become unmanageable.

Oftentimes, clients come into my office for the first session and immediately break down crying because they can no longer contain the pressure. Other times, clients come in for the first session and tell me they like cutting. They don’t see why others are making an issue out of it, and they plan to continue cutting as a life long activity. Wherever the starting point with a client, as we begin to work, I always discover feelings of isolation, shame, and loss of control. There is profound emptiness and lack of connection to a sense of purpose that emerges from within and extends out to emotional intimacy with others. The inner compass has been lost, or not fortified from within. The majority of my clients feel overwhelmed, confused, lost, disconnected, lonely, depressed, anxious,depleted, and totally exhausted. My clients often have difficulty managing and being the creators of their own lives, beyond knowing how to perform according to the “rules”.  Cutting is one symptom of the despairing need to soothe the gap between the frantic pressure of achievement,and the agonizing loss of connection with the deeper mind/body/soul. It is away to force presence in the here and how amid a life that is incessantly directed at an ideal future. Cutting is greatly misunderstood because it has yet to be talked about openly in the mental health community, the educational community, or in society at large. William Cox dares to talk about it through poignant and disturbing images. He has invited and collaborated with twelve women who chose to emerge from their secrecy, and thus, courageously enact a new bridge across the gaps in their mind/body/soul connections. Their images and prose, shown through the uncensored reverence of William Cox’s photographic eye, will undoubtedly disturb the culture of secrecy in the larger community and stimulate dialogue about this growing epidemic. My hope is that this work will stimulate education and change. Education will shift the culture of shame into a culture of understanding. With understanding comes compassion and support, replacing fear and judgment. The risk of visibility demonstrated by the women in this book can inspire others to come forward, knowing they are not alone. This series is both an act of healing and an act of advocacy. William Cox’s work has the potential to move the healing forward.

The images that you are viewing are a tangible message of hope for those who may feel hopeless and alone. Cutting is 100% treatable. My commitment to the power of this work is that it will bring hope to light, and compel people who cut to come forward to seek treatment. It is possible to have the goodness of life without cutting. My clients have shown this to themselves, and to me. They are courageous fighters and resilient survivors who have found their power to choose, and thereby make their healing and recovery 100% achievable. They have proven to themselves that it is in fact possible to attain a sense of freedom and an organic happiness beyond what is attainable while cutting. With this conviction, I direct my final words to you, the reader who may consider coming  out of hiding because of this work: There is immense recovery power in speaking out loud. Speaking out loud and cutting cannot coexist. Cutting makes one disappear farther and farther into oneself. Treatment, speaking out loud and becoming visible in a safe and understanding environment will lead to the healing power of words instead of the silent pain of your scars.  It will lead to discovering your voice,standing up on your own two feet, embracing your vulnerabilities, holding firm in your progress, and reaching out to others for support. These things will protect you in a sacred embrace, and provide a depth of caring, simply unreachable through cutting. I hope you will find your courage to risk that visibility, as the women in this series did. 

 Allison  Kress PsyD

  I am Not a Cutter


    Sabrina Yocono

            Walking to the café I passed a photograph that caught mein the chest and held my eyes.  A youngwoman is shown standing.  Her left hand,with shiny red nail polish and a blue heart tattoo floating above at the wrist,hangs next to her bare thighs.  We seeonly from the top of her black bikini underwear with delicate red stitching tothe tops of her knees below.  Legsslightly crossed suggesting that her torso would be askew; she appears bothcasual and declarative.  It is the longhealed scars across her thighs, like screaming mouths sewn shut, that stop mecold.  I stand and take it in, thisunapologetic baring of private struggle. Then with great effort I stop looking and move along my day. 

Theclass assignment the following week reads, select a piece from the art galleryin the atrium that you feel a connection with. Without heading down the hall, Ialready know what I’m connected to, but I don’t like it.  The piece we choose will become a writingassignment complete with an interview of the artist.  I know what piece I feel connected to, but Idon’t want it.  I look around the galleryand see other pieces; some pretty, some bright, some calming. The photo justwaits.  It sits at eye level and screamsfrom the wall.  It doesn’t need to argueor persuade – it simply screams.  A wallof thought, images and emotion that are only my own but that I seek todeflect.  I will write about anotherpiece, I think.  Something without rawtouch and stomach churning would surely be an easier choice.  This photo starts a journey, but I don’t wantto embark on it.  Wouldn’t it be simplerto write about the ladies in hats with blue and white dishes or the swirling ofocean water as it meets rocky shore? There would be nothing personal about summer hats and oceancurrents.  The photograph though isdeclarative and I knew all along that I would write about it. 

