Ask a Psychologist: I Have a History of Self-Injury

How do I keep hiding the scars?

Q: Dear APW,

I’ve had a long history of recovering from mental problems, including cutting and bulimia. I very much appreciated the Ask a Psychologist post on eating disorders. It’s helped me manage my body image issues as I try and deal with trying on bridesmaid dresses for two upcoming weddings, as well as embarking on my own wedding planning.

My problem now is that even though it’s been a couple years since I’ve cut myself, I still have scars on my upper arms, with a few on the right arm that are large, discolored, and bumpy. You can’t miss them.

This has caused two wedding issues for me. The first is that one of the brides that has asked me to be in her wedding does not know about the scars. She lives in another state so I thought I’d be trying on dresses and just sending her pictures for her to choose from, so I could just make sure that the scars weren’t visible in the pictures. She is letting us choose our own dresses, and I don’t think she has a problem with me wearing a jacket or cover-up, so I thought I was set, although I believe that would make me the only member of the bridal party not going sleeveless. This week, though, she offered to fly me to her state so that I could go dress shopping with her. This is an incredibly generous and thoughtful offer, and I’d love to, except I don’t know to hide my scars from her while trying on the sleeveless dresses. She’s a nurse, so I think she’s bound to notice even the more minimal scarring.

I do not want to come off as a diva or like I’m being difficult by refusing to try on sleeveless dresses, but I don’t know how to tactfully get around it. I don’t want to make an excuse about me covering my arms because they’re too fat because 1) I am really trying to stop thinking about my body like that, and 2) She and one of her bridesmaids are a bit bigger than me, and I don’t want her to think I’m judging them negatively for wearing sleeveless/strapless dresses. I wonder if maybe I should have just not accepted her request for me to be a bridesmaid, but she’s offered to help me with travel expenses and everything to make sure I can be there, and I do feel incredibly honored that she wants me to participate. There is really no way for me to back out now without potentially ruining our relationship.

The second problem I have is similar. I plan on having my parents and a couple of other family members present when I try on my dress. Although most of my family know about some of my psychological problems, none of them know about the bulimia or the cutting. I’ve yet to try on a formal dress with sleeves that wasn’t incredibly restrictive/uncomfortable. I know I could probably find something to cover up to wear at the wedding itself, but I feel like it would be awkward and lead to more questions if, while shopping for my dress, I ducked back into the fitting room every time I wanted to try on a different jacket because I was too embarrassed to change in front of my family. It’s bad enough for me to have a permanent reminder of my past destructive behavior without letting everyone around me know just how crazy I used to be.

I feel like my options at this point are to elope, buy the dress alone (and both those thoughts make me extremely sad), or have such outlandish hair or makeup that people can’t help but stare at my head.


A: Dear Anon,

Your question brings up concerns about body image, friendship, family relationships, and what Meg might refer to in her book as skeletons in the closet. You are in good company in the APW community, since we can all relate to your question on some level: How do we see ourselves in our bodies? Are we comfortable in them? How do others see us? How do we navigate relationships with friends and family members? How does our past inform our present and future, and how much of it do we choose to share with the people we love?

My first concern is how you are managing all of this. You mentioned that none of the people involved in shopping for your bridesmaid dresses or your own wedding dress know that you used to cut. Does anyone know, e.g. your partner, or have you kept it a total secret? If you have kept it a secret, that is a huge burden to bear. It’s already involved going to extremes to get around it, as well as thinking up new extremes to continue to do so. Even if you have told a few people, this is an important time to make sure you’re taking care of yourself by seeing a trained mental health professional: someone to help you sort through this stuff and help ensure that you don’t return to unhealthy ways of coping with stress.

You are wondering whether to show your scars, and if you do show them, how to explain how you got them. Here are some thoughts. You could continue to keep the scars hidden, but it seems like that has become increasingly difficult. There is the reality of the clothes we wear today: the often exposed arms in the dresses your friends want their bridesmaids to wear, or the dress that you may want to wear for your wedding. There is the difficulty, as you bring up, of going to extremes to hide your scars. Ducking into fitting rooms. Possibly threatening meaningful relationships.

Another thought is: if you do show the scars, you don’t have to disclose what they are. People may not realize that they are from self-injury. You are very attuned to your scars, and you know what they’ve looked like over the years. Other people may be less focused on them, and they may not ask. Also remember that just because people ask doesn’t mean that you’re required to fully answer. “It’s a long story,” or “I don’t want to get into it today,” will suffice, and will let you set appropriate boundaries for self-care.

