Reports from a Resident Alien

I have three main special interests.

Psychology
I got interested in psychology when I was a teenager; it explained a lot about the multiple episodes of depression I have had over the years, starting at about nine years old, and helped me to learn more about myself. From there, I started studying psychology from textbooks and at the library; by the time I was at college, I ran out of things to learn from textbooks and started reading the journals to sift through the newer information on the topic. I eventually got fascinated with cognitive psychology, especially neurological development during the "language explosion" of the early childhood years. I took some college classes in psychology, and easily earned "A"s, generally with 100% on the tests.

Naturally, studying child psychology and language led me to autism, and from there to Asperger's. At this time I had already been hospitalized for depression; but learning about psychology eventually paid off in my personal life in a big way. During a phone call to my mother, I mentioned studying autism and Asperger's, and that I thought I might have some of the same traits as someone on the autism spectrum. Reluctantly, my mother, an occupational therapist who sometimes works with autistic children, revealed to me that she had known I was autistic when the DSM-IV had been revised in 1994, but had refused to have me "labeled".

I went to my psychiatrist with this information, and after an hour-long interview, she agreed that my mother and I were almost certainly right; I had a missed diagnosis of Asperger Syndrome, probably because psychologists who work with adults are not looking for "childhood disorders". (Lately I have been studying the diagnosis of autism spectrum disorders, and believe my correct diagnosis is probably PDD-NOS because I had highly odd speech and some trouble learning how to take care of myself. I look forward to seeing the new diagnostic criteria in the next edition of the DSM, since this might clear up the confusion that causes over half of autism diagnoses to be thrown into the "PDD-NOS" catch-all.) The specific diagnosis isn't nearly as important as what I've learned from it, though.

Now that I know my own diagnosis, I can research autism itself and apply many solutions that other people have found to the problems I myself face. I learned, for example, to regulate sensory input and lower my stress level by wearing sunglasses outside and wearing comfortable clothes. I learned many techniques for calming myself when I become overwhelmed; before that, I had either had tantrums or resorted to self-injury (scratching, cutting, biting, banging, etc.). I learned how to deal with executive dysfunction by breaking tasks into smaller pieces and making up lists and procedures. Since I got my diagnosis, I've been able to learn to drive, keep up a 3.8 at college (I had a 2.1 before), and be successfully employed at an internship in the pharmacology/toxicology department for the first time. Understanding my own weaknesses and my own cognitive style has helped me to realize that people are not all meant to think, learn, and do things the same way; and that I have to tailor those things to my own odd brain.

Cats
I first got interested in cats when my grandparents dropped a pair of barn kittens on our doorstep. Unimaginatively named Tiger, my first cat taught me how to read feline posture, movement, and vocalizations. Oddly enough, I have much more trouble gauging the mood of a human being than I do with cats; I can look at a cat and see how comfortable it is in its environment, what interests it, what it thinks of me, what it is feeling at the moment, and a little about its personality. Cats are comfortable social interaction that require no words to understand and be understood.

I went about studying cats the same way I study most things: I raided the library and exhausted their resources. Later, when I was on my own, I started volunteering at cat shelters and helping manage the feral cats in my own community. In my neighborhood, when a new cat is dumped or a feral moves in from another area, we put out bait in a trap and take the cat to the Humane Society to be neutered and receive a rabies shot. Then, after recovery, the cat is released back into its environment to live as part of a small managed feral colony. The advantages of feral cat TNR (trap-neuter-release) are that one doesn't have to constantly round up feral cats to be euthanized; nor is there a problem with intact cats fighting, spraying, and having litter after litter with a high mortality rate for the kittens and often the mother.

Managed colonies save a lot of money since feral cats tend to keep to themselves and be nearly invisible, and all that's required is to set up a program to watch for new ones and get them neutered. A neighbor two doors down manages a feeding station for the neighborhood ferals, and we even get the food for free from the Humane Society.

I have one cat myself, and am also taking care of two foster cats. Fostering a cat means that the cat is not doing well at the shelter and needs extra care, and hopefully can recover its health and be adopted out. One of my fosters is a very shy little calico who is just learning that it's OK to sit on people's laps after a year; another foster I've had for a week; she was picked up with the worst flea problem any of us has ever seen, anemic and undernourished, and may possibly have cancer. I am taking care of her until we know whether she can recover, or whether she will have to be euthanized. If she recovers, I will try to find her a home. Currently, I am helping manage a database of adoptable cats for the shelter where I volunteer; we hope that an online resource might help improve publicity and get more cats adopted.

