Cutting isn't new, but this form of self-injury (SI) has been out in the open more
in recent years, portrayed in movies and on TV — even talked about by celebrities
who have admitted to cutting themselves at some point.
Cutting is a serious issue that affects many teens. Even if you haven't heard about
cutting, chances are good that your teen has and might even know someone who does
it. Like other risky behaviors, cutting can be dangerous and habit-forming. In most
cases, it is also a sign of deeper emotional distress. In some cases, peers can influence
teens to experiment with cutting.
The topic of cutting can be troubling for parents. It can be hard to understand
why a teen would deliberately self-injure, and worrisome to think your teen —
or one of your teen's friends — could be at risk.
But parents who are aware of this important issue and understand the emotional
pain it can signal are in a position to help.
What Is Cutting?
Someone who cuts uses a sharp object to make marks, cuts, or scratches on the body
on purpose — enough to break the skin and cause bleeding. People typically cut
themselves on their wrists, forearms, thighs, or belly. They might use a razorblade,
knife, scissors, a metal tab from a soda can, the end of a paper clip, a nail file,
or a pen. Some people burn their skin with the end of a cigarette or lighted match.
Most people who self-injure are girls, but guys do it too. It usually starts during
the teen years and can continue into adulthood. In some cases, there's a family history
A sense of shame and secrecy often goes along with cutting. Most teens who cut
hide the marks and if they're noticed, make up excuses about them. Some teens don't
try to hide cuts and might even call attention to them.
Cutting often begins as an impulse. But many teens discover that once they start
to cut, they do it more and more, and can have trouble stopping. Many teens who self-injure
report that cutting provides a sense of relief from deep painful emotions. Because
of this, cutting is a behavior that tends to reinforce itself.
Cutting can become a teen's habitual way to respond to pressures and unbearable
feelings. Many say they feel "addicted" to the behavior. Some would like to stop but
don't know how or feel they can't. Other teens don't want to stop cutting.
Most of the time, cutting is not a suicide attempt. But sadly, people often underestimate
the potential to get seriously sick or hurt through bleeding or infections that go
along with cutting.
Why Do Teens Cut?
Teens cut for many different reasons:
Powerful overwhelming emotions. Most teens who cut are struggling
with powerful emotions. To them, cutting might seem like the only way to express or
interrupt feelings that seem too intense to endure. Emotional pain over rejection,
lost or broken relationships, or deep grief can be overwhelming for some teens.
And many times they're dealing with emotional pain or difficult situations that
no one knows about. Pressure to be perfect or to live up to impossible standards —
their own or someone else's — can cause some teens unbearable pain. Some teens
who cut have been deeply hurt by harsh treatment or by situations that have left them
feeling unsupported, powerless, unworthy, or unloved.
Some teens have experienced trauma, which can cause waves of emotional numbness
called dissociation. For them, cutting can be a way of testing whether they can still
"feel" pain. Others describe cutting as a way of "waking up" from that emotional numbness.
Self-inflicted physical pain is specific and visible. For some,
the physical pain of cutting can seem preferable to emotional pain. Emotional pain
can feel vague and hard to pinpoint, talk about, or soothe.
When they cut, teens say there is a sense of control and relief to see and know
where the specific pain is coming from and a sense of soothing when it stops. Cutting
can symbolize inner pain that might not have been verbalized, confided, acknowledged,
or healed. And because it's self-inflicted, it is pain the teen controls.
A sense of relief. Many teens who cut describe the sense of relief
they feel as they're cutting, which is common with compulsive behaviors. Some
people believe that endorphins might add to the relief teens describe when they cut.
Endorphins are the "feel-good" hormones released during intense physical exertion.
And they can be released during an injury.
Others believe the relief is simply a result of being distracted from painful emotions
by intense physical pain and the dramatic sight of blood. Some teens say they don't
feel the pain when they cut, but feel relieved because the visible SI "shows" emotional
pain they feel.
Feeling "addicted." Cutting can be habit forming. Though it only
provides temporary relief from emotional distress, the more a person cuts, the more
he or she feels the need to do it. As with other compulsive behaviors, the brain starts
to connect a momentary sense of relief from bad feelings with the act of cutting.
Whenever the tension builds, the brain craves that relief and drives the teen to
seek relief again by cutting. So cutting can become a habit someone feels powerless
to stop. The urge to cut — to get relief — can seem too hard to resist
when emotional pressure is high.
Other mental health conditions. Cutting is often linked to —
or part of — another mental health condition. Some teens who cut are also struggling
with other urges, obsessions, or compulsive behaviors. For some, depression
or bipolar disorder can contribute
to overwhelming moods that might be difficult for a teen to regulate. For others,
mental health conditions that affect personality can cause relationships to feel intense
and consuming, but unsteady. For these teens, intense positive attachments can suddenly
become terribly disappointing and leave them feeling hurt, anger, or despair too strong
to cope with.
Other teens struggle with personality traits that attract them to the dangerous
excitement of risky behavior or self-destructive acts. Some are prone to dramatic
ways of getting reassurance that they are loved and cared about. For others, posttraumatic
stress has had an effect on their ability to cope. Or they're struggling with
alcohol or substance problems.
Peer pressure. Some teens are influenced to start cutting by another
person who does it. For example, a teen girl might try cutting because her boyfriend
cuts. Group peer pressure can play a role too. Some teens cut in groups and might
pressure others to cut. A teen might give in to group pressure to try cutting as a
way to seem cool or bold, to belong, or to avoid social bullying.
Any of these factors may help to explain why a particular teen cuts. But each teen
also has unique feelings and experiences that play a role. Some who cut might not
be able to explain why they do it.
Regardless of the factors that may lead a teen to self-injure, cutting isn't a
healthy way to deal with even the most extreme emotions or pressures.
Some teens call attention to their self-injury. Or if the SI requires medical attention,
that might be a way others find out. But many teens cut for a long time before anyone
else knows. Some teens eventually tell someone about their self-injury — because
they want help and want to stop, or because they just want someone to understand what
they're going through.
It can take courage and trust to reach out. Many teens hesitate to tell others
because they fear being misunderstood or worry that someone might be angry, upset,
disappointed, shocked, or judgmental. Some teens confide in friends, but ask them
not to tell. This can create burden and worry for a friend who knows.
If confronted about the cutting, teens can respond in different ways, depending
partly on the teen and partly on the how they were approached by it. Some might deny
the cutting, while others might admit to it, but deny that it's a problem. Some might
get angry and upset or reject efforts to help. Some teens are relieved that someone
knows, cares, and wants to help.
Bringing a Halt to Cutting
Whether or not anyone else knows or has tried to help, some teens cut for a long
time before they try to stop. Teens whose cutting is part of another mental health
condition usually need professional
help. Sometimes cutting or another symptom leads to a teen's admission to a mental
health hospital or clinic. Some teens have more than one hospital stay for self-injury
before they feel ready to accept help for cutting or other problems.
Some teens find a way to stop cutting on their own. This might happen if a teen
finds a powerful reason to stop (such as realizing how much it hurts a friend), gets
needed support, or finds ways to resist the powerful urge to cut. To stop cutting,
a person also needs to find new ways to deal with problem situations and regulate
emotions that feel overwhelming. This can take time and often requires the help of
a mental health professional.
It can be difficult to stop cutting and a teen might not succeed at first. Some
people stop for a while and then start cutting again. It takes determination, courage,
strength — as well as support from others who understand and care — to
break this powerful habit.