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Doc's Corner: Self-Injury, Self-Harm and Cutting Among Teens 
January 31st, 2019

As we all know, teens encounter a variety of stressors in their lives, and develop both healthy and unhealthy ways to cope with their internal difficulties. Among the most alarming coping mechanism that parents can discover is that their child is engaging in self-injury. The behaviors are primarily cutting on oneself, but can also include burning, interfering with wound healing (picking at wounds), inserting objects into the skin, punching or hitting oneself and certain forms of hair-pulling. It can occur in a very rare and minimal way, or it can be so severe as to draw blood.

How prevalent is this problem?

It is alarming to know that cutting is on the rise among teenagers. It is also alarming to realize that those who begin cutting as teens will likely continue in their adult years, without proper treatment. The statistics are difficult to capture, as much of cutting among teens goes unnoticed and unreported. Some figures include:

  • Each year, one in five females and one in seven males engage in self-injury
  • Ninety percent of adults who cut began as adolescents
  • Almost 50 percent of those who cut have been victims of sexual abuse
  • Cutting begins early, often at around 14
  • Two million cases are reported annually
  • Seventy percent of teens who have engaged in self injury behavior have made at least one suicide attempt
  • Perhaps as many as 1/3 of adolescents have experimented with cutting

Why do teens cut?

Teens generally cut as a reaction to stress and feelings of helplessness. When internal emotions feel too overwhelming, cutting can provide some distorted sense of relief; 55 percent of self-injurers said they wanted to get their mind off their problems, while 45 percent said it helped them relieve tensions and stressors. Some people cut on themselves because of a sense of low confidence and self-esteem, and feel the need to punish themselves. Many teens report a sense of emotional numbness, and cutting provides a way to feel, and release feelings. For others, there are friends and websites who encourage the behavior. Cutting also occurs with other emotional difficulties, including eating disorders, depression, anxiety and substance abuse. Some experts believe that forms of piercings and tattooing are self-injury and self-harm. Cutting can be anything from light scratches in times of great distress, to daily cuts so deep they draw blood. Cutters generally cut on their wrists, upper arms, inner thighs and stomachs.

What should parents do?

If you suspect or know that your child has a problem, it is important to communicate with them and to seek professional help. Be aware that the cutting is a symptom of underlying problems, and just getting them to stop cutting is not enough. They need help finding the source of the emotional pain and to gain healthy tools for coping. It is also important for a professional to help determine if the cutting is a precursor of suicidal ideation and intent. Try to avoid judging, criticizing or attacking the behavior, and recognize that it comes from a troubled emotional place. Try not to be panicked, repulsed or shocked – learning that your child is engaging in this is a time for acceptance, love and assistance.

Remember, if you have issues you would like to see addressed, please email me at askdrgelbart@gmail.com.

Moe Gelbart, Ph.D. 
Executive Director, Thelma McMillen Center