Physics & Mathematics
I picked "physics & math" out of a longer list of science-related topics; the other really strong interests in that area are statistics and calculus. I first got interested in astronomy as a child; I learned all the constellations, and then I branched out into the laws that dictated how the stars in those constellations worked. I didn't have the mathematics for it, but by the time I was about fourteen, I understood how relativity worked and had opinions on the newer ideas in quantum physics.

Modern physics has always been a love of mine, but mechanics (Newtonian physics) had their turn, too, when I took a statics class and started really learning how to use Newton's laws to balance forces against each other and fully describe a system with numbers. In college, when I learned calculus, I enhanced my collection of ideas in modern physics with the ability to put numbers on the ideas of what happens when space-time gets curved.

My interest in mathematics is especially odd because I was actually delayed in mathematics as a child; I was working on first-grade concepts in the third grade, and only caught up around the sixth grade and the beginnings of algebra. Apparently, what was hard for me wasn't the logic of mathematics but the memorization of math facts (I finally learned my multiplication tables in high school, when I turned the mathematical ideas of numbers into mental shapes and imagined how they interacted.

Even now, I don't do multiplication the normal way; asked to multiply 8*6, I will imagine 6*4*2 instead. I know that a 4x6 rectangle has 24 squares in it because I can imagine that many squares; then, I stretch that rectangle two units into the third dimension, making a solid with 48 units and coming up with 8*6=48, or else double the 6*4 rectangle to make 48. It's no wonder I took to calculus like a duck to water--calculus is all about merging algebra and geometry and I think of numbers in terms of logic and shapes, not as abstract facts to be memorized!

My current topic in this field is statistics. I love the way you can take a lot of random data, find the patterns in it, and then find the exact odds that this list of numbers actually matches your predictions! I've gotten the opportunity to actually do this semi-professionally during a summer internship at the pharm/tox department at my university. I get to crunch the numbers in an experiment to determine the effects of fructose on the circadian rhythm.

Can I turn these special interests into a job? Well, if internships count, yes. Maybe even for a long-term job.  At one point I thought I should be a veterinarian, but there's too much social contact involved... The problem with special interests and employment seems to be that many jobs require social skills plus whatever interest it is, which is why I can't become a psychologist. My current internship is meant for minorities, including disabled people, and I am receiving a lot of help that makes up for my weaknesses and lets me use my strengths properly.

People are a lot like numbers... no, really, hear me out.

Look at these numbers:
6
10
15
30

They're different numbers, right? Unique, with all sorts of different properties to them?

OK. Prime factor time.

6=2x3
10=2x5
15=3x5
30=2x3x5

See those factors? They're parts of the numbers. Take the prime factor, set it at right angles to all the other prime factors, and you've got the number.

Those numbers are all made up of the same group of prime factors, and yet they've got different properties and different shapes.

People are a lot like that. You might have the same prime factor as somebody else, but that doesn't mean you're anything like them, because it doesn't predict the other prime factors you might have.

Replace prime factor with psychological trait, personality trait, neurological trait, and maybe you get what I mean.

There are ever so many more composite numbers than primes--infinitely many more. People are composite numbers, by their very nature, with more dimensions to them than anybody can even count. They can't be defined by any one trait any more than 30 can be completely defined by its status as a multiple of 2.

There's one way people are different from numbers, though. 30 will always be 2, 3, 5; but people are forever adding and dropping factors, changing their shapes and their places in the patterns of life.

When I say I am "Autistic":

I use "autistic" as a general term for the entire autism spectrum. I think Asperger's and other types of autism are too similar, with too much overlap between them and no clear dividing line, with too many cases on the borderline between them, to be truly separate entities. Certainly you can pick examples of other types of autism that are very far away from certain other examples of Asperger's, but you can also pick examples where they are entirely indistinguishable. I am more in favor of a broad range of expressions of Autism than separate entities with different names. When I say I am "autistic", I am saying I am "on the autism spectrum", not that my official diagnosis has suddenly switched from Asperger's Disorder to Autistic Disorder (it hasn't, and there's been no reason to re-classify, since one is as good as the other and it gets me the services I need).