Or, you can disclose what the scars are from. Keeping the scars a secret may ultimately be more burdensome and cause way more anxiety than just accepting that they’re there. It’s very difficult, because this was a private problem and a very challenging time in your past, but you’ve had the strength to move on. Clearly, the people who’ve asked you to be in their weddings care deeply about you and want to honor your friendship by having you be a part of their weddings. And you have a partner who has chosen to build a life with you, and you are preparing for your own wedding. These are really, really good things. Keep them in mind as you’re working through all of this.

You might have heard of Dialectical-Behavioral Therapy (DBT), a kind of psychotherapy developed and researched by the psychologist Dr. Marsha Linehan. DBT is often very helpful for people with histories of self-injury and difficulty managing stress, intense emotions, and relationships. DBT approaches recovery by teaching healthy coping skills and working to change unhealthy thought patterns and behaviors. It also incorporates mindfulness and acceptance techniques in “building a life worth living.” DBT is based on the dialectic between acceptance and change. We have to accept certain things about ourselves, and we also have to change them. Both of these things are true.

It’s true that your scars are a permanent reminder of the past. That can’t be changed. But they can also serve as a permanent reminder of the behavior that, based on your internal and external resources, you don’t have to go back to. That is the good news, and that is the part you can change.

The trouble with moving forward is that emotions get in the way. You are making a lot of assumptions about how things will go, and how people will react, based on your own, understandably, strong emotions about your scars and what they mean to you.  You wrote, “I feel like my options at this point are to elope, buy the dress alone (and both those thoughts make me extremely sad), or have such outlandish hair or makeup that people can’t help but stare at my head.” You feel like—key word being feel. Your feelings are totally valid and make sense. And they are very powerful, so they are also getting in the way of considering more perspectives. When we integrate, as DBT would suggest, a more rational, or “reasonable” perspective with your (totally understandable) emotional response, we realize that, fortunately, these are not the only options.

So, think about the larger picture: how you want to maintain and strengthen your relationships, how you can continue to take care of yourself and live a healthy, meaningful life, and how you’d like to do things differently in the future. As Meg wrote in her book (one of my favorite lines), “I can’t wait to see what you create.”

For more information and resources on DBT, or to find a therapist trained in DBT, visit The Linehan Institute Behavioral Tech website.

The information provided in Ask a Psychologist is intended by Dr. Brofman and APW to serve as general advice and guidance for all readers. The advice herein does not constitute a clinical recommendation or relationship, and Dr. Brofman and quoted mental health professionals do not take clinical responsibility for this information. Ask a Psychologist does not take the place of a confidential clinical consultation with a trained mental health professional. 

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  • Guest

    In my experience people are usually much too oblivious to notice even obvious scarring. When they do notice, they are usually much too tactful to ask about it. If you’re committed to hiding them, doing so in plain sight may be your best option, honestly. The more you dance around trying to hide them, the more you draw attention to it. A vague brushoff like “it’s a long story” is an excellent backup for the occasional person who might ask.

    Most of the people closest to me know I used to self-injure. Telling people isn’t for everyone, but it was pretty helpful for me. Friends usually don’t know what to do with that information, but if it’s not current behavior, they’ve usually been supportive. People I told when I was still doing it were understandably more freaked out, because they were actively worried.

    I hope the OP can make some peace with her scars, one way or another.

  • Heather

    I self-harmed for many years and have many scars that seem incredibly obvious to me. One thing I’ve found is that most people will not even notice them. The majority of my family and friends did not know the extent of my mental illness or that I self-harmed, so I was incredibly nervous when I started wearing clothing that did not hide my scars. Very rarely will people ask about it, but for the most part no one has ever even mentioned them. I think in this day and age where mental illness is not quite as stigmatized as it used to be – people know better and will be kind and not ask invasive questions. People really aren’t looking as closely at us as we might think.

    • Lauren from NH

      If I may say, those who may recognize your scars for what they are, I would imagine, are people who have encountered similar demons in their lives and would look upon you with hearts full of compassion and say not a word.

      Wishing you all the best Anon.

      • anon

        I second this. I recently worked on a project with a colleague who had many visible (healed) scars on her forearms. I assumed they were from self-harm, but of course do not know because I wouldn’t dream of asking. Self-harm or no, my only thought: here’s someone who’s been through some shit and came out on top. Kudos to her.

