So, on to cutting.
Let’s start with a story. MP was a 15 year old girl in high school, a good student. Really good student, actually. Great parents (though annoying at times, like they always are), but they were present, supportive, all that stuff. She liked school, had friends, was on a sports team, lots of clubs. Was kind of a perfectionist. High achievement was expected of her by herself, and by everyone else, frankly. She had a friend who slit her wrists, and actually needed to be hospitalized to help her get treatment for depression. During one particularly stressful period in her life, MP was taking a hot shower, and crying in the shower, which she did from time to time, especially when she was really feeling stressed. She was using her razor to shave and all of a sudden had this irresistible urge to slash the razor into her legs. And she did. Not sure where the impulse came from, and after the episode she was a bit stunned. But it seemed that seeing the blood come out made her feel like her stress was coming out too. She did this a few more times, and after each time, covered up the evidence with sweats or long pants or whatever. No one knew.
Now, MP is not a real person. But she could be. Maybe she could be someone you know? Maybe she could be you?
Before we go on further, if you are worried that you (or a friend) are in danger of hurting yourself or having thoughts of suicide, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255), or visit the Web here: National Suicide Prevention Lifeline . And remember, asking or talking to someone about suicide does NOT increase the risk that they will… it actually DECREASES the risk of attempted and fatal suicide.
Back to the topic at hand:
Cutting is a deliberate act of self harm that a teen may do for many reasons. Unfortunately cutting and other self-harm behaviors are not uncommon. About 1 in 100 people deliberately hurt themselves. And this occurs across all races, economic groups, countries, genders, sexual orientations, etc. While pulling together info for this post, I looked around on Blogger, Tumblr, Twitter, and Pheed – places on the web where Real Talk with Dr. Offutt is. No surprise – tons of posts and channels and sites dealing with cutting. Some are definitely “pro-cutting” and others are on-line communities for people trying to stop cutting. So cutting is definitely not a rare phenomenon.
Cutting is not the only type of self harm out there. Some people burn themselves, hit themselves, punch walls, bang their heads into walls, take dangerous substances, take huge risks where they want to hurt themselves (jumping from heights, etc). Cutting is the most common of these, and is done with razors (like MP did), with pins, with the sharp edge of soda cans, with anything sharp. There actually seems to be an increase in cutting over the past few decades, and people are not sure why. Some think it is because it is kind of “contagious” and others worry about it spreading through online media. Most of these acts of self-harm (that is more than 80%) are done at home.
Cutting and other similar acts increase rapidly during early teen years, and is actually thought to be related to some of the neurodevelopment (that means: your brain getting built and growing) that occurs in puberty that makes some teens vulnerable to self- harm. I looked at a couple of medical studies about cutting, and one showed that about 4% of teen guys and 13% of teen girls did some kind of self-harm at some point in their lives. It seems that a lot of teens think about it – with 10% of guys thinking about it, and about 20% of girls. So one take home point is that if you think about hurting yourself or if you do it, you are not alone. That means, don’t be embarrassed. That does not mean you shouldn’t get help. This means that doctors and therapists and counselors will not be shocked if you reach out to them and tell them what you are doing and that you want help.
Why? Why do people cut?
One thing that docs are still trying to sort out is whether teens that hurt themselves have an increased risk for suicide. Basically, what we think now, is that most teens that cut or hurt themselves in some way are not at increased risk for suicide, but some definitely are. Those that don’t seem to be at high risk of suicide are those whose goal with the self harm is not death, but rather tension release, or something similar. Those that are at high risk of suicide generally fall into 2 groups. Some are at risk because they really want to die. And others are at risk because the methods they use to “just” hurt themselves turn out to be deadly. Regardless, this is really hard to tease out, and a doctor or therapist is needed to help here.
So, if cutters don’t want to die, what are they trying to do? Common reasons are to release tension, to punish themselves, to show how awful they feel inside so that other people will understand, to feel “something” since they feel numb all the time after learning to bottle up their feelings and emotions, and to get relief from a terrible state of mind. Most teens cut for more than one reason, and often have a whole cluster of feelings that lead them to cut. Often teens have difficulty coping with a challenging or stressful part of their life and turn to hurting themselves for some sort of relief. (more on that later).