            The memory is this. With each closing of my eyes the image flashes.  Her left forearm sliced inside where theflesh is soft and tender; seen as we cleaned and prepared the wound forwrapping.  She had asked to talk to me atthe end of my shift.  I was still intraining at the teen shelter and put my bag back in the office before Ifollowed her upstairs to talk.  Herreclusive behavior that evening suggested that she had something to share andthe way she covered her arm told of a secret. Upstairs she admitted to cutting herself, that it was deeper thanintended and that she needed help.  Sheproduced the broken razor blade she had used and assured me that it was new andtherefore ‘clean’.  This was not herfirst time at the rodeo.  Together wewent to other staff in the office for basic medical care and response.  I had not yet worked three full shifts.  Though I spoke with calm and confidence inthe moment I felt wildly beyond my depth for providing care.  Alone in my apartment that night, I saw thewound each time I closed my eyes. Accompanying the image was a rise of disorientation and nausea.  I kept my eyes open, staring at nothing in aneffort to stop seeing it.  In the end Igot stoned just to lessen the effect.  Goaway.  I beg of you, just go away.  I’ll try to face you again tomorrow, but fornow, just go away.

            In my time at the shelter I would encounter other girlswho used cutting as a coping skill.  Wewould check in with each girl, asking if they felt safe or needed furthercare.  We would help them bandage theirwounds and discuss other coping strategies. At the time that they presented their cutting , they were not suicidal.  Self-injurious behavior (SIB) is not aboutwanting to die.  It is about wantingcontrol and release even at the cost of one’s own body.  It often speaks to a deep running hurt andisolation.  Cutting is often a behaviorseen in women, though SIB affects people of every gender, age andsocio-economic status.  Rarely spoken ofand often greeted with confusion, condemnation and shame, the behavior canserve to further isolate those who already feel broken and different.  The body may respond to cutting with itsprotective endorphin rush, leaving the individual with a temporary sense ofrelief.  Like any momentary high though,it abates and leaves the individual to face not only the pressures previouslyweighing them down, but also the burden of hiding an action that is so oftenresponded to with disgust or horror. Cutting is a strong visual expression of injury to oneself.  Usually such evidence is hidden beneathclothing.

            William Cox is a photographer who believes in payingattention to coincidence.  In two back toback days of photo shoots, the models he worked with had scars on theirbodies.    To the first, he made a lightsounding comment that the scar would have required a trip to the ER and herparents must have been worried.  With thesecond he became curious.  What wouldmake a person tear and rip their own skin? He didn’t want to talk to therapists or doctors he wanted to know fromthe women who did this.  He wanted to tryand understand where they were coming from. He didn’t realize that he was falling down a rabbit hole.

            Now in his fourth year of the project, Cox is in theprocess of trying to market his collection for educational use and publicawareness.  He sought out individuals whocut.  Primarily women (there was one man,but he stuck out like a sore thumb) shared their journal entries and poetry asa way of explaining their stories.  Theyprovided their bodies, their wounds as subject for photos.  No longer hidden beneath clothing butpresented for all who will look.  Theimages and words come together for Cox’s project,  I Am a Cutter. 

            Early one Saturday evening, I met with Cox in his livingroom.  His pug greeted meenthusiastically at the door but quickly settled down on the couch, near Coxwho was nursing a knee injury from skiing earlier in the day.  Smooth music filled the room as wetalked.  Early on the strains of BlueMoon saturated the space.  We talked abovethe bass that vibrated in my ribcage.  Iheard how a simple curiosity became a journey and then a responsibility to thewomen who dared to lay bare their fallacy and addiction.

            First he would interview them.  Cox presented a calm and genuine presencethat would have helped him to develop the trusting relationships at the centerof this project.  Once he felt that theywere a good match for the project (not just seeking exposure, but honestlysharing) they would set up a photography session.  Cox, who is married with three growndaughters, expressed the importance of demonstrating respect for each of themodels.  The women being photographedwere invited to choose what they would wear and what they wanted to show.  The resulting photos are full ofdignity.  They stand as witness not as avoyeur.   