      • I agree with Lauren. Many people will not notice or not associate your scars as being from self-harm. And if they do it’s because they themselves have experience or know someone who has self-harmed. My sister suffers from depression and often turns to cutting, so I recognize very well these types of scars and when I see them on others, I silently wish them peace and warmth from my heart. I highly doubt your friends and family would wish anything different.

    • Emily

      I agree with this. After working on an ambulance, I recognize these scars. I see them as scars: evidence of old wounds. We all have old wounds of one type or another, even though they aren’t all visible. I appreciated the advice about having an answer ready just in case, something like what was said above (“It’s a long story” or “I don’t want to get into it today.”). Take care of yourself.

  • Rebecca

    I think most people are far too tactful to ask. Probably, hopefully, people who recognize will not ask in a large group because they will understand. I am not really sure I should give advice, but, if you would like to wear a dress with sleeves you could try searching for Mormon wedding dresses.

  • I agree that most people wouldn’t notice, or know what the scars are. I have noticed scars on some of my best girlfriends from university, but I usually assume they’re from an accident long ago… I’ve always thought that unless someone chooses to share, it’s none of my business, and either way their personal history doesn’t affect our friendship.

    Something to consider: maybe, try to gradually get comfortable wearing clothing that doesn’t hide your scars before these shopping trips. Maybe just for a walk in the park with your fiance, or at the mall. Or at your own dress shopping, designate a family member that you’re comfortable telling to help you with jacket changes and so on, so that they can help divert others’ attention and fence off awkward questions.

  • pajamafishadventures

    I too have a history of self-injury and have some scars that seem very noticeable at least to me. They are almost never noticed/commented on and when someone does ask I always saw “gosh. I’ve had it so long I don’t even remember.” Sure I’m lying but in this situation I think I have a right to not be completely forthcoming.

  • Anon

    Keeping the scars a secret may ultimately be more burdensome and cause way more anxiety than just accepting that they’re there.” This!
    As someone who doesn’t really know anything about self harm, I can’t really offer any advice, except to wish you all the best. But I do know that keeping things secret is usually more stressful than accepting and being open about them. In my experience, usually your friends and family are better at dealing with these things than you fear they will be. I do not think of my friend who confided in me about being raped as ‘the girl who was raped’ but as my friend who is super intelligent, outgoing and talented. Similarly, my partner who was so scared to tell me homeless for several years before we met is just my strong, complex, funny, loving guy. Finding out these things about people we love can be a shock – its scary because we don’t want to think about bad things happening to the people we love and care for. But once the shock has worn off and we see that they’re coping, it’s usually easy to move past it and see the person for who they are, not what they’ve experienced.
    I’m as bad as anyone when it comes to opening up about private things in my life, but generally I find the reaction of the people I confide in is much more positive and accepting than the picture I build up in my head.

  • Anon

    I have numerous scars from chronic skin picking (Excoriation Disorder is its newest name – similar to trichotillomania). I remember entire summers where I refused to wear a swimsuit or tank tops. I was so afraid of random comments. I was so tired of having to cover up all the time that I slowly tested my boundaries – a tank top when I was going somewhere no one I knew would be, a swimsuit on my family vacation. While I still deal with this behavior, I’ve found that, as Heather said, most adults won’t say anything. Kids do sometimes, but you just explain to them that it’s not polite to say things like that.

    My experience with telling friends and family is that we have one conversation where they could ask any questions, and then it never really gets talked about again. It doesn’t get brought up in day-to-day conversation. And it’s such a relief to have it out there and not feel like I need to be ashamed or hiding something. I’m much more comfortable with the idea of someone making a comment, because I have responses planned out.

    OP, I’m hoping you find support and strength in this, so you can fully enjoy being a bridesmaid, and a bride, without fear or worry inhibiting you.

    • Anonna

      Oh man…I suffered from this for years, and in weaning myself off I switched to scratching my upper arms compulsively. And while the scars I leave look similar to acne scarring and are a little easier to hide or explain away, I’m still mortified at the idea of someone “recognizing” them for what they are. Your comment is spot on. I think mental preparedness is the only way to get around the worries. Knowing in your heart that even if someone asked, you’d have an answer for them is armor against bad feelings most days. I really, truly hope the letter writer can make peace with being seen, knowing full well that most people won’t notice or ask, and those who do will not judge her for it. Hiding is not necessary.