The way the ASDs are diagnosed, the names have become pretty close to meaningless. There's the whole annoying problem of the diagnostic criteria overlapping to the point that most Asperger's cases, including mine, can also be diagnosed as Autistic Disorder. Diagnosis is often based entirely on what the doctor thinks will get the child the proper services, or the doctor's impression of functioning level (which doesn't actually even have an official definition), or even an attempt not to say "autism" and diagnose PDD-NOS in a person who clearly fits into the Autistic Disorder category.

The only diagnostic sure thing I know of is that someone who is labeled Asperger's generally has some use of spoken language, though whether it's reliable or whether it was delayed is anyone's guess. They don't diagnose by-the-book, so the labels don't mean too much; and if they did diagnose by the book, the labels still wouldn't mean very much because the Autistic Disorder category would pick up so many more cases from the PDD-NOS and Asperger's groups.

In any one ASD category, you'll have wildly different people with the same label. Pick one person diagnosed Asperger's, and you might have a shy bookworm with a PhD; pick another one, and you might come up with a wildly eccentric extrovert who repeatedly embarrasses himself and doesn't care; pick a third, and you might have an overly polite housewife who doesn't get out much and spends a lot of time on the Internet. For that matter, you could pick the same three people out of the "Autistic Disorder" or "PDD-NOS" boxes.

If you can't predict what someone will be like based on the particular ASD they have, and if you can't predict what particular ASD they will be diagnosed with based on what they are like, then aren't the specific categories a bit meaningless to begin with?

So I have decided to forgo identifying as any precise diagnosis and simply gone for calling myself "autistic". This is the general term for anyone with a PDD--Autistic Disorder, Asperger's, Rett's, CDD, and PDD-NOS--and I much prefer it to compartmentalizing the spectrum artificially, especially since I have grown very annoyed with the tendency to say one group is either "better off" or "more truly autistic" than another. There's too much divide-and-conquer going on as it is; until there are better official criteria, I'm going to forget about specific labels altogether.

We're just going to have to deal with the fact that we are too diverse for any one way of experiencing autism to be anything near universal; and we're better off wasting no time making it clear that human rights apply no matter what sort of weird brain you have. Who says you can't demand universal human rights for people who don't experience autism the same way you do?

No, you don't know "what it's like" to be someone else. No, you can't speak for them any more than you could speak for your identically autistic twin. (Those who think we share an "autistic hive mind" are sadly mistaken and should see us argue some time!) Of course you can't; you can't move into someone else's brain and know what they are thinking! Besides, a lot of what this neurodiversity thing is all about is that everybody gets to speak for himself. That, and actually being represented by people who are autistic, not NT psychologists, which is about as silly as having somebody who's lived all his life in Canada represent the interests of people in Madagascar.

Bottom line: Despite all the diversity, there's no reason we shouldn't work together. After all, the only thing you really need to demand human rights for someone else is to be as human as they are. Last I heard, we all had that in common.

I've had a few mental-health problems over the years. I have also had several psychologists, psychiatrists, and counselors; and it seems like every time I had a new one, it was like playing Russian roulette with my sanity.

One therapist insisted I was manipulating him when I couldn't organize myself well enough to remember all my appointments; another said that my abusive stepfather would not have hit me if I had been better behaved. I've been diagnosed with Borderline Personality Disorder on the strength of a single symptom, and then had it presumed that anything I did was obviously manipulative, impulsive, or overly emotional. This diagnosis has a lot of stigma... I was very lucky to be rid of it not too long afterward, but I wonder how people with real BPD are supposed to get any help if they are treated the way I was.

During one in-patient visit, I was given Haldol simply because I was crying (lying on my bed and crying for twenty minutes--not in any danger of hurting myself or anyone else--and I do not have a disorder that involves psychosis). Another patient at the same hospital was restrained for half the day because he yelled at the nurses. I was overmedicated to the point that I couldn't think straight; and nobody consulted me about what I was thinking and feeling--they only threw more medication at me.

I have, of course, been assigned therapists I simply didn't match with very well. That was nobody's fault; communication styles differ.

