Cathy Collins' first memories are of knowing that she was adopted. The hardships of childhood--the difficulty of communicating with her parents, the cruelty of other children--all fed her belief that she was unwanted, her sense of being alien and unreal. She began abusing drugs and alcohol as an adolescent, but by freshman year discovered a better release. Using a knife or a razor, she would methodically slice open her arms. "A main part of it was to know I was real," she says. "With the blood flowing down my arms, I was real."
For the past decade, Collins, 31, a...
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