It was the news of my best friend’s engagement that set me to thinking about it this time. A picture like many others of its kind, a hand with a beautiful sparkling ring, except this hand belonged to someone I love, so I admired it a little longer and thought about it more. It’s a picture I know I’ll never take if I become engaged myself because of what my hands look like, because of what I’ve done to them.
It began some time in my late teens or early twenties, though it’s impossible to isolate when, because I wasn’t aware that I was doing anything at all for a long time. Here’s what I do: I pick, bite, chew and otherwise harm the skin of my fingers, and especially my thumbs. I do it with such repetition and insistence that I’ve created sores and painful and unsightly areas of permanent thickened scar tissue. It took years for me to acknowledge that I was doing this, so unconscious was the habit, and so practiced at lying did I become.
When a friend asks “What happened to your hand?,” it’s easier to reply that you suffered a cooking injury than to try to explain that you’ve bitten a part of that hand off, and it isn’t healing as well as you might have hoped.
I’ve gotten better at avoiding actual injury. In years past, particularly when I was single and had nobody to subject me to scrutiny, I would sometimes let it get so bad that both thumbs were open wounds, nearly always infected and never left alone long enough to heal. Now, they have largely cemented into calluses that have grown over the creases of the knuckle. I don’t go around bleeding through Band-Aids any more, but I still stuff my hands into my pockets when a stranger on the train throws a curious glance in their direction, still delete pictures where I’ve given a thumbs up the wrong way around, still feel apologetic and tearful when my boyfriend has to gently remove my hand from my mouth during moments of high anxiety. I’m ashamed of what feels like uniquely, viscerally ugly behavior, the mess of skin and bone and chewing, all so animal.
I know that I’m not unique, though. Since I became aware of this thing that I do, I’ve noticed more and more acquaintances of mine, mostly women, who do some version of it. They are often high achieving, attractive, successful women, women whose general appearances don’t cohere with this habit. Dermatophagia is the formal name for it, and it falls under the umbrella of the broadly termed “body-focused repetitive behaviors,” which also includes trichotillomania, pulling out one’s hair, and trichophagia, eating one’s hair. It is estimated that up to 5 percent of the population engage in some behavior of this kind, and that it stems from attempts to self-soothe. The behavior has high levels of comorbidity with anxiety and depression.
Body-focused repetitive behaviors are not thought to relate to self harm like cutting, but I can personally trace their appearance in my life to the erosion of my more overt forms of self injury. Like many other depressed teenage girls, I cut myself fairly routinely, a practice concentrated largely before I left home that lingered on sporadically into my early adulthood — until about the time that I began with my hands.
The connection isn’t as direct as beginning to bite my hands once I gave up cutting myself — there isn’t so clear a line as that — but it does make me think about how self-injurious inclinations can change and disseminate as we get older. There wasn’t a single moment when I decided I would no longer cut myself. The cutting slowly stopped, partially because of stabilizing mental health and partially because it is somewhat infeasible to be visibly mentally unwell if you also want to be a functioning adult. As a teenager, your despair is all-important, your fury is concentrated and the future beyond your immediate feelings hasn’t yet become real. As an adult, there are other concerns that must take precedence. Showing up at work with visible signs of self harm, for instance, is likely to make colleagues uncomfortable at best and put your job at risk at worst.
I suffer much less now than I did when I was younger, and I am basically mentally well. The moderated suffering that remains has integrated itself into my life, my body, so my inclination toward self injury is not so severe. It manifests itself through my hands, only-minorly bloodied and easily hidden.
I do not, of course, miss that righteous fury of my adolescence, the consuming purity of feeling that led me to cut myself. Along with that act, there was always some other way I could use my body to distract me from myself, with sex, with food, with no food — all expressions of an untidy anger without borders, all these great diverting performances of rage. I am happier to have this current problem of mine than those earlier ones.
But it does sadden me to know that my inclination to soothe myself through the degradation of my body — no matter how big or small — has not gone away but has simply mutated to a less public form. This shame of mine has been a largely private one until now. It was one so private that once, in the midst of a tearful separation, pondering how we would ever begin new relationships and lives without the other, my ex took my hands in his and asked “How can you explain your hands to anyone else?”
I think sometimes about what makes it so compelling, why I am so addicted. It has something to do with seeking completion, I think, or resolution. When I try to stop, it’s always then that I find some last stray bit of loose skin, which I feel I must get rid of to be finally done. So I chase that around my hands, uprooting it and stripping it and following it around and around, keeping the whole act going indefinitely. I keep going because I never finish. There is no end to me, my body, myself; I am a problem there is no solution to.