On the other hand, I've had a few very good therapists, from whom I've learned very much. One finally figured out "autism" (which is rather difficult when you are treating an adult and not expecting childhood disorders), though she wasn't the first to know--I learned that my mother knew I was autistic when I was a child and didn't want me labeled. As a result, I understand myself better than I have ever done, and have become much more independent than ever before. Another counselor has helped me to recover from depression and slowly clean up the nasty automatic thoughts that one gains from such an episode. My current counselor has been so helpful in teaching organization and planning that I am seeing real differences in the way that I study and organize my house. I even started studying four days in advance for a test I had yesterday--though I was still too distracted and only thoroughly studied half the material, it's a great deal better than my record of finally buckling down at 2 a.m. the night before the exam.

One common trait of the therapists with whom I've made the best progress: They acted in ways that made it obvious they thought I was an important part of what was going to help me get better. I wasn't an object anymore; I didn't have to sit down and be a good little mental patient. They weren't superior; I wasn't defective. That made all the difference.

Oddly enough, they also tend to be the ones with the lower ranks on the psychology totem pole: A social worker; a graduate student in psychology; a nurse-practitioner. Coincidence? No idea.

How do you tell the difference between one kind and the other? It seems like some people really want to help, and are competent and ethical about it; and others--perhaps jaded over the years, or having a habit of feeling superior to their patients--have become negligent, incompetent, or outright abusive. You can't even tell from looking at them--they seem like nice people. I don't know that an NT could tell any better, seeing as how psychologists often have completely different behavior patterns between patients and "normal" people.

Professionals in the field of psychology see people when they are emotionally and cognitively very vulnerable. Getting quality treatment is important. And yet--if my experiences are typical--there doesn't seem to be that much quality control. How can you ever be sure of finding a competent therapist who will treat you with respect?

Just being a human being in the Western world, you have about a fifty-percent chance of ending up with some kind of mental problem sooner or later. It could be when you're very old and you get a stroke; it could be complicated grief; it could be social anxiety disorder; it could be something less common. And being autistic, of course your risk is greater just because your stress level's higher. Maybe you already have a mental illness. So, yes, the possibility of getting a comorbid mental illness is a realistic thing to think about--but it doesn't make much sense just to worry. After all, anxiety is meant to spur you into planning or action, not to just hang around and make you uncomfortable.

You know how, if you want to reduce the chances of things like heart disease or high blood pressure, you get regular checkups, start eating real food, and find out what kind of physical activity you like? Well, there's a mental version of that, which will both reduce your vulnerability to mental illness, and increase your ability to manage and/or recover from one if you get it.

(Physical health, incidentally, does affect mental health. Maximizing physical health gives you maximum resources to do mental things with.)

Lifestyle stuff that maximizes your mental health:

• Having a hobby you enjoy
• Having meaningful social connections (not necessarily a lot of them, or seeing them frequently; it's having the connections at all that's important--yes, they can be online)
• Having a pet you enjoy spending time with
• Working to gain insight into your identity, personality, and thought style
• Working to gain awareness of your emotions and how they affect you
• Managing stress, to keep the level just high enough to motivate you, but low enough so that it dissipates whenever you spend time relaxing
• Spending time outdoors--sunlight has mental benefits as well as physical ones
• Keeping a good sleep schedule, or at least getting enough sleep
• Learning things throughout your lifetime; staying mentally active (it needn't be academic subjects)
• Having purposeful activity to engage in (may be work; may be something else)
• Learning to let things go instead of worrying about them; the past is unchangeable, and once you have learned from it, there's no point in regretting it
• Volunteering, formally or informally; spending time helping other people
• Keeping in touch with family, provided they're not abusive
• Learning to forgive people--without also letting them hurt you (or others) again
• Having a well-defined religious or philosophical belief system; joining a religious organization
• Regularly listening to music you enjoy (seriously; music has mental health benefits)
• Keeping up an exercise program that you enjoy (it has much less benefit if you hate it and feel forced)
• Learning to understand and deal with anger
• Learning to be assertive
• Being able to recognize that you have made a mistake or done something wrong--while also being able to apologize and move on, without unduly punishing yourself for your error
• Learning to recognize inefficient or dangerous coping strategies, and replace them with effective, safer ones (ex. If you drink too much or max out your credit cards when you're stressed, finding another way to deal)
• Learning to identify and solve problems when they occur, rather than assuming they are unsolvable and must be endured
• Keeping a journal; updating a blog; putting your thoughts down on paper in the form of stories, poetry, essays, etc.
• Learning your strengths and weaknesses; learning to accept and understand both
• Not keeping secrets from yourself
• Learning how to accept your own mistakes; learning it's acceptable to make mistakes
• Having some place where you can go to be alone and relax, where work, family and friends aren't allowed to bother you
• Learning to be proud of yourself for your effort and the way you used your skills, not for the way you're judged by others
• Spending as little time as possible (none, if you can) with people who do not accept you as you are
• Learning to identify the times when your feelings are illogical, and don't reflect reason or reality
• Finding out what things you are unconsciously telling yourself; changing them, if necessary
• Knowing where to find help for psychological problems (it needn't be a psychologist; counselors, mentors, and religious leaders can help too), and being willing to start working on the problem before it becomes really overwhelming
• Finding ways to solve relationship problems
• Defining exactly how much you will change to please someone else, and what parts of your behavior, beliefs, and values are inviolate