There is some impulsivity that leads to cutting. In one study, the researchers asked teens how long they had been planning to hurt themselves before they actually did it. With cutting, most often it was less than an hour. Sometimes it was even just a few minutes. Now, as with everything, not everyone fits into a specific mold or pattern, but this gives you an idea. For cutting, since so few thought about it even for an hour before acting, maybe this means it is something that you can actually wait for the urge to pass (more on that later, too).
Any triggers or risk factors?
Common problems that may be a risk for cutting or other self-harm include:
- Difficulty with relationships (Like fighting with parents, having problems with your BF or GF, not getting along with friends, experiencing abuse)
- Stress or problems with school (Academic stress, bullying)
- Health issues (Depression or other mental health problems, bad physical health)
- Having friends that cut (for real, there are even websites and groups that are pro-cutting sites) – it can be kind of contagious…
- Alcohol or drug abuse
- Low self esteem (for more: I'm not worthy - self esteem )
- Feeling isolated or alone (Having a hard time being socially connected, having different sexual orientation than others around you, and being excluded for it)
Cutting may occur only once. In fact, most self harm urges, thoughts, and acts actually are outgrown. So, obviously, that is a really good thing. The problem is it is hard to know who will have more serious outcomes from self-harm, including suicide, or who will hurt themselves for a long time down the road. So again, I urge you to reach out to your doctor, a counselor, a therapist, a parent, a teacher. They can get you the help that you need. They can help figure out if you have depression or another problem that is causing you to hurt yourself.
So you deliberately hurt yourself. What should you do?
Once more, TELL SOMEONE! Most teens feel a huge relief once they take this first step. Don’t go it alone. First of all, you need to make sure you don’t have depression, bipolar disorder, or another mental health problem that needs treatment. That means reach out to a trusted adult – a teacher, counselor, nurse, doctor, therapist, parent, family friend. They can get you to the right person for evaluation and help. If those problems aren’t treated properly, cutting won’t get better. They can also help you even if you do not have one of these problems underneath the cutting (which is often the case). Getting help does not mean you are crazy – therapists can work with you to help you learn coping strategies and to help you learn how to break the urge to hurt yourself, and replace those acts with better ways to deal with your feelings or difficult situations. You have to realize that it is really important to stop cutting since the more you repeat it, the harder it is to stop. Part of this is thought to be because when cutting is used to release tension, you actually feel better right as you are doing it. Not so much after. But it can become a vicious circle. And then it can become an impulse that controls you rather than you controlling it. A really bad habit.
So to help with that, in addition to reaching out for help, here are some things you can do to help yourself stop:
- Wait out the urge. Distract yourself with something else.
- Respect your body. If you think this way, you will be less likely to punish your body for your feelings.
- Figure out what feeling or emotion is causing you to cut. Feel it. Accept it. TALK about it. Talk it through. Acting on your feelings with talking is a lot healthier than acting on your feelings by hurting yourself. Don’t blot it out and make yourself numb.
- Figure out if there is a particular situation that is causing you to want to cut. Accept it and figure out a way to make it more tolerable.
- Make a plan of what you will do if a situation or feeling that triggers cutting pops up. This plan needs to be really detailed (“I will call my BFF” or “I will leave my room and go to a room with another person in my house so I am not alone with the urge” or “I will put on Netflix and watch an episode of______”)
- Soothe yourself in a positive way – do something that always makes you feel better. All the time I see teens talk online about how the right music can change their mood and outlook for the better. Take a walk. Play with your pet.
- Don’t hang out with other people who cut (unless you all want to try to stop together…)
Finally, a really important thing is to learn some good coping strategies. Stressful and unpleasant things happen in life. And good and bad feelings and emotions are all part of the fabric of life. But coping skills help you to navigate those things in a healthy way. Your counselors and nurses at school, your minister, doctors and others can help you with this. Don’t be shy about asking for help. There are tons of people out there that care about you and love you and want to help you.
And next up, we’ll talk about stress again. It is a big issue for teens (I don’t have to tell YOU, do I?!), so we will revisit that and go over some stress management tips and coping strategies. That will help with this too!
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