Helping Teens Who Cut

The largest population of people coming into my office are teens who deliberately cut themselves. They don’t just cut themselves down with harsh self-judgments, they literally cut themselves up with knives, razor blades, scissors, or broken glass.

This problem seems to be growing. It appears more and more teens cut.

Statistics show that 1 in 5 females and 1 in 7 males engage in deliberate self-injury each year. Many experts expect that the number is much higher.

What Motivates Teens to Cut?

• It is a way to manage or cope with severe distress.
• It provides significant relief and distraction from emotional pain.
• It provides a sense of control over feelings, body, or life situations.
• People cut to feel something, anything, when feeling emotionally numb and empty.
• It is a way of expressing internal feelings in an external way.
• It can be addictive due to intensity and immediacy of relief. Once someone cuts, they often want to cut again.
• A preoccupation with thoughts about cutting to get psychological relief.

Common Cultural Factors

• Media attention: Teens learn about cutting through the media.
• Peer factor:  Teens follow the crowd. They see their friends doing it. (They often don’t realize that cutting can be addictive.)
• Continuous exposure to violence in media.
• Increased violence in young people.

Common Family Factors

• Hypercritical parents, lack of emotional warmth.
  
• Invalidating home environment.
• Violence in the home.
• Childhood physical, sexual, or emotional abuse.
• Parental divorce, separation, or dysfunction.
• Death of  a parent.
• Family history of mental illness or alcoholism.
• Child not feeling loved, important, or wanted within the family.

Common Personal Factors

• Depression
• Personal history of chronic illness with hospitalization in childhood.
• Social Isolation or a desperate desire to form intense interpersonal relationships.
• Pervasive difficulty with interpersonal relationships.
• A struggle with identity. Who am I? Where do I fit?

Other Disorders That May Accompany Self-Injury

• Depression
• Eating Disorders
• Borderline Personality Disorder
• Anxiety

What to Look For

• Scars, wounds, multiple scratches on arms or legs
• Long sleeves and long pants in warm weather
• Excuses for not swimming or participating in activities requiring skin exposure
• Poor impulse control
• Anxiety
• Sadness
• Low self-esteem
• Mood swings
• Anger
• Intense interpersonal relationships (either hot or cold- not a whole lot of in-between)

What Do I Do if My Child Cuts?

• Avoid yelling at your child and making threats.
• Express Concern. Listen to your child. Validate your child’s feelings.
• Consult a pediatrician along with a mental health specialist for an evaluation.
• Call 911 if the self-harm is accompanied by suicidal thoughts.

Interventions in Counseling

• Identify key stressors.
• Work on communication skills.
• Work on emotional regulation.
• Work on healthy ways to cope with distress.
• Assertiveness training.
• Active and genuine listening on the part of the therapist.
• Improve parent/child connection.
• Learn healthy ways to expressing feelings and needs.

Effective Therapies

• Cognitive behavioral therapy
• Dialectical behavior therapy
• Psychodynamic therapy
• Mindfulness based therapies

If your child engages in self-injurious behaviors, please seek help immediately. The self-harm is an indication of a much deeper issue. A child filled with self-love and self-acceptance does not deliberately harm themselves. A child filled with pain, may. Don’t blame yourself. Instead, get your child the help that he or she needs. With the right treatment, teens who cut themselves or engage in any type of self-injurious behavior can decrease their distress and learn to manage it in healthy ways.

This post was written by Kristin Barton Cuthriell, MEd, MSW. Kristin is a licensed clinical social worker and author of the book The Snowball Effect: How to Build Positive Momentum in Your Life.  She counsels teens, adults, and families at Eden Counseling Center in Virginia.