This is simple prevention... It may not keep you from getting a mental illness; and by itself it probably won't magically make you recover; but in general your resistance goes way up if you do this kind of stuff. I've had several episodes of depression, as well as PTSD; I've had other diagnoses thrown at me that didn't stick because they weren't correct in the first place. Doing things like those on the list above has kept me--literally--sane.

And yeah, obviously what I've described isn't going to actually be possible to do completely and constantly. But then, it's possible to greatly reduce your chances of getting heart disease--even if you do have a burger or skip your workout once in a while. You don't have to be anywhere near perfect to start getting a rather large increase in your mental resilience; anyway, worrying about whether you're working hard enough is kind of counterproductive anyway, because it involves stress and anxiety you really don't need.

Still, there's no shame in having a mental illness, just like there's no shame in having a heart attack; but just like you're more likely to survive a heart attack if you've been living healthy and went to the doctor the second you felt chest pain, you're more likely to come out of a mental illness intact if you practice these sorts of preventative strategies, and go find help when you  first see there's a problem.

Finding a decent counselor, psychologist, etc.: Don't settle for anyone who doesn't:

• Treat you with respect
• Put more weight on your words than on the diagnostic handbook
• Consider you an equal partner in your treatment
• Know, or be willing to learn, how autism affects your experience of life and of mental illness in particular
• Respect your opinions about medication
• Use medication only when it is the best choice of treatment, at the lowest dose possible
• Keep your conversations confidential
• Encourage you to take control of your own treatment
• Reconsider a diagnosis if it can be shown not to be accurate
• Reject stereotypes associated with a diagnosis
• Understand that there is a difference between behavior that is not typical and behavior that is harmful
• Understand that harmful actions and thoughts have a purpose, and simply stopping them will not solve the problem if that purpose is not filled in another way
• Focus on teaching skills, rather than "fixing" what is "wrong"
• Understand that you are the one who knows yourself best, and that no one else can tell you what you "ought" to be feeling
• Understand the basic individuality of people, and the fact that no treatment strategy is ideal for everyone
• Keep clear goals for treatment

Yes, it can be difficult. I consider myself lucky: It took me only eleven counselors, doctors, and psychologists before I found someone who fit these criteria! (It helps if you have some control over who you see; if you're on Medicaid like I am, you usually don't have much.)

So that's about it, I guess... keeping tabs on your mental health is a lot more important when you're already vulnerable. Using some of these strategies to maximize your resilience will help you prevent or manage mental illnesses; and the nice thing about it is that they'll make your life more enjoyable in general.

Is Asperger Syndrome a mental illness?

That depends on how you define "mental illness". If you define it as "something in the DSM-IV, treated by a psychologist, with primarily mental symptoms", then yes, it's a mental illness. But consider: Under this definition, many other things are mental illnesses: Mental retardation, learning disabilities like dyslexia, ADHD, speech impediments, Alzheimer's. Putting autism in that group makes sense--even if "mental illness" has connotations that those things don't have.

On the other hand, let's define mental illness as "a condition with emotional, behavioral, and sometimes psychotic symptoms, treated by a psychologist, which causes distress and impairs function." Under that definition, none of the above (including autism) qualify. This is the more commonly used definition of mental illness...

