A lifetime ago, Paja Russell of Medford developed a coping skill she may never fully shake — she learned to cut or burn herself as a way to deal with the pain of childhood abuse.

Even after two decades of therapy and a loving support system, the wife and mother of two admits she still is still tempted at times to hurt herself. Russell uses adjectives such as "comforting" and "familiar" to describe her last self-inflicted lighter burn, even though it was done well over a year ago. 

As a recovering self-injurer, Russell has sought to help others and humanize a heavily stigmatized issue, in the hopes their scars can heal more easily than her own. Russell reaches out every way she can, starting online with a WebMD forum about a decade ago, more recently on her own blog, "Getting the Bucks Out," and for the past three years as a regular attendee at the Human Library Project, a program where people "check out" others like a book and hear their story.

Russell says it's important for her to put her scarred and burned arms in plain view, rather than hiding them as many who struggle with self-inflicted violence do. Since before kindergarten, self-injury has been a mechanism to relieve deep emotional pain, she says, typically a last resort when she was overwhelmed by suicidal thoughts.

"It kept me alive," Russell says.

But it also has diminishing returns, according to Russell. The negative coping skill demands self-abusers step up their injuries for similar amounts of relief.

"I knew the injury would be fatal some day," Russell says.

Her turning point came 17 years ago, when she had a dark thought in an otherwise happy moment. At the age of 23, she was actively planning her suicide while holding an infant. Long suffering from depression, Russell was living in a rented room on a farm and helping her landlord's teen daughters, who were both new mothers. Holding the child changed her mind.

"I kind of like this baby," Russell recalls thinking.

Russell says she sought help, but didn't necessarily know the way out of something she'd done for so long. When she grew up in the 1980s, information about self-injury was sensationalist fodder for talk shows such as Sally Jesse Raphael and Geraldo. Her behavior was also new for her Grants Pass therapist.

"He knew nothing about it," Russell remembers. "I didn't know why I was doing it, so it was a perfect match."

What worked was her therapist's efforts to "re-parent" her, Russell says, revisiting traumatic memories and reprocessing them with his guidance. Through counseling, she also learned how to reach out to others.

"He did a lot of work reconnecting me with humanity," Russell says. 

Russell's next step was a hypnotherapist with a nurturing personality who taught Russell how to stop treating her body like it was separate from herself. Her hypnotherapist brought in tools such as warm, fuzzy clothes to help her be comfortable in her own skin.

Those years of trial and error meant that not every tool placed in her toolbox was helpful. Russell uses her blog to share lessons learned from experience. She's vocally opposed to contracts therapists often require patients to sign, in which self-abusers make a promise never to hurt themselves again. She says they're futile without new ways to process emotions. Ultimatums are similarly unhelpful. Loved ones' first reaction when a self-abuser relapses is often anger, but the self-abuser need compassion, Russell says.

"People who self-injure are both the abused and the abuser," Russell says. 

Russell also advises against support groups for self-injurers. The ways participants have hurt themselves vary dramatically, and putting self-injurers in a group provides ideas for new injury methods more often than support, possibly turning into "one-upping contests," Russell says.

At times, it hasn't been easy to be so up-front about self-injuring. She recalls that during one of her pregnancies, a look a nurse gave her when she saw Russell's arms filled Russell with fear.

"I was so afraid they'd take my baby," Russell says.

She emphasizes that as a self-abuser, the last thing she wants to do is hurt someone else.

"All this is directed in," Russell says.

Keeping herself "safe" is a challenge, Russell says. In her blog, she talks about her triggers, big and small. She recalls the weight a recent kitchen accident carried, when her arm brushed a hot pan. An incident most would shake off was a temptation to go back to hurting herself, she says.

Instead, she applied a Band-Aid, telling herself, "You've been hurt enough."

Reach reporter Nick Morgan at 541-776-4471 or by email at nmorgan@mailtribune.com.