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Self-harm: The Rising Concern About Cutting


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Q: I just found out my daughter’s best friend is a “cutter.” What exactly does that mean and should I be worried about my daughter?

A: Your question is an important one, and with today’s increased media attention around the subject of self-harm, educating yourself and maintaining communication with your daughter are the two most important things you can do to protect your daughter’s emotional health.  “Cutting” is one of the most common methods of self-harm. It refers to intentionally injuring one’s body by making superficial cuts in the skin with sharp objects (razors, knives or broken glass). This is usually a way to deal with unresolved emotional pain. Cuts are often made on the wrists because it is easy to reach this part of the body. This often leads to people mistaking it as a suicidal gesture. However, many people who cut will tell you that it is merely a way to cope with feelings they can’t otherwise handle and they deny any suicidal intent. Observers of the behavior may dismiss it as attention seeking, however people who self-harm are often ashamed and will go to great lengths to hide their cuts. Cutting should be addressed as an outward sign of inward pain, which requires special care and attention. Those who suffer from this harmful and potentially addictive behavior generally require support from family and friends as well as help from trained professionals to adopt healthier coping skills and end this self-mutilation.

Cutting is most often seen in adolescents and is frequently associated with other mental-health issues such as depression, anxiety disorders, personality and eating disorders. It is difficult for most people to understand why anyone would intentionally harm himself or herself. Those who cut, describe it as a way to “feel calm” when under stress or to “feel something” when they feel emotionally empty or numb. Chemically speaking, there is a release of endorphins when the skin is cut due to the body’s response to physical pain and its attempt to soothe itself. This contributes to its addictive nature as people who cut may habitually begin to seek that feeling when under stress. Some professionals say it is more of a compulsive rather than an addictive behavior. Regardless of how it is classified, cutting should be taken seriously as it can lead to permanent scarring, nerve damage and even death if one accidentally cuts an artery or there is a subsequent infection from using dirty or shared tools.

Peers are very influential during adolescence, so if your daughter’s best friend is cutting she is likely to be concerned and will want to try and help her. Approach your daughter from a position of love without judgment. Use active listening. Encourage her to speak freely and listen carefully to what she says. Repeat what you heard in your own words and confirm that you understand what she is saying. This allows both of you to grow and learn from the discussion. Support your daughter in speaking with her friend about getting professional help and talking to her school counselor about available resources.

There is help available for people who self-harm. Mental-health professionals can offer assistance through a variety of therapies, including medication if necessary, to address an underlying depression or anxiety disorder. Counseling is important to help the adolescent deal with issues of abuse and trauma as well as current stressors and family conflict, any or all of which can be at the root of this self-abusive behavior. Helping a person learn about themselves, their relationships and life events is important in helping them move toward healing. Interrupting and replacing the behavior with positive outlets such as talking, journaling, music, physical activities and hobbies can be helpful as a healthier means to cope when feeling overwhelmed. Recovery is an individual journey. Seeking help is an important first step.

Susan Michels works with children and adolescents at Cone Health Behavioral Health Hospital. Please submit your questions to “Is My Kid OK?” by emailing sherri.mcmillen@conehealth.com.

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