    • Violet

      Not exactly the same, but I pick the skin at my fingertips, often until they bleed, then I have little cuts for days while they heal (and then I start again). It’s not hide-able, because I use my hands for so many things- handing cards over to cashiers, any kind of pointing, etc. The only people who comment are children, and a “Yeah, it’s a really bad habit,” is a sufficient answer that works for me.

  • up_at_Dawn

    Upon seeing my scars (yes that kind), my fiancé thought that they were just stretchmarks and was surprised when I disclosed that they were self-inflicted. I don’t have too many of them- but they probably aren’t as noticeable as you think they are.

  • Valerie Day

    In my experience, when friends are self-harming I don’t see the scars–just the small forms of hiding. When I do see them it means healing is happening, and that recovery has already occurred. I’m always glad to see the scars.

  • anon

    As someone else who self harmed, I really, really feel you in this. I agree with what everyone else has said that most people aren’t going to ask – I have a ton of really visible scars, and have very rarely been asked about them. I think having a standard answer helps for when those questions come up (mine is “Oh, when I was 19 I had a lot of feelings and nobody understood me,” but I’m sarcastic and self deprecating so that works for me).

    But family is different – at least if yours is anything like mine, they don’t have to be polite. Maybe you could tell the people you want to go shopping with ahead of time – either work out a little speech or just send an email? I think it could be simple – just wanted to give you a heads up, one thing that was a part of my mental illness was I harmed myself. It isn’t something I do anymore, but I do have scars that you’ll see during wedding dress shopping. I just wanted to let you know ahead of time so that we can have as much fun as possible during the day! And then answer or deflect any follow up questions as you’d like.

    Wishing you so much luck in this.

  • swarmofbees

    Whatever you chose, I wish you strength and continued healing.

  • Also anon

    Hey Anon,

    I have a veritable tapestry of scars on my arms that are very clearly self-inflicted. (too, shall we say, geometric to be accidental) My nearest and dearest all know some version of the story and, more importantly, know that I am okay now. I got married last year in a sleeveless dress and wear sleeveless dresses to work all the time and no one comments. I don’t think people really notice, and as others have mentioned, most are too tactful to bring it up.

    What I want you to know, from someone on the other side of the journey you are on now, is that while it feels embarrassing to address the issue, those you love aren’t going to worry about how you look, they’re going to worry about how you feel. They want to know if you’re still struggling, and if they can help. They want to know if you’re in a happy place, and if not, what they can do to be supportive. They want your wedding day to be filled with JOY! (and in the case of your friend, she wants to celebrate with you and for you to feel comfortable)

    Maybe this is a great time to have a few heart-to-hearts. You don’t have to tell all the details. Sometimes I say, “I was really sad for a while, but now I’m a lot better.” and leave it at that. Having control over the situation, instead of worrying that they’ll notice or wonder about your modesty, might make things more comfortable.

    I’d like to close by saying that even with all of this openness and honesty (and hopefully, warm, embracing acceptance from your family and friends), please choose dresses and accessories that make you feel great. Even if that means a cute bolero jacket or an antique lace shawl, or buying extra fabric and getting a seamstress to add flounce sleeves or make a wee pashmina/wrap thingy.

    Go be awesome!

  • emilyg25

    I don’t have visible scars, but I do have a history of suicide attempts. A few years ago, I started being really open about it. It was so, so scary. I thought people would see me as “that crazy girl” and I’d lose all my friends again. But the funny thing is, people just didn’t really care. Like Shara said, they wanted to know if I was better now, and if not, what they could do to help. And then it became not a big deal. Except it was a really big deal to me, because it freed me to be open about myself, my history, my successes, and my continuing struggles.

    You need to do what feels right to you, but I think you might be surprised my how freeing it is to be open with close, trusted confidants. Maybe try letting just one person in and go from there? You don’t have to tell everyone, and you don’t have to tell everything. But you also don’t have to hide. And remember, regardless of what you choose, you’ll still be gorgeous!

  • Penny7b

    I think there’s a recurring theme in these comments about being able to share a little, without feeling like you have to reveal every detail. I think it’s true of any demons from our pasts that it can be difficult, even after we’ve started to heal, to be comfortable sharing and talking about it. Sometimes we can feel like once we start talking about it we’ll have to tell all in a detailed sob-fest to any stranger who wants to know. That’s not the case. Gradually, I have learned that I can mention that I got through some heavy stuff in my earlier years, but that I don’t want to talk about it any further. We can say “I have some scars I feel self-conscious about and would like a dress that covers them up” and leave it at that.

