William  Cox

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. 

  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 collaborative environment of dignity that was 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 , and perhaps begin healing their deepest wounding.    

  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 the 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. This collaborative 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