You know, reading the above paragraph, I realize I have trouble properly explaining the average-person idea of "mental illness"; my definitions don't really seem to draw a mental line between the two groups. All I really have is a large list of examples which people would consider to be "mental illness" and I have trouble properly drawing out the common characteristics.

So maybe it would be better to just make a list of what most people would consider to be "mental illness".

• Various anxiety disorders: Panic attacks, GAD, OCD
• Schizophrenia and other conditions that involve psychosis
• Depression and related conditions
• Bipolar disorder and related conditions
• Hypochondria and other psychological conditions with physical symptoms ("It's all in your head")
• Dissociative identity disorder (multiple personalities)
• Eating disorders

I went through literally all of the DSM-IV categories to pick those out. (Wikipedia rocks, incidentally.) They made up barely a quarter of the available diagnoses. Also note that the previous list includes mostly very severe psychological disorders--the "flashy" kind they put on TV a lot--and the ones you're most likely to be hospitalized for. I actually had to debate whether to put hypochondriasis on that list, because most people wouldn't immediately associate it with "mental illness" so much as "making a fool out of yourself".

"But," some say, "Asperger's isn't a disability. If it isn't a disability, it can't be a mental illness." Hate to burst your bubble, but yes, Asperger's is a disability. That there are positive aspects to AS doesn't change that we lack some skills the world expects of us. By the social model, we are disabled, just like deaf people and wheelchair users who, just like us, simply need the right environment. Social model: A deaf person in a hearing world is quite disabled; a deaf person in a signing world is not disabled. An Aspie in a world where people use lots of vague communication is disabled; in a world where people say what they mean (and where special interests are OK and people don't create overwhelming sensory situations), he's not disabled. But of course, the social model of disability is quite another issue altogether.

The "Asperger's is not a mental illness" protest, I think, stems from this popular concept of mental illness as something that makes you "go crazy" and get put in the looney bin. This is an unfortunate state of affairs because, technically, in the medical sense, AS is a mental illness; but in the colloquial sense of the term, it's far from it.

How to explain Asperger's? Describe it as neurological--"My brain works differently". This should evoke the right connotations in the listener's mind.

I've read a lot about schizophrenia, especially things written the patients themselves, and the common denominator between their stories seems to be that they were treated at best, as children; at worst, as subhuman animals. Nothing they said was believed, they weren't taken seriously, they were put in restraints at the slightest provocation, and they were overmedicated just so the staff wouldn't have to deal with them.

Naturally, schizophrenia is often severe and these people needed treatment; but they didn't need to be dehumanized. The worst possible thing you can do to someone with hallucinations, delusions, and who knows what else is to treat them as though they aren't human... you might be severing their only lifeline.

I see medication as a tool, for use by the patient and not the doctor. For that matter, the doctor himself is a tool as well. It's the person doing the recovering or management of his problem who should be using these tools. Even someone out of touch with reality, with developmental delay, or who has borderline or antisocial personality disorder, is still human, and should be given control over his own treatment. Sometimes the disease itself prevents such control--for example, a delusion may prevent clear thinking--but it should be the disease and not the doctor who is preventing the patient from making his own decisions.

When someone has a mental illness or disability, it's often the knee-jerk reaction of medical personnel to treat that person as an object, someone to whom things are done--passive, not active. That is a tendency to be avoided, both by the doctors and by the patient. A patient who is an active participant in his own treatment, and, as far as possible, the main decision-maker, will eventually be able, using those tools available to him, to take control of his own mental illness.

Turn a patient into a passive recipient of treatment, and you have made him institutionalized, unable to make decisions on his own, having lost all faith in himself.

OK, so I'm a self-injurer--mostly recovered, now. Automatically people will gasp and shudder when they hear that, but, tell you the truth, it isn't as "bad" as people think it is; it's just socially unacceptable, dangerous in a minor way, and an ineffective way to cope with emotional problems.

I used to cut myself; I started when I was in my early teens; recently, I've stopped doing that. I still bang my hands into things, or bite myself, or pull at my hair. But those other things almost never break my skin or leave more than a fading red mark; they're hardly self-injury at all. And now I know how to predict when I'll feel so overwhelmed by the world; and I'm able to withdraw into my quiet, comfortable room (and maybe even under my nice, heavy blanket) and curl into a very small ball, and feel safe. Knowing I'm autistic has helped me to understand that aspect of myself a great deal more.

