Why is Miley Cyrus Harming Herself?

The internet is abuzz with pictures of Miley Cyrus’ visible “side boob” at Clive Davis’ pre-Grammy party.

But blogger Perez Hilton pointed out something something much more disturbing in the photos – a series of scars above Miley’s left wrist on her inner forearm indicating self-harm.


This is not the first time that suspected cutting marks have been seen on Miley’s arm — suspicious marks were also apparent last July.

And Miley has certainly been thinking about cutting — last month she spoke out against an online prankster’s campaign to urge Justin Bieber fans to harm themselves after a picture of Justin smoking marijuana emerged.  #cutforbieber became a major Twitter trend afterwards, but Miley tweeted:

#cutforbieber? Cutting is NOT something to joke about. There are people who are actually suffering from self-harm, this is so disrespectful.

If Miley Cyrus is, or has been, engaging in self-harm, she certainly is not alone. Fellow Disney star Demi Lovato has been very open about her battle with the disorder. Other celebrities who have admitting to cutting include Fiona Apple, Russell Brand, Johnny Depp, Colin Farrell, Darrell Hammond and Drew Barrymore.

What is cutting, who does it and why?

Cutting is the most commonly used method for self-injury or self-harm where people use a sharp knife or razor to cut themselves on their arms, stomach and/or legs.

Thoughts of self-harm typically occur when a person is alone and experiencing negative thoughts or feelings such as worthlessness, anger, guilt, helplessness, rejection or self-hatred. It is widely believed that self-harm is done in most cases as a means of self-soothing stress relief or help-seeking.

According to experts:

  • Self-injurers make up nearly 1% of the population with a higher proportion of females than males.
  • The behavior typically begins around puberty.
  • Persons seeking treatment are usually from a middle to upper class background, of average to high intelligence and have low self-esteem.
  • Nearly 50% report physical and/or sexual abuse during their childhood.
  • As many as 90% of self-injurers say that they were discouraged from expressing emotions, particularly anger and sadness.

Is cutting a suicide attempt?

Cutting is usually considered a symptom of non-suicidal self-injury (NSSI) in which the cutter has no intent to die.  But this is not a diagnosis to make on your own. If you or anyone you know has thoughts about hurting themselves, you must seek the help of a mental health professional.

Researchers such as Dr. Matthew Nock believe that cutting or NSSI is not itself a mental illness but rather a form of communication where actions speak louder than words.

What the warning signs that someone may be cutting?

Cutters typically often fiercely try to hide their cutting.  Warning signs that someone is injuring himself or herself include:

  • Unexplained frequent injury including cuts and burns
  • Wearing long pants and sleeves in warm weather
  • Low self-esteem
  • Difficulty handling feelings
  • Relationship problems
  • Poor functioning at work, school or home

How is self- injury diagnoses and treated?

For medical doctors and psychologists there are methods to test whether or not a person is engaging in deliberate self-harm. The most effective treatment for NSSI is most often a combination of cognitive behavioral therapy (CBT) and medication.

There are a number of interesting and useful books on NSSI including:

Click here to go the Resounding Health Casebook on NSSI.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.


  1. anon

    February 10, 2013 at 8:12 pm

    I’m going with ‘relationship problems.’ Liam’s an asshole and treats her like shit.

    • Belmont

      May 27, 2013 at 7:52 pm

      Or you know, she’s a fucking psychotic slut and does it for attention, like everything else she’s ever done?

  2. Elizabeth Godfrey

    November 19, 2014 at 2:31 am

    “But You Don’t Look Sick!”: Invisible Injury
    “But you don’t look sick.” Nearly everyone with an internal disorder or other invisible ailment has cringed at this phrase, which delegitimizes the challenges they face daily. It comes in other forms: “But you don’t look fat” to diabetics; “But you seem so normal” to people with mental conditions; “But you should be over that by now” to anyone suffering from depression. Ubiquitous remarks like these illustrate how insensitive the general public is toward invisible injuries. Through lack of understanding, tact, or empathy, people sometimes approach sufferers of diseases without obvious visual representation with disregard.
    Miley Cyrus may be an individual with an invisible disorder, manifested visually only by the scars of [possible] self-harm. The responses of previous commentators on this article exemplify the treatment of invisible disorders as illegitimate. ‘Anon’ may try to rationalize Cyrus’s mental health issues in a way that supports her (anon says, “I’m going with ‘relationship problems.’ Liam’s an —hole and treats her like s—“), but blaming self-harm on a bad relationship is a gross oversimplification of mental wellness. Nevertheless, anon’s comment still compares favorably to Belmont’s, which accuses Cyrus of engaging in self-harm for attention and calls her psychotic.
    We are incredibly reliant as a culture on visual representations. An illness’s severity is judged by its visibility. One red flag signaling how heavily we rely on our eyes is the prevalence of medical imaging in healthcare. In my experience, when someone has abdominal pain, muscle aches, a twitch, a lump, it’s off to the MRI for them—and invariably, when there is no clear aberration, no diagnosis is offered. Pregnancy may not be an illness, but its legitimacy is also judged by visual representations: the blue lines of a positive pregnancy test, the growing belly, and finally, the [usually unreadable] ultrasound film, which seems to be viewed as the ‘real proof’ of pregnancy. When we are so hung up on how things look, how can we possibly understand health challenges that are by definition without outward sign?
    Part of the problem arises because images are treated as objective. If a disease or injury can’t be visualized (or represented in any sensory manner), it can only be evaluated on the subjective basis of narratives. Relying on others’ reports seems to introduce more room for misunderstanding, since they may experience things differently, emphasize different issues, or even choose language different from the listener. But images have shortcomings too. The angle at which an x-ray is taken, the experiences of a radiologist, and the position of the body being imaged can all drastically alter how that radiologist sees the image.
    Just as an x-ray of a broken hand may not reveal the injury within, there may be no visual representation that can adequately display invisible injuries from diabetes to bipolar disorder. But the failure of an outsider to see an injury does not lessen the pain it causes the sufferer, and this perception of disorders as being real only when they can be easily seen must be reevaluated.

  3. Monica Bodd

    November 21, 2014 at 5:59 pm

    I completely agree with Elizabeth’s comments on the invisibility of disease and the perception of objectivity in medicine. So many diseases are based heavily on outward appearances, and I believe that this shows our inability to document and measure such psychiatric diseases that lack numeric indicators. Until all diseases can be measured based on the levels of certain hormones, or the mutation of certain genes, it is imperative to look at the ways in which we can preserve and identify the signs of these illnesses. As Patel emphasizes in his paper, the medical system now looks at every patient as having a disease rather than an illness – having a “dysfunction of the body…[rather than] the social and moral meaning attached to this dysfunction”. This is the reason for less-than-perfect patient outcomes and diagnoses in healthcare systems where doctors look to pinpoint a cause rather than make a cumulative judgment based on the patient’s narrative. Narrative medicine is such a key aspect of the forthcoming healthcare system, where doctors are able to record and be active listeners to the story surrounding the patient’s illness, which will help treat the patient much more efficiently. Possible self-harm and related illnesses such as depression currently can only be identified using the stories surrounding a patient’s history. According to Topol in The Creative Destruction of Medicine, this is at least until we have the emergence of a newly powerful EMR system that creates a way for physicians to display both subjective and objective narratives in coexistence. So many stories like Miley Cyrus’ have yet to be found and for these patients to be treated, but as long as physicians make a continued effort to utilize patient storytelling, we are on our way to a more effective method of treatment.

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