The crisis of abstaining from self-cutting: a phenomenological study of three women's divergent trajectories after cessation.

Background: Self-cutting is often treated as a symptom to be eliminated, with behavioral cessation regarded as a sign of therapeutic success. However, little is known about how individuals experience the absence of self-cutting after it has stopped-especially when the behavior has served complex symbolic, regulatory, and relational functions. Objective: This study explores how women with long-term histories of severe self-cutting experience the cessation of the behavior. It examines why abstaining from or stopping may not be experienced as recovery, but instead as a crisis, rupture, or new forms of suffering. Methods: Using Interpretative Phenomenological Analysis (IPA), we conducted and analyzed in-depth interviews with 12 women aged 18-35. All had engaged in repetitive self-cutting for several years and most reported having stopped or being abstinent at the time of the interview. Three cases-Solveig, Angelica, and Rachel-were selected for idiographic analysis to represent divergent ways of making sense of cessation. Results: Each woman experienced the end of cutting differently. For Solveig, cessation led to psychic collapse and emotional disintegration; the scars had functioned as containers of identity and trauma. For Angelica, cutting had regulated emotional extremes, and its absence exposed her to panic and somatic dysregulation. Rachel described a shift from cutting as a mode of survival toward a position in which meaning could increasingly be held in language and relationship rather than on the skin, allowing her scars to function as symbols of survival rather than sites of enactment. Rather than indicating a uniform trajectory of recovery, cessation marked a divergent and meaning-saturated transition shaped by how cutting had functioned psychically for each of them. Conclusion: The study highlights the psychological functions that cutting can serve, and the vulnerabilities that may arise when it stops. Clinicians should be cautious to equate behavioral change with psychological integration. Sustainable transitions away from self-harm require relational containment, narrative support, and symbolic substitution. Cessation may mark the beginning of deeper therapeutic work, not the end.