"cutting" as a spiritual problem

When is the practice of "cutting"-- cutting one's own body-- a physical problem with psychological manifestations rather than a spiritual problem with psychological manifestations?

At least on occasion-- if not most/all occasions-- it is spiritual. (And I love the end of the story-- how people respond to the healing and to Jesus!)

From Mark 5, we read about Jesus' encounter with the demon-possessed man in the region of the Gerasenes:

²When Jesus got out of the boat, a man with an evil spirit came from the tombs to meet him. ³This man lived in the tombs, and no one could bind him any more, not even with a chain. ⁴For he had often been chained hand and foot, but he tore the chains apart and broke the irons on his feet. No one was strong enough to subdue him. ⁵Night and day among the tombs and in the hills he would cry out and cut himself with stones.

⁶When he saw Jesus from a distance, he ran and fell on his knees in front of him. ⁷He shouted at the top of his voice, "What do you want with me, Jesus, Son of the Most High God? Swear to God that you won't torture me!" ⁸For Jesus had said to him, "Come out of this man, you evil spirit!"

⁹Then Jesus asked him, "What is your name?"

"My name is Legion," he replied, "for we are many." ¹⁰And he begged Jesus again and again not to send them out of the area.

¹¹A large herd of pigs was feeding on the nearby hillside. ¹²The demons begged Jesus, "Send us among the pigs; allow us to go into them." ¹³He gave them permission, and the evil spirits came out and went into the pigs. The herd, about two thousand in number, rushed down the steep bank into the lake and were drowned.

¹⁴Those tending the pigs ran off and reported this in the town and countryside, and the people went out to see what had happened. ¹⁵When they came to Jesus, they saw the man who had been possessed by the legion of demons, sitting there, dressed and in his right mind; and they were afraid. ¹⁶Those who had seen it told the people what had happened to the demon-possessed man—and told about the pigs as well. ¹⁷Then the people began to plead with Jesus to leave their region.