The problem with self-injury, especially cutting, is that it is very seen in a very bad light, except in very specific cultures--it might be accepted among "goths", or, if it is decorative, among people who are into body modification, or among people for whom it has cultural significance.

Here's why cutting is socially unacceptable:

We are all born with a huge instinct for self-preservation. People do amazing things when their lives are in danger; look at any account of people who have survived things like fires, or being trapped in the wilderness, or plane crashes... Human beings are very, very motivated to survive.

The very strange thing is that when I cut myself, banged my head and arms against things, and scratched and bit myself, it was because it was a last-ditch effort to survive. But other people didn't understand that.

There's a visceral reaction that people have when they see someone else with an injury--a psychological sympathy-pain reaction, I suppose. Whenever I see someone else with an injury, I know I kind of cringe in sympathetic pain... I don't know if you feel it the same way, but there's always a sort of knot in my stomach when I see someone else has been injured.

The second reason is that people see anyone who hurts themselves deliberately as mentally ill, and that there is a huge stigma associated with mental illness.

Because cutting is so "dramatic", and people can't imagine themselves doing it, they often think that it is much more severe than it actually is, or that it is a suicide attempt. In reality, superficial self-injury is usually an indicator of a relatively common mental illness like depression or autism--both of which I have, the depression, severe (but now in remission) and the autism, mild and permanent.

People are afraid of those with mental illnesses. There are a lot of reasons for that:

• Horror movies have a lot of villains who are psychopaths or otherwise insane... Despite that a murderer or other violent criminal is very likely to be perfectly sane, people associate mental illness with violence.
• The stereotypical mental illness--schizophrenia--is also one of the worst.
• People are often afraid that they will "catch" your mental illness.
• There's a certain social code that people follow. Whatever language you speak, that's only about half your communication to other people. The other half is nonverbal... gestures, clothes, the way you walk, your posture. People with mental illnesses (or PDDs like autism) often don't follow these unwritten codes; and people who see them don't "speak" the same nonverbal language. Therefore, people will often ostracize those with very mild problems... just because they can't predict their nonverbal actions.
• People are afraid of what they don't know and can't predict. Prejudice against the unfamiliar--whether it's a different culture, or a different religion, or even a different hobby or career--is very common. And those with mental illnesses, even common ones like depression or PTSD, are different in a fundamental way. Our brains define us.

When people see my scars, they know I have broken a taboo: The unwritten rule that one must always act to protect one's physical health. That rule is imprinted on the instincts of human beings.

The reason I broke that rule is because I knew that, with my limited options, I might hurt myself worse--even fatally--if I didn't hurt myself superficially. It's like getting a splinter out of your skin, so it doesn't get infected... It hurts, but it'd hurt a lot worse if you didn't.

When I felt like everything was too overwhelming, too unpredictable, or even too loud, noisy, messy, smelly, and bright... That was when I used self-injury.

Because I had limited options, I chose to hurt myself in a small way to avoid big pain. Now that I have more options, mentally and emotionally, to deal with emotional overload, I no longer need such a drastic coping strategy. Cutting really doesn't work all that well, anyway; so once you find a better way to deal with life, why go back?

But people don't understand that people who cut themselves felt they hadn't any other options. They jump to the conclusion that the only reason someone would want to hurt themselves would be to commit suicide or because they were mentally unstable and thus likely to hurt others and not only themselves. And they are afraid of anyone who would break such a taboo.

A third reason that people might look down on someone who cuts is that they believe they are doing it for 'attention'. This is sometimes true; but only occasionally. Usually, when the person does it "for attention", they need the attention!--Because someone desperate enough to hurt themselves and make it obvious that they have done so, is pretty desperate for help. "Just looking for attention" usually means there's something wrong, not that the person should be ignored and belittled.

But most of the time, a cutter is not "doing it for attention". I hid my own habit for ten years... If they are hiding the cuts, they aren't looking for attention--though sometimes they might subconsciously want help, and forget to hide a cut, or not hide it well enough.

Some people are just afraid of blood... for them, it's a phobic reaction.

All in all, the reaction to cutting is much greater than the habit warrants. Cutting is much less dangerous than drugs, smoking, unprotected sex, or even not using your seat belt... yet it gets a much more emotional reaction because it's "not normal".

People are simply afraid of what they can't predict and don't understand.