            Cox sounds most in awe of the writing that these womenshared.  He is passionate about keepingevery line and every word of every poem or diary entry that was entrusted tohis care.  Working on the book, he mustnegotiate  with the publisher for how thefinished product will be sold, but in his mind cutting the text is not a realoption.  It is not his words, but thewords of those who have trusted him to share their stories.  He sees them all as beautiful human beings.  From their written word it is easy to seethat they did not see this beauty in themselves. 

            He directed me to a couple of passages of diaryentries.  Difficult to read, he warned,but it will give you a glimpse into their world.  I read a few pages as he passed to the otherroom and back.  The words were raw,profane and bitter as they attacked the writer herself.  I was getting lost in the repetition ofreprimand and rage when he said, ‘You’ve probably never read self-loathing likethat before’.  A grunt got as far as mythroat, in way of ironic commentary.  ‘Atleast not since the last page’ he finished into the remaining space; and I wasoff the hook.  Still the words pressedagainst my teeth and dared to be spoken. They never met the room, but my mind filled with the words, ‘I have readthis self-loathing before.  For I havehated myself with the same kind of blind raging passion.  I am not a cutter, but I do understand’. 

Sweet Janeby the Cowboy Junkies played through the speakers and enveloped the room. 

Anyone who's ever had aheart

Wouldn't turn around andbreak it

and anyone who's everplayed a part

Wouldn't turn around andhate it

 Sweet Jane

Coxshared with me some of the images from the project.  He allowed me to read the forward written bya top clinical psychologist who specializes in treating teens and adults whocut.  We talked about the differentgalleries and educational institutions that he hopes to share this projectwith.  Cutting is a behavior that stilllives in the darkness.  Cox hopes that byshining light on it, he can help bring about greater awareness and treatment;much the same way that other addictive SIB, such as eating disorders, have beenbrought to light over the past decade. Discussion can be the first step to change.  He didn’t know at the start that this wouldbecome a mission.  He just knows that hecan’t walk away from it now.  He has tosee it through.

            I left without sharing my personal response to hisart.  I went home and tried to collectall the pieces of this project in my brain. A photograph from a project seeking to give voice to an epidemic that isoften ignored; the beautiful, complicated women who live these choices; aphotographer who seeks to understand and a connection that reached off the walland into my gut.  When I look at thephoto, I see a reflection of my own emotions. It touches on a place of darkness and frantic despair that threatens todestroy the very person feeling it.  I amnot a cutter – but I recognize in the act, the desperate attempt atsurvival. 

            Often in the sharing of stories we find that the detailsare merely plot advancing points for a deeper truth.  It’s what makes stories compelling even ifwe’ve never had the same personal experience. We lay our own reality down next to the tale and we see all the placeswhere they butt up against one another or just outright overlap.  From there we weave a fabric of existence andnormalcy.  We create a framework forunderstanding and expectation of what our world is and how it should be.  The beauty of this project is that it strivesto give voice to a reality that sits in darkness.  Shine a light on that which once lived in thedark and you remove the power from the monster; remove the shame from thesubject and you allow for connection to begin. This connection goes beyondthose who cut.  It reaches those like mewho know self-loathing and suicidal thought. It reaches anyone who has ever loved someone who self-injures.  It speaks to those who fear that they arebeyond understanding and it offers connection to those who thought they wouldalways cower in darkness alone.  Thephotographs are a wonderful juxtaposition of honest baring and beauty.  The untitled piece that hung in our gallerywas both arresting and beautiful.  Markedand scarred and beautiful, like all of us. 

Excerpts from emails that I have received 

"Most people look at my scars and think that they are just nasty. I  look at your portraits of cutters and think that they are so beautiful. I wish that you could liberate me like that".           Anonymous

I looked at your art many months ago. I was moved by the Raw beauty of humanity that you  captured, in its imperfections. I adore photography that isn't perfection in  life, but the harsh realities that so many people don't want to capture on  film. Life is not all sunshine and roses. I should have told you a while  ago  how much I enjoyed looking at your work. As I try to unwind after a long night  at work I was viewing it again...this time I needed to share my appreciation.  Emily 

Your cutting series made me burst into tears. I've never done  that, but my past lover cut her self so bad that she had gashes all up the  inside of her legs. I applaud you for giving cutters and past cutters a voice-they need it just like all of us. 

I would love to work with you someday.


I just wanted to tell you that I was touched by the manner in  which self-injury is portrayed in your portfolio.  Rarely have I seen it  treated with such artistic sensitivity and respect.  

Thank you. 


"You help me feel that I am not alone".


All images copyright © William Pearce Cox No use without prior authorization
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