There are few things more disturbing for a parent than finding out that your child is intentionally hurting herself. Unfortunately, it’s very common, especially among girls. Experts call it self-injury, and as many as a quarter of all teenagers do it.
The most common form of self-injury is cutting or scratching the skin with anything that causes bleeding. This could be razors or even paper clips or pen caps. Some kids self-injure by burning themselves, picking at skin or wounds or even hitting themselves.
Your Reaction Is Important
If you discover that your child is cutting, it’s normal to be worried, afraid or even angry. But it’s extremely important to avoid being judgmental toward her. Comments like “How could you do this to yourself?” or “This has to stop right now” are the last things you want to say when beginning a discussion about cutting.
Instead, it’s important to understand that your child is in pain. You don’t want to make her feel worse by making her ashamed. Tell her you’re there to listen and to get her help. Chances are she wants to stop and doesn’t know how.
Why Do Kids Cut?
There are a number of different reasons people give for cutting.
The physical pain provides a distraction from intense emotional pain.
They feel dead or numb inside, so they cut in order to feel something.
It’s a way of nonverbally communicating how unhappy they are and that they want help.
But cutting is a complicated behavior. It may serve all of these purposes for the same kid at different times. Whatever the reason, cutting develops as a bad way of managing the problems in a child’s life. It brings temporary relief or distraction from those problems, but doesn’t help solve them.
Unfortunately, this bad “habit” can be addictive. The more times a child cuts to relieve emotional pain, the more she’ll feel the urge to do it again. That’s why it’s important to get help early. Experts say that if you can get help before the cutter has performed 10 self-harming acts, the treatment is significantly easier. After that, it’s no longer just a behavior but a real addiction.
Cutting can also be copy-cat behavior inspired by YouTube videos that show other kids cutting. These videos have the effect of making self-injuring behavior seem normal and therefore encouraging it.
What Puts a Child at Risk for Cutting?
Having ADHD, even if symptoms are less apparent than they used to be
Having another condition like anxiety, depression, an eating disorder or bipolar disorder
Being sexually or physically abused
Feeling rejected and lonely
Feeling unsafe at school or at home
A tendency toward perfectionism
Frequent conflicts with friends and family
A tendency to be impulsive
A tendency to take risks
Red Flags for Cutting
If you suspect that your child may be hurting herself but you’re not sure, look for these signs:
Talking about self-injury
Wounds that don’t heal or that get worse
Cuts on the same place
Collecting sharp tools such as shards of glass, safety pins, nail scissors, etc.
Wearing long-sleeved shirts in warm weather
Avoiding social activities
Wearing a lot of adhesive bandages
Refusing to go into the locker room or change clothes in school
What Are the Most Common Triggers for Cutting?
The irresistible impulse a child feels to harm herself is almost always triggered by a specific event in her life. The most common “trigger” for cutting is feeling rejected: by a boyfriend, by her close friends, or by a general feeling of being left out or criticized.
Other common triggers include:
Does Cutting Lead to Suicide?
Self-injury might look like suicidal behavior, but it actually isn’t. People who self-injure aren’t trying to kill themselves. They’re trying to manage whatever emotional pain they are feeling.
However, cutting is a sign of deep psychological suffering that could lead to a suicide attempt. It should be taken seriously.
The behavior is also dangerous because people who cut may hurt themselves more seriously than they mean to or develop infections from their wounds.
How Can I Help Her Stop?
Evaluation: Have your daughter evaluated by an experienced mental health professional to find out her reasons for hurting herself and whether cutting may be connected to another disorder. (Learn more about when to get your child counseling.)
Dialectical behavior therapy (DBT): One highly recommended treatment is DBT, in which a psychologist works with your child to help her learn how to tolerate uncomfortable feelings without resorting to cutting. In DBT, kids are taught how to regulate emotions like anger, anxiety and rejection.
Cognitive behavioral therapy (CBT): In cognitive behavioral therapy, a psychologist teaches your child to challenge negative, distressing thoughts, to recognize the pattern and train herself to think outside it. In many cases, particularly with teenagers, this treatment is very successful.
Family therapy: If there is a lot going on at home—fighting, job loss, a death, anything that could be the source of your daughter’s emotional troubles—family therapy is a good way to begin treatment for cutting.
Medication: Often if there is another disorder involved, a doctor will prescribe medication to treat that condition. The combination of medication and psychotherapy is very successful at treating kids who self-harm.
Breaking the cycle of self-harm is not easy. Treatment can be an emotionally challenging time for your kid while she’s going through it.
It will help her if you let her know that you are there for her and provide her with empathy, caring and unconditional love and acceptance.
Learn more about the types of emotional help available for kids. See examples of behavior changes that can be signs of depression. And get more information on self-harm in children at the Child Mind Institute.