Cotten was born in Carrboro, North Carolina to a musical family; her parents were George Nevills and Louise Price Nevills. Elizabeth was the youngest of five children. She began writing music while toying around with her older siblings instruments, sometimes having to sneak into her older brother's room to lay the hidden guitar across her lap and play. After more tinkering with these instruments she began playing the guitar upside down, since she was left-handed. This position required her to play the bass lines with her fingers, and the melody with her thumb. Her signature, alternating bass style is known as "cotton picking".
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