Emma's mom first noticed the cuts when Emma was doing the dishes one night. Emma
told her mom that their cat had scratched her. Her mom seemed surprised that the cat
had been so rough, but she didn't think much more about it.
Emma's friends had noticed something strange as well. Even when the weather was
hot, Emma wore long-sleeved shirts. She had become secretive, too, like something
was bothering her. But Emma couldn't seem to find the words to tell her mom or her
friends that the marks on her arms were from something that she had done. She was
cutting herself with a razor when she felt sad or upset.
Injuring yourself on purpose by making scratches or cuts on your body with a sharp
object — enough to break the skin and make it bleed — is called cutting.
Cutting is a type of self-injury, or SI. People who cut often start
cutting in their young teens. Some continue to cut into adulthood.
People may cut themselves on their wrists, arms, legs, or bellies. Some people
self-injure by burning their skin with the end of a cigarette or lighted match.
When cuts or burns heal, they often leave scars or marks. People who injure themselves
usually hide the cuts and marks and sometimes no one else knows.
Why Do People Cut Themselves?
It can be hard to understand why people cut themselves on purpose. Cutting is a
way some people try to cope with the pain of strong emotions, intense
pressure, or upsetting relationship
problems. They may be dealing with feelings that seem too difficult to bear or
bad situations they think can't change.
Some people cut because they feel desperate for relief from bad feelings. People
who cut may not know better ways to get relief from emotional pain or pressure. Some
people cut to express strong feelings of rage, sorrow, rejection, desperation, longing,
There are other ways to cope with difficulties, even big problems and terrible
emotional pain. The help of a mental
health professional might be needed for major life troubles or overwhelming emotions.
For other tough situations or strong emotions, it can help put things in perspective
to talk problems over with parents, other adults, or friends. Getting plenty of exercise also can help
put problems in perspective and help balance emotions.
But people who cut may not have developed ways to cope. Or their coping skills
may be overpowered by emotions that are too intense. When emotions don't get expressed
in a healthy way, tension can build up — sometimes to a point where it seems
almost unbearable. Cutting may be an attempt to relieve that extreme tension. For
some, it seems like a way of feeling in control.
The urge to cut might be triggered by strong feelings the person can't express
— such as anger, hurt, shame, frustration, or alienation. People who cut sometimes
say they feel they don't fit in or that no one understands them. A person might cut
because of losing someone
close or to escape a sense of emptiness. Cutting might seem like the only way
to find relief or express personal pain over relationships or rejection.
People who cut or self-injure sometimes have other mental health problems that
contribute to their emotional tension. Cutting is sometimes (but not always) associated
with depression, bipolar disorder,
eating disorders, obsessive thinking, or compulsive behaviors. It can also be a sign
of mental health problems that cause people to have trouble controlling their impulses
or to take unnecessary risks. Some people who cut themselves have problems with drug
or alcohol abuse.
Some people who cut have had a traumatic experience, such as living through abuse, violence, or a disaster.
Self-injury may feel like a way of "waking up" from a sense of numbness after a traumatic
experience. Or it may be a way of reliving the pain they went through, expressing
anger over it, or trying to get control of it.
What Can Happen to People Who Cut?
Although cutting may provide some temporary relief from a terrible feeling, even
people who cut agree that it isn't a good way to get that relief. For one thing, the
relief doesn't last. The troubles that triggered the cutting remain — they're
just masked over.
People don't usually intend to hurt themselves permanently when they cut. And they
don't usually mean to keep cutting once they start. But both can happen. It's possible
to misjudge the depth of a cut, making it so deep that it requires stitches (or, in
extreme cases, hospitalization). Cuts can become infected if a person uses nonsterile
or dirty cutting instruments — razors, scissors, pins, or even the sharp edge
of the tab on a can of soda.
Most people who cut aren't attempting suicide. Cutting is usually a person's attempt
at feeling better, not ending it all. Although some people who cut do attempt suicide,
it's usually because of the emotional problems and pain that lie behind their desire
to self-harm, not the cutting itself.
Cutting can be habit forming. It can become a compulsive behavior
— meaning that the more a person does it, the more he or she feels the need
to do it. The brain starts to connect the false sense of relief from bad feelings
to the act of cutting, and it craves this relief the next time tension builds. When
cutting becomes a compulsive behavior, it can seem impossible to stop. So cutting
can seem almost like an addiction, where the urge to cut can seem too hard to resist.