  • TW for self-harm–

    My fiancé engaged in self-harm a very long time ago, and he has noticeable, thick, bumpy pink scars all over his shoulders and upper arms. They’re not the worst self-mutilation scars I’ve ever seen, but they’re significant, and he’s deeply ashamed of them. When he and I first started dating, he was terrified of being shirtless around me, and very, very nervously told me about them before we had our first sexy naked fun time. I had to explain to him that I never would have asked, especially so early in the relationship, and that it didn’t bother me or make me think differently of him.

    To this day, he still refuses to go shirtless around anyone except me. That includes swimming–he wears swim shirts. And he has an intense fear of other people seeing them.

    It breaks my heart because I see his scars as something that he endured and survived; they’re not exactly something to be proud of (“Look at my COOL SCARS I gave myself when I was dealing with intense depression!”), but surviving is certainly something to be proud of.

    Here’s my advice to you, as someone who deeply loves someone with scars from self-harm:

    – Wear what you feel comfortable in. If you don’t want to wear a sleeveless dress, then you don’t have to wear a sleeveless dress. You don’t need a “good enough” reason; if someone asks, you can reply, “I don’t want to wear a sleeveless dress, and so I’m not trying any on. Thanks for your suggestion.” You don’t need an excuse about whether or not your arms are too big or too small (spoiler alert: your arms are not too big or too small).

    – In terms of trying on dresses, depending on where you’re going, a sales associate will help you in an out of dresses. I went dress shopping with my fiancé and the only person who saw me in various states of undress was the associate helping me. If an associate/consultant comments on your body in any way, you don’t have to pretend that their comment isn’t entirely inappropriate. You can just say, “I’m sorry, but this isn’t something I talk to strangers about,” and then change the subject.

    – I also strongly recommend not keeping your scars a secret from so many people. It’s up to you–it really is!–but I agree with the advice above: it seems like a huge burden just keeping it secret. I can’t speak for my fiancé, but he seems entirely comfortable with his body when he’s with me, and I know that I don’t really notice or think about his scars unless the subject actually comes up.

  • A friend

    I self-harmed many years ago, and have been left with one, large, obvious scar on my upper arm, that occasionally people (boyfriends, family members) have asked about. I’ve usually told them that it was just a superficial cut that got infected (which is true, albeit not the whole truth) – they’ve never asked more. As everyone else has mentioned, other people are much less interested in our bodies than we are. The only person who knows how I really got that scar is my husband. And when I told him – he just hugged me.

  • Becca Daniels

    I engaged in self-harm for years in high school and college and have visible scars on my chest and upper arms as a result. I have also experienced similar experiences with shame and relationships centered around trying on and wearing certain types of garments. For a long time I was certain that I wouldn’t be able to wear certain types of wedding dresses because of my scars. Being plus size as well, it really left me with few options when I would dream about my wedding day. Fast forward a few years, and my husband knows about my scars and the behaviors of my past. After awhile, I stopped worrying about my scars showing and found that people don’t ask. Most people in my family don’t know that I engaged in this kind of behavior specifically, just that I have dealt with depression, and only one person has asked me point-blank if the scars were from cutting. When I finally started trying on wedding dresses I realized that my scars were just like other parts of my body that I don’t like so much and I didn’t worry about finding a neckline that would hide them. Instead, I focused on finding a dress that made me feel pretty and happy in my skin.

  • frances kirk

    I agree with what others have said that people will either not notice, not ask, or not think twice about it if you give them an excuse. Since I stopped cutting and my scars have been scars not fresh wounds I’ve never had any comments on them.

  • Katharine

    The level of support and compassion here is incredible. It’s been a long time since I’ve cut myself – probably going on 9 years. When I got married three years ago, I was at a place where I wasn’t worried about my scars. The people close enough to me to come to our wedding had been through many of those dark days with me. Over time I have failed to be concerned about it at all – I have several fairly noticeable scars that I now see as an integral part of who I am and the journey I have been on with my body. Understanding them in that way has actually been easier for me than accepting the width of my hips, or the texture of my skin in certain bumpy places. It takes time, but I hope that through healing you will find a place where you can look at these as markers of your strength and perseverance. In the meantime, I hope you won’t let fear overcome your desire to share such important experiences with your friends and family. Those are things you will remember for a long time, regardless of whether your scars are a non-issue or require some uncomfortable conversations. Be true to yourself and the experience you want to have!

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