A behavior that starts as an attempt to feel more in control can end up controlling
How Does Cutting Start?
Cutting often begins on an impulse. It's not something the person thinks about
ahead of time. Shauna says, "It starts when something's really upsetting and you don't
know how to talk about it or what to do. But you can't get your mind off feeling upset,
and your body has this knot of emotional pain. Before you know it, you're cutting
yourself. And then somehow, you're in another place. Then, the next time you feel
awful about something, you try it again — and slowly it becomes a habit."
Natalie, a high-school junior who started cutting in middle school, explains that
it was a way to distract herself from feelings of rejection and helplessness she felt
she couldn't bear. "I never looked at it as anything that bad at first — just
my way of getting my mind off something I felt really awful about. I guess part of
me must have known it was a bad thing to do, though, because I always hid it. Once
a friend asked me if I was cutting myself and I even lied and said 'no.' I was embarrassed."
Sometimes self-injury affects a person's body image. Jen says, "I actually liked
how the cuts looked. I felt kind of bad when they started to heal — and so I
would 'freshen them up' by cutting again. Now I can see how crazy that sounds, but
at the time, it seemed perfectly reasonable to me. I was all about those cuts —
like they were something about me that only I knew. They were like my own way of controlling
things. I don't cut myself anymore, but now I have to deal with the scars."
You can't force someone who self-injures to stop. It doesn't help to get mad at
a friend who cuts, reject that person, lecture her, or beg him to stop. Instead, let
your friend know that you care, that he or she deserves to be healthy and happy, and
that no one needs to bear their troubles alone.
Pressured to Cut?
Girls and guys who self-injure are often dealing with some heavy troubles. Many
work hard to overcome difficult problems. So they find it hard to believe that some
kids cut just because they think it's a way to seem tough and rebellious.
Tia tried cutting because a couple of the girls at her school were doing it. "It
seemed like if I didn't do it, they would think I was afraid or something. So I did
it once. But then I thought about how lame it was to do something like that to myself
for no good reason. Next time they asked I just said, 'no, thanks — it's not
for me.' "
If you have a friend who suggests you try cutting, say what you think. Why get
pulled into something you know isn't good for you? There are plenty of other ways
to express who you are.
Lindsay had been cutting herself for 3 years because of abuse she suffered as a
child. She's 16 now and hasn't cut herself in more than a year. "I feel proud of that,"
Lindsay says. "So when I hear girls talk about it like it's the thing to do, it really
gets to me."
There are better ways to deal with troubles than cutting — healthier, long-lasting
ways that don't leave a person with emotional and physical scars. The first step is
to get help with the troubles that led to the cutting in the first place. Here are
some ideas for doing that:
Tell someone. People who have stopped cutting often say the first
step is the hardest — admitting to or talking about cutting. But they also say
that after they open up about it, they often feel a great sense of relief. Choose
someone you trust to talk to at first (a parent, school counselor, teacher, coach,
doctor, or nurse). If it's too difficult to bring up the topic in person, write a
Identify the trouble that's triggering the cutting. Cutting is
a way of reacting to emotional tension or pain. Try to figure out what feelings or
situations are causing you to cut. Is it anger? Pressure to be perfect? Relationship
trouble? A painful loss or trauma? Mean criticism or mistreatment? Identify the trouble
you're having, then tell someone about it. Many people have trouble figuring this
part out on their own. This is where a mental health professional can be helpful.
Ask for help. Tell someone that you want help dealing with your
troubles and the cutting. If the person you ask doesn't help you get the assistance
you need, ask someone else. Sometimes adults try to downplay the problems teens have
or think they're just a phase. If you get the feeling this is happening to you, find
another adult (such as a school counselor or nurse) who can make your case for you.
Work on it. Most people with deep emotional pain or distress
need to work with a counselor or mental health professional to sort through strong
feelings, heal past hurts, and to learn better ways to cope with life's stresses.
One way to find a therapist or counselor is to ask at your doctor's office, at school,
or at a mental health clinic in your community.
Although cutting can be a difficult pattern to break, it is possible. Getting professional
help to overcome the problem doesn't mean that a person is weak or crazy. Therapists
and counselors are trained to help people discover inner strengths that help them
heal. These inner strengths can then be used to cope with life's other problems